BF Basics: Sugar Shock (Part Two)

Three Common Natural Sugars: Lactose, Fructose, Maltose

It is a little known fact that sucrose is actually NOT a naturally occuring sugar. The three major, naturally occurring sugars are lactose, fructose and maltose. Here's the down-low on each.

Lactose

I cannot count how many times I’ve answered posts or e-mails from a new post-op with the following exclamation: “there’s sugar in my MILK????”

Yes, there is sugar in your milk. But it’s not table sugar. It’s lactose. Well...unless you're drinking flavored milk (chocolate or strawberry), in which case there probably IS sucrose in there.

Lactose is a naturally occurring sugar found in milk. If you think about it, the fact that there is sugar in milk makes sense. Milk is, after all, intended for newborn babies (humans or animals). They need to grow and they need to grow fast. Their bodies can't sit around waiting to convert complex carbs into energy. They need that energy now! As such, lactose is also on the simpler carb spectrum, although it doesn't have quite the same effect on the body as sucrose.

Now that doesn’t mean it’s automatically ok for you post-op. Some people develop what is called “lactose intolerance” which means their body doesn't produce an enzyme (called lactase) required to break down lactose.

And for others still, while they are not lactose intolerant, too much lactose makes them dump too. Many surgeons still aren’t sure why this happens, but we’ve heard it enough that we are inclined to believe it.

Fructose

Now most of us know there is sugar in fruit. Mostly because we associate sugar with sweetness and, since fruit is sweet, it translates well to our minds that there is sugar in it. Again, fructose is a natural sugar but that doesn’t necessarily mean you’ll do well with it.

After all, fructose is the mother of high fructose corn syrup AND honey (whose father is glucose, by the way...). This is not to scare you about fruit. There are lots of fruits that sit perfectly fine with a lot of post-ops. And some that don't.

For a long time after surgery, I couldn’t do certain fruits. Some are still iffy (for instance, my pouch seems to hate oranges. I always dump when I eat oranges for some reason). Because fructose contributes to the sweetness of fruit, it’s easy to find fruit products with no table sugar in them, which is a plus.

How do you judge for yourself whether a fruit is good to try? Well, we each have to decide for ourselves, but your best bet, in my humble opinion, is to use the glycemic index. If you are, or were, diabetic, you probably already know what this is. For others, it's an international index of foods, ranked by how fast they cause your blood sugar to rise. While the rising of blood sugar and dumping syndrome are two different things, foods with a low G.I. number (meaning they make your sugar rise more slowly) can often sit better than higher G.I. foods.

All this is to say, the glycemic index is a tool that you can use to determine if you want to try a fruit. But the only real way to know if it will affect you is to try it.

Maltose

You ever wonder where the carbs in beer come from? Mostly from maltose, another naturally occurring sugar. Now I KNOW I don’t have to talk to any of our Poucher newbies about beer, do I????

There’s a few other sources of maltose in our diets, but mostly it is a sugar found in wheat. I haven’t heard many stories about the effect of maltose on our systems, but then again what post-op is going to cop publicly to drinking a bunch of beer??? ;)

For those interested in reading more about maltose, here is a good link to everything you ever wanted to know (and about seven things you didn't).

The most important things to remember about these three naturally occurring sugars is:

• Although all three can be quickly converted to energy, making them simpler carbs, they are not the same as sucrose (table sugar) and don't work the same way in the body
• Some people may be lactose intolerant after weight-loss surgery, meaning their bodies no longer produce the hormone, lactase, necessary to break down milk sugar
• With fructose, different fruits have different levels of sugar and different amounts of fiber, both of which affect how fast your blood sugar rises as a result of eating them. Doctors use the glycemic index to rank foods based on how fast your blood sugar rises after eating them. Some foods, like bananas, have a very high glycemic index, while others, like berries, are lower. Here is a good list of fruits by G.I. ranking. This is helpful not only to diabetics, but to those wishing to limit the sugars in their food plans.
• Naturally occurring sugars DO make some people dump (by their own accounts). So be careful when starting to try any kind of sugar, even naturally occurring ones.

Next: What the nutrition label has to say about sugar
Previous: Part One - Sucrose

BF Basics: Sugar Shock (Part One)

Ok, let’s start with what we all think of when we think “sugar.” We think of this guy:

This is table sugar, or sucrose. Now, he isn't by himself in our collective consciousness. When we talk about sugar we could also be talking about this guy:

Or this guy:

And even this guy:

All of these things can make up sugar content in food. But for the purposes of THIS post, we're going to talk mainly about sucrose, which is the base for maple syrup, but not for high fructose corn syrup or honey (we'll talk about that more in the next post).

Sucrose is usually derived from sugar cane or sugar beets and is refined to give it a pristine, white color. We won’t get into the deep-down science of this guy, but we will say this—this guy? Is an outlaw on most post-operative eating plans.

Why?

Well, table sugar is an extremely simple carbohydrate and it doesn’t give you good nutrition. Aside from that sugar is a trigger for that phenomena in bypass patients known as “Dumping Syndrome” (I personally call it hell). Here’s a good explanation of dumping syndrome for those who want to learn more.

Now, getting back to those other guys up there. We're going to talk about naturally occurring sugars tomorrow, but know that when looking at ingredients on a nutrition label (which we'll discuss on Wednesday), the following ingredients, while not always sucrose, can cause just as bad a reaction post-RNY gastric bypass:

• High fructose corn syrup
• Anything that has the word "syrup" in it

In terms of cooking, the most challenging thing about not using table sugar post-op, in my experience, is in baking. Sugar lends texture and color to baked foods that can be difficult to achieve with sugar substitutes. But it can be done! Check out part five for more information on the various types of sugar substitutes. And check out the "dessert" tag on this blog for ideas of making fabulous desserts without sugar!

The most important things to remember about sucrose:

• It is a very simple carb. Meaning it can be easily converted to energy. HOWEVER, if you aren't using that energy, it is stored as body FAT. We don't like body fat.
• Because sucrose is so easily convertible, it raises your blood sugar level very fast...but then it crashes...and you are hungry again way sooner than you should be.
• While there are other natural sweetners besides table sucrose out there, they too are very simple carbs as well, including honey and molasses. Many people use natural sweeteners (meaning not man-made) like Stevia to sweeten things. I can't vouch for Stevia as I've never tried it. I'd love to hear from anyone that does, especially someone who would normally dump on table sugar.
• Be on guard! Simple sugars can hang out on ingredient lists under assumed names. If you learn nothing else from this series, learn this: ALWAYS look at the ingredients list!
  

Next: Naturally Occuring Sugars

BF Basics: Sugar Shock

Sugar. From our experience it’s one of the most widely misunderstood substances among post-ops in general. Whether you’ve had bypass, band, DS, VSG…many folks seem perplexed by sugar—what it is and what it means to US!

No fear…Bariatric Foodie is here!

In this BF Basics series, we’re going to give you a good primer on sugar that will help you understand what you see on a food label, what’s generally ok for consumption and what to avoid.

Starting tomorrow, and through Friday, we're going to post each part of the series. Not to worry, though, we'll still be posting the recipes you love this week!

Here is a summary of the topics covered in this BF Basics:

Part One: The #1 Suspect: Sucrose!

Part Two: Lactose, Fructose Maltose – Naturally Occurring Sugars

Part Three: So what does this all mean? The nutrition label

Part Four: Smoke and Mirrors – how the food industry tries to confuse us about sugar

Part Five: Sugar Substitutes

So tune in tomorrow, sweet thangs, and let's talk sugar!

Low Country Boil, Shrimp Fritters, & Lemon Pesto Oh My!

~~posted by Jen

So last night I got semi-ambitious and made Low Country Boil for our Friday night dinner. For those who're asking "WTH is Low Country Boil?", I'll tell you! It's a very common dish in Coastal Georgia and the Carolinas. For you Northeastern folks, it's like a clambake in a pot. Quite simple to make, here's how:

Basically you bring a ginormous pot of cold water up to a boil, season it with some Old Bay, and a couple tablespoons of butter. For your main ingredients, base the amount of each on how many people you're feeding. Once the water is at a good boil, throw in some whole potatoes and kielbasa or smoked sausage links.

Let them boil for about 5 minutes, then add in some ears of fresh corn on the cob, boil another 5 minutes, then add your seafood. I usually add shrimp, crab claws, crab legs if I get a good price on them, and sometimes clams. (You can use lobster, mussels, whatever seafood you like. I would not try fish, only shellfish or mollusks.)

Boil it for another 2 or 3 minutes, just until your seafood is done. (When the shrimp turn pink, they are done. Same with the crab claws. MAKE SURE NOT TO OVERCOOK THEM, or they will be rubbery and your pouch will NOT be happy.) Then drain the water out, spread your table with newspapers or brown paper bags, and pour the whole lot down the middle of the table. (Kids LOVE this because it's like making a big mess, only not.)

Serve some melted butter, lemon wedges, mustard, and cocktail sauce as condiments for the seafood and sausage. Toss a loaf of crusty bread on the table to pass around. It's a great way to entertain, very easy, and LOTS of fun! Everyone eats with their hands, then when it's all finished, roll the whole thing up and toss it in the trash. Best of all, only 1 pot to wash!

I had some leftover shrimp from dinner that I wanted to use up, so I made Shrimp Fritters today. You can also use leftover salmon, crab, tuna, or basically any kind of fish if you prefer. I hate serving leftovers in the exact same form I originally served them, so I try to make them over into something "new" for the second round. It's kind of a challenge, and I think it's fun. But y'all know I am twisty like that anyway. Sooooo, here's how I did it!

Shrimp Fritters with Lemon Pesto Dipping Sauce

Jen’s Shrimp Fritters

12 large shrimp, peeled, deveined, chopped fine, I use mini chopper

1 c TVP, ground fine (I use mini chopper)

2 large eggs

1 tbsp Onion Powder

2 tbsp Garlic Powder

2 tbsp Old Bay Seasoning

2 capfuls Lemon Extract

2 tbsp celery flakes

4 tbsp multigrain pancake mix, I use Arrowhead Mills

1 c Fage 0% total Greek yogurt

4 tbsp minced dried onions (or you could use fresh onions, just sauté them first)

¼ c French’s Spicy Brown Mustard (or Dijon if you prefer)

2 c shredded cheddar cheese

4-5 tablespoons of olive oil for frying

In a mini food chopper or food processor, combine TVP, onion powder, garlic powder, celery flakes, Old Bay seasoning.  Pulse until TVP is ground to consistency of coarse bread crumbs.   Pour the dry ingredient mixture into a large mixing bowl and set aside.  

Add the shrimp to mini chopper and pulse until well chopped.  Add shrimp to the mixing bowl.  Stir in the eggs, Greek yogurt, minced dried onions, mustard, and cheddar cheese.  Fold ingredients together until well blended.  

Form into 20 small patties.  Pre-heat olive oil in a skillet and fry the shrimp fritters on each side for 2-3 minutes until golden brown, turning once.  Drain on a paper towel lined plate until ready to serve.  

 *****Note:  I formed up a very tiny patty and cooked it to test for seasoning before I formed and cooked up the whole batch.  This is advisable anytime you make fritters (or meatballs, meatloaf, etc ) so you don’t end up with a big batch of under or over-seasoned meat patties.****** 

Makes 20 small shrimp fritters, 2 fritters is my usual post-op WLS portion.  Stats for 2 fritters (without sauce), using these EXACT SAME INGREDIENTS:

Calories: 211  Fat 7.9 g   Carbs  13.5 g   Fiber 3 g  Protein 20.3 g

Jen's Lemon Pesto Dipping Sauce:


Ingredients:
1/2 cup Greek Yogurt
3 tablespoons Pesto (I make my own, but you can buy it prepared in the Italian food section of the supermarket)
2 tsp Lemon Extract

Directions: 
Combine all 3 ingredients in a bowl and whisk together until well combined. Give it a taste to make sure you don't need to add any salt or adjust the seasonings. Great dip for seafood or chicken, also an awesome sandwich spread, or even salad dressing!

Veggie Tales

~by Nikki

Ok so I had all these veggies to use up. Long story short, I visited this grocery store called “Harvest Fair.” They had these packages of fresh veggies that I’m guessing were approaching their end (but weren’t quite there yet). I scored oodles of tomatoes, patty pan squash, eggplant, zucchini, yellow squash and onions for like $3 (and, on a side note they had these HUGE things of Tribe Hummus 2/$5!).

So I bring it all home and it didn’t look like much…until I chopped it all up. Then I said to myself, “Self? What the HELL do you plan to do with all of these veggies?”

My brain likes these challenges though. Here are three ways I used this mixture of vegetables. My apologies for only having one picture. The dishes literally went THAT fast!

Remix #1: Chicken and Veggie Alfredo

I heart Alfredo. What’s not to love? Cheese…cream…mmmmmm…I tend to use low-fat Alfredo sauce (just cuz it makes me feel better about the whole thing). This was super easy to make and super good to eat! For the divas, I paired this with whole wheat penne. I ate it by itself. The entire pan was gone that night, no lie. Usually, however, when I make this I have enough left over to slap on a high-fiber tortilla for a pizza set up or as the fillings for an omelette!

Nik’s Chicken & Veggie Alfredo

2 c. of whatever veggies you want to use, chopped

2 cloves of garlic, minced

2 chicken breasts, cubed

Salt and Pepper

1 jar of low-fat Alfredo sauce

Directions:

1. Cook chicken in a sprayed pan until done through, then remove to a bowl

2. In that same pan, add veggies (so they get all that chicken love stuck to the pan) and garlic and cook until tender

3. Return chicken to the pan, stir thoroughly and add Alfredo sauce

4. Simmer for 15 minutes

If serving with noodles, boil them separately, drain them and then toss with the chicken mixture.

Remix #2: Veggie Hash

I was thinking what I want for breakfast one morning and decided I wanted some hash. You ever just been in the mood for some hash? (I realize for people who lived through the 60’s and 70’s that statement has more than one meaning, but I mean FOOD hash…)

Since I don’t do potatoes (I CAN do them…I just don’t…because Nik=ZERO self control around taters…), I decided to make a hash out of my big ass pile o’ veggies.

The thing about squash is that you kinda have to give it the right environment to become crispy. It gives up its water pretty quickly but you have to pan cook them a good while before they crisp up for you. But the nice thing is they turn out just how I like it: crispy on the outside, soft on the inside! YUMMY!

Nik’s Veggie Hash

2 c. of whatever veggies you have (I used patty pan squash, zucchini, yellow squash, eggplant and onions)

1 clove of garlic, minced

1 tbsp extra virgin olive oil

Salt and Pepper to taste

Directions:

1. Heat oil in a pan and add veggies

2. Allow veggies to cook a few minutes on one side (time varies but about 4-5 minutes), then flip the other side and let it cook the same amount of time. You should see some caramlization of the veggies when you flip them.

3. Add garlic when veggies are almost done through to avoid burning

4. Let all liquid reduce from the pan and they are done!

Remix #3: Re-invention of my mom’s corn, okra and tomatoes

Jen says corn, tomato and okra. Or is it okra, corn and tomato? Hell, I can't remember but she says it in a different order than I do! I am convinced that the order of the wording says something about your regional upbringing. At any rate, my momma used to make corn, okra and tomatoes all the time. And I loved it. Somehow the okra wasn’t slimy and the smoky flavor of the bacon and kick of the chili powder and red pepper flakes came through so perfectly.

Since I was on this veggie kick though, I decided to make a vegetarian version of this to see how that would go over.

This is not my veggie dish, but mine looked pretty much like this. Except my camera sucks!

Nik’s “Corn, Okra and Tomatoes” Remix

2 c. whatever veggies you have on hand

1 onion, chopped

2-4 slices of bacon (or, if doing vegetarian, 1 tbsp liquid smoke)

1 can of diced tomatoes (you can use whole, which is what my mom uses. I prefer diced)

1 clove of garlic, minced

1 tbsp chili powder

1/8 tsp cayenne pepper (or red pepper flakes…or you can skip both if you don’t like the heat)

Salt and pepper to taste

If you want to try the traditional recipe, use:

1 bag frozen, cut okra
1 bag frozen corn
1 can of diced tomatoes
Same seasonings as above

Directions:

1. Fry up your bacon in a pan and remove. Reserve drippings in pan.

2. Sautee your veggies (except tomatoes) in bacon drippings with garlic (if you are doing vegetarian, start with this step and add liquid smoke in step 3)

3. Add tomatoes and seasonings

4. Crumble excess bacon into mixture

5. Simmer for 10 minutes.

Verdict: YUMMY! At the same time, I FINALLY explored the Asian market near my surgeon’s office (where I am doing a Pouch Party™ in just two weeks!) and scored a bottle of fish sauce.

If you’ve never tasted this Asian condiment, you are missing out! It’s made of anchovies and…salt. And is used in place of salt. Don’t use too much, as it has a fishy smell to it, but it makes savory dishes sooooo yummy. I splattered some on my veggies and went to TOWN!