Your goal isn’t SMART
It could be the goal itself is the problem. Goals like “eat healthier” or “sleep more” aren’t helpful because they don’t describe what to DO and HOW MUCH to do it. “Sleep more” than what? How much are you sleeping now?

You will need an amount you can MEASURE and it needs to be ATTAINABLE given what you can already do. If you sleep for about 5 hours each night, 8 hours may not be a realistic goal for you yet. Instead, you may consider adding an hour each night.  

New goal: This week, I’ll add 1 hour of sleep each night by going to bed 30 minutes earlier and sleeping 30 minutes later.  
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This goal fits the criteria of a SMART goal.  

• Specific: I’m adding an hour of sleep but I describe how I will do it.  
• Measurable: I can measure hours of sleep.
• Attainable: I’ve got an extra 30 minutes each evening that I’ve been using to watch a second episode of a television series.  If I stick to one episode, I can get to bed earlier. Shaving 30 minutes off my morning may be trickier… Our goals should challenge us too!
• Relevant: I’m only sleeping 5 hours now and 7-9 are recommended so this goal is relevant to my overall goals to improve my health.
• Time bound: I’m doing this for a week, then I will want to decide if the plan worked. I can change it, if needed, for the next week. 

Ready to try your own SMART goal? Sign-up for our monthly newsletter here and get our free, SMART goal worksheet delivered straight to your inbox.

Your goals have been SMART since 2010. You’ve just got too many of them.
Start with ONE behavior or goal. You want to do all the things and you absolutely can accomplish more than one thing in 2020, but not all at once. Once you’ve narrowed it down to make one small change, break it down into small, manageable steps.  

You need a strategy to turn healthy behaviors into habits.
​Most of the resolutions we set are about making changes to improve our lives and we want those changes to stick. The goal to “sleep 1 more hour per night” is a short-term goal, we hope will get us to the long-term goal of 7-9 hours of sleep per night to meet the recommendation for adults. The overall goal is to build a healthy habit. Changing behaviors is tough enough, getting them to stick is even tougher, but you can do this. We recommend that you include the following steps in your strategy:

• Plan ahead for how you will do the thing
• Change the space around you to make doing the thing easier
• Build support so you can or want to do the thing

If the goal is to add a 30 minute walk to the day, these steps could be…

• Plan: Bring walking shoes.  Add a walk during lunch hour.
• Change: Block off time in the calendar. Keep shoes visible.
• Support: Walk with Gina in accounting.  She rarely misses her walk.

You want your gold star (You need to see a benefit)
We reach adulthood and no longer hear “good job” or get a sticker next to the chore chart when we feed the dog. Why is this the case? Because we are responsible for ourselves and the goals we set are for us and for us alone. This doesn’t mean we shouldn’t be rewarded. In fact, rewards, particularly immediate rewards, provide the motivation needed to keep going when changing a behavior gets tough.

Immediate rewards include:

• Time spent with other people
• Mood lift
• Increased energy
• Fun
• Improved focus

 
Interestingly enough, health isn’t a big motivator over the long term. If we want sustainable change, we need a “gold star” we can feel now. But, if an “attaboy” is something you feel you need, there are a number of apps that provide that positive reinforcement including MyFitnessPal when you reach your goals.

Now isn’t the right time.
There isn’t anything magical about January. Don’t feel bad about yourself if you aren’t ready to sign up for a gym membership or start bringing lunch instead of eating out immediately after the holidays end. You need to be ready to make changes. You may have 1-4 down but a big barrier stands in your way. Maybe you are recovering from an injury, selling your home, or being audited. There may be a more pressing need that deserves your time and attention. Focus on maintaining the habits that you already do to care for yourself during this time. Big life changes can mess with our routines and the healthy habits we had in place. Add new habits later, once you weather the current storm.

The storm has passed - You’ve removed barriers to change.
You are ready to begin. You’ve paired down your list of resolutions (or new habits to build) to focus on one to start. The SMART goal is written (post it on your fridge or somewhere else where you will see it often), you have a strategy (including Plan, Space, Support), and a reward in mind to motivate you. All that’s left is to DO THE THING.  
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Take the first step. Just begin. Knowledge doesn’t lead to change, ACTION does. You have all the information and resources you need. Remember, it won’t always go the way you plan. You’ll have to change your strategy, add a visual reminder or new support.  

Resources:
Images from: FDA
FDA-https://www.fda.gov/consumers/consumer-updates/nutrition-facts-label-reboot-tale-two-labels
AND-https://www.eatright.org/food/nutrition/nutrition-facts-and-food-labels/the-basics-of-the-nutrition-facts-label
AHA-https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/understanding-food-nutrition-labels

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​Will artificial sweeteners lead to a stroke?
Short answer: We do not know. More research is needed.

Tell me more: Earlier this year, a study published in the journal Stroke showed an association between artificially-sweetened beverages (ASB) and the risk of stroke in a large group of women. They used data from the Women’s Health Initiative - a big study tracking the health of women over time. Women who drank an average of two or more ASB per day (24 ounces/day or more) had an increased risk of all stroke (all stroke types overall), in particular ischemic stroke, coronary heart disease, and all-cause mortality (death from any cause) compared with those who had less than one ASB per week. The results were the same as previous studies but not all of them. We need more evidence to draw conclusions, especially when studies show different outcomes.  ​

The information gathered from this type of study can be used to plan future research. Important questions such as “which ASBs are people using?” and “how long have they used them?” may be asked in future studies. Weight changes and history of dieting are important to know too. In the Stroke study, they grouped together results by body mass index (BMI) and found that women with higher ASB intake were only at a higher risk for stroke if they were also “obese” based on BMI. High intakes of ASBs in “normal” or “overweight” women did not match up with a higher risk of stroke so maybe it isn’t to do with the ASBs at all. Could women classified as “obese” have something else in common? Yes! Weight stigma, experienced by those in larger bodies, may do more harm for health. 

How do artificial sweeteners affect my taste preferences?
Short answer: High-intensity or artificial sweeteners are much sweeter than table sugar and may affect how your taste buds pick up on sweet flavors.  

Tell me more: Using large amounts of artificial sweeteners could skew your taste preferences more toward overly sweet foods and beverages. There is no harm in this. If you find that a preference for sweet makes it difficult to eat a variety of foods, then it may be worth lowering your intake.  

Bottom Line: Artificial sweeteners are safe well beyond the Adequate Daily Intake (ADI) for the individual sweetener. Numerous studies were done to ensure that they are safe to eat and drink and do not cause cancer. Early research suggests changes in the bacteria in our gut but we don’t know yet if and how these changes influence health. More research is needed to understand the impact of long-term artificial sweetener use, especially in children and individuals with specific health conditions, like diabetes. As research continues, it will be important to explore how characteristics like body size, age, etc. influence the effect of artificial sweeteners within our bodies.

For those managing diabetes: Check your blood sugar so you know how a food or drink affects you. Write down blood sugar readings to share with your doctor, dietitian, and/or diabetes educator.
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We’ve covered the top questions we hear.  What did we miss? Reach out to us on social media or send in the Ask a Dietitian form with your questions.

The average American takes in 23 teaspoons of added sugar per day. Concerns about the impact of added sugars on health led to a smackdown on sugar from healthcare professionals and the media. Many of us look to sugar substitutes to provide the sweet taste we desire, in particular, sugar substitutes with little to no calories or energy.  

The U.S. Food and Drug Administration (FDA) refers to these low to no calorie sweeteners as non-nutritive sweeteners. The term artificial sweetener may be more familiar. The food industry often uses one or more artificial sweeteners in manufactured foods and beverages. Additionally, many of us add them directly to foods and beverages to improve the taste. 
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It is clear there is widespread use of artificial sweeteners but what do we know about the long-term effects to our bodies? This blog will describe artificial sweeteners and address commonly asked questions. If you were looking for information on natural sugar (or want to read both), check out our earlier blog The Lowdown on Added Sugar.

What is an artificial sweetener?
An artificial sweetener is one type of sugar substitute. Sugar substitutes are added to foods and beverages to provide sweetness. Some artificial sweeteners are marketed as “natural” even though they are highly processed or refined. This is because artificial sweeteners may be made from natural products. For example, sucralose is made from sugar sucrose. The structure of sucrose is changed to make something new that is no longer a sugar. The new sucralose molecule (sold as Splenda) is not broken down in our digestive tract so we do not get calories (energy) from it.  

Common artificial sweetener brand names include: Equal® (aspartame and acesulfame-potassium), NutraSweet® Neotame (neotame), Sweet N’ Low® (saccharin), and Splenda® (sucralose).

What is a sugar alcohol?
Another type of sugar substitute is a sugar alcohol (polyol). Sugar alcohols do not contain alcohol, as the name suggests. They are not sugars either. They are carbohydrates (one of the main nutrients our body needs) that can be found naturally in fruits and vegetables but some are manufactured. Our digestive tract does not break them down all the way. This means sugar alcohols provide calories and raise blood sugar but not as much as regular sugar.

​Sugar alcohols are not sweeter than sugar like artificial sweeteners. In fact, many are less sweet than sugar. They are often combined with artificial sweeteners in products to create the desired taste such as the stevia-based sweetener Truvia® (Erythritol). Sugar alcohols you may find in an ingredient list include: xylitol, mannitol, sorbitol, erythritol. When it makes sense, we share information about sugar alcohols but the focus will be artificial sweeteners.

Are artificial sweeteners like sugar?
Not entirely. When you eat or drink sugar it will raise your blood sugar. It tastes sweet, has no chemical aftertaste, provides calories (energy), adds bulk or structure to baked goods, and browns when cooked. Also, even though sugar browns, it still tastes sweet when heated to high temperatures.

Artificial sweeteners may taste as sweet as (or much sweeter than) sugar but they may vary in these other qualities:

• Blood sugar - Artificial sweeteners are not carbohydrates so they do not break down into glucose and do not raise blood sugar like sucrose and other sugars do.  
• After taste - Many artificial sweeteners have a chemical after taste.
• Heat stability - Some may be used in cooking and baking but not all of them.  For example, aspartame does not hold up to high heat and loses its sweetness.
• Structure in baked goods - Many artificial sweeteners do not add bulk to baked goods. Other ingredients (like sugar alcohols) may be added to brand name sweeteners so they work more like sugar. Check the label. You may need to adjust your recipe. 
• Calories (energy) - Most of the approved artificial sweeteners do not provide calories (energy). The exception is aspartame. It contains calories but since it is 200 times sweeter than sugar, you are not likely taking in enough of it to get much energy from it.

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Why do we use artificial sweeteners?
The main reason Americans choose artificial sweeteners is to lower our intake of added sugar and calories that come with it.

The American Heart Association (AHA) recommends cutting sugar to no more than 6 teaspoons per day for women and children and 9 teaspoons per day for men, and the Dietary Guidelines for Americans 2015-2020 recommend lowering added sugars to less than 10% of calories for the day. This has actually been in versions of the guidelines since 1980 but we continue to go well beyond the recommendations. 

The average American takes in 91 g of added sugar per day (over 16.5% of calories), which is equal to 23 teaspoons of table sugar. It may be worth another look at the methods we use to change habits. Restricting foods high in added sugars may backfire when low sugar diets may increase sugar’s appeal. At Let’s Move! STL, we believe that all foods fit!
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You do not need to cut out sugar completely to improve health, but large amounts of any one food or nutrient are not usually helpful. Research studies show an association between higher intakes of added sugar in the diet and the presence of certain diseases, like heart disease and diabetes. There aren’t clinical trials to show added sugar causes the diseases, but that has not prevented the harsh verdict that health professionals and the public have dealt out to sugar. Given the concerns about added sugars in the diet, the AHA and American Diabetes Association (ADA) suggest artificial sweeteners may be a way to meet the goal to lower added sugars. However, researchers at Columbia University recommend only short-term use, as a transition to less sugar, and caution against long-term use.

Are artificial sweeteners safe?
If by safe we mean “not toxic”, then, yes. All ingredients added to foods in the U.S. must be safe for us to eat. The FDA regulates food additives to ensure they are safe before they are added to foods and beverages.

The FDA gave the green light to use these artificial sweeteners as food additives: acesulfame-potassium, aspartame, advantame, neotame, saccharin, and sucralose.  
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Polyols are approved as well. Steviol glycosides (highly purified extracts from Stevia leaves) and Luo Han Guo fruit extracts (also known as monk fruit) are regulated differently and research was limited so we do not cover these sweeteners in this post.

There are numerous studies into the safety of acesulfame-potassium, aspartame, advantame, neotame, saccharin, and sucralose.  

Acesulfame-potassium - find it in frozen desserts, candies, beverages, and baked goods
Acesulfame-potassium (acesulfame-K or aceK) was approved in 1983 for use in foods and beverages and in 2003 as a general use sweetener (except meat and poultry).  There are over 90 studies to support its safety.

Advantame - 20,000 times sweeter than sugar
To find out if this sweetener was safe, the FDA reviewed 37 animal and human studies to look at toxicity to systems (immune, nervous, reproductive, and developmental).  They also reviewed studies that looked at whether this sweetener caused tumors in laboratory animals (carcinogenicity studies), studies that looked at how the sweetener was absorbed, broken down, and removed from the body (pharmacokinetic studies).  Then, Advaname was approved in 2014 as a general use sweetener and flavor enhancer in foods (except meat and poultry).  

Aspartame - safe for most of us
Aspartame, the nutritive (has calories) sweetener on the list, has the most research behind it.  Over 100 studies support its safety. You may see “cooking with aspartame not recommended” on the label. This doesn’t mean it is not safe for you to eat.  Aspartame doesn’t like heat and loses its sweetness so don’t add it to your baked goods. Aspartame is considered safe with the exception of those with a rare disease called phenylketonuria. Individuals with this disease cannot break down phenylalanine, an amino acid and building block of proteins. Aspartame contains it and those with phenylketonuria need to know about it so you will see a notice that it contains phenylalanine on the label.

Neotame - Brand name Newtame®
Neotame was approved in 2002 for use as a general purpose sweetener and flavor enhancer in foods (except meat and poultry). The results from over 113 animal and human studies were reviewed to look for signs of toxic effects on immune, reproductive, and nervous systems.

Saccharin - a bitter backstory
​Saccharin got a bad rap for a while because of studies in rats. This was in the 1970’s. Since then, there have been over 30 studies in humans and in 2000 it was removed from the list of carcinogens (substances that cause cancer).

How much of these sweeteners can I eat or drink?
Short answer: Check the FDA’s table for the ADI of your favorite sweetener.

Tell me more:  An acceptable daily intake, or ADI, is set for each sweetener.  This is the amount that is safe for you to eat or drink each day for the rest of your life.  The FDA sets the ADI low to be cautious (it is usually 1/100 of the maximum amount with no harmful effects seen in animal experiments).  

The ADI is the amount of sweetener in milligrams (mg) per kilogram (kg) of body weight so there is a little math to figure out how much that is of your preferred sweetener. For those who enjoy Splenda (Sucralose), a 160 pound person (73 kilograms) would need to eat/drink 365 mg sucralose or 26 packets of Splenda to get to the daily limit.  Find the ADI for your favorite sweetener in the FDA’s table.  

There are limited data for intake levels in the U.S. but a 2018 scientific review looking at global use of the major low- and no-calorie sweeteners, like sucralose, are well below the ADI for these sweeteners.  Keep in mind that food companies are adding artificial sweeteners to more and more products, including gum, toothpaste, protein bars, and tea bags.  You may use only a few packets of a sweetener each day and think your intake is low but are unknowingly eating or drinking large amounts. Fortunately, you can spot these sweeteners by name within the ingredient list for the food or beverage.

What happens if I eat or drink artificial sweeteners everyday?
Short answer: Artificial sweeteners are safe well beyond their ADI but we do not have a clear picture of how they affect our health when we use them over a long period of time.  
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Research is underway to find out how artificial sweeteners influence our risk for disease, gut health, hunger/fullness cues, taste preferences, and so much more. We will explore some common concerns and the current evidence in our blog next month… stay tuned! 

Bottom line: Artificial sweeteners are safe well beyond the acceptable daily limits.
For those that enjoy the flavor of an artificial sweetener, using them may make a beverage or food more delicious while you work toward goals to eat and drink less sugar.  

Since we do not have a clear picture of how they affect our health over time, it may be best to use them for only a short time until we have more research.  For more on the research, watch for next month’s blog!

Remember: HOW you eat is as important as WHAT you eat.
Prioritize your plan to fuel your brain so you may improve your ability to hold attention, stay focused, think critically, store information, and make decisions. You know, all the ways your brain needs to function at work and school. Nutritious, balanced meals and snacks before, during, and after school or work help you achieve your goals. Keep the WHAT simple until you’ve got a routine that works for you. Then, play around with food swaps to maximize brain health.
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As the kids are gearing up to go back to school, here are some nutrition tips that will get their year started strong! Excerpt from our Back to School Nutrition post.

• Prep for breakfast and lunch ahead of time. Plan a day during the week when you are less busy and slice fruit and veggies or make hard boiled eggs.
• Focus on fiber from fruits, vegetables, and whole grains. Make it a balanced breakfast with eggs, whole grain toast, and fruit.
• Include omega 3 fatty acids to help the brain work and grow. Find omega 3s in fatty fish, like salmon, and pumpkin seeds. Try this lunch full of omega 3s: Tuna salad sandwich, DHA-fortified orange juice, low-fat milk, yogurt, or nut-free trail mix with pumpkin seeds.
• Set up a healthy snack station in your pantry and fridge.  Tasty items to add:
  • Fruit cups (with no sugar added) or fresh fruit salad
  • ​Applesauce (also with no sugar added)
  • Nuts (if no allergies are present), such as walnuts, pistachios, almonds or peanuts
  • ​Raw veggies (ready to pack) such as carrot sticks, sugar snap peas or celery sticks
  • Cheese sticks (2% sharp cheddar or part skim-milk mozzarella)
  • Healthy snack bars (individually wrapped) with 3 or more grams fiber, less than 10 grams sugar, and no more than 1 gram saturated fat
  • Yogurt with less than 10-12 grams of sugar per pack (or purchase the plain yogurt and add honey and fruit)

Not sure if you’ve found a healthy snack?  Check out this tool to help you choose a healthier packaged snack (you will need to register to use the tool but it is FREE). ​

Have no fear! We have your top ten tips to hosting a healthy barbecue this summer!

1. Choose your protein - One of the biggest contributor to heart disease is that high saturated, fatty meat. Choose leaner proteins such as turkey burgers or chicken. We also love grilled fish like salmon or tilapia, which are full of heart healthy fats. Additionally, beans and legumes offer a great source of plant-based protein. Try out making your own black bean burgers like these here!

2. Aim for whole grain - When choosing buns for burgers or whipping up quick side dishes, opt for whole grain alternatives. Whole grains are a great source of fiber, which can help slow rises in blood sugar, keep you full longer, and promote digestive health. Make sure your whole grain breads and buns have the first word “whole” in the ingredient list on the back of the package. For more on whole grains, check out our blog article! 
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3. Grill up those seasonal vegetables - Grilling can be an excellent way to prepare seasonal vegetables. Most veggies can be tossed in some olive oil with a pinch of salt and thrown on some foil onto the grill. Try out some Missouri summer vegetables!

1. Asparagus
2. Summer Squash
3. Zucchini
4. Tomatoes 
5. Peppers
6. Mushrooms
7. Kale
8. Corn

7. Hydrate with H2O - Many barbecues tend to be accompanied by lemonade, sweet tea, sodas, or alcoholic beverages. These beverages add empty calories and do not offer many other health benefits. Stay hydrated in the summer months with good old water! Take a look at our creative tips to make water a bit more exciting.

8. Use the MyPlate Method - The MyPlate method focuses on ½ of your plate fruits and non-starchy vegetables, ¼ of your plate whole grains or starches, and ¼ of your plate lean proteins and nonfat or low-fat dairy. Build your plate with a whole grain bun, lean protein burger or fish, grilled vegetables or salad, and grilled fruit dessert! 

9. Upgrade your Side Dishes - Try to health-ify your side dishes! Make coleslaw with a vinegar base instead of mayonnaise, add veggies to your pasta salad, bring guacamole or hummus with cut-up vegetables, or use plain Greek yogurt in your go-to potato salad recipe.​

10. Indulge! Finally, don’t get so caught up in trying to be healthy that you don’t allow yourself to indulge. Choose indulgences mindfully. Pick foods that you truly enjoy; don’t just eat desserts you aren’t excited about just because they are available. Balance your indulgence by eating all of those delicious veggies and still giving yourself permission to eat those foods you love!