Rule 5- Avoid foods that have some form of sugar (or sweetener) listed among the top three ingredients.

Pollan explains that:

...there are now some forty types of sugar used in processed food, including barley malt, beet sugar, brown rice syrup, cane juice, corn sweetener, dextrin, dextrose, fructo-oligosaccharides, fruit juice concentrate, glucose, sucrose, invert sugar, polydextrose, turbinado sugar...

Again, read those labels and look out for those ingredients. Food labels list its ingredients in order, from most to least, by weight. By avoiding sugar in food, you are avoiding excess sugar in your diet. Now remember that this is added sugar.

Why is added sugar so bad? Well, you don't need it. The macronutrients (carbohydrates, protein, and fat) and even alcohol can all break down to glucose to provide fuel for all cells of our body. When sugar is in excess, blood glucose levels are high, signaling our pancreas to produce more insulin - a hormone that brings glucose into cells for storage and signals fat cells to stop breaking down for energy use.

When blood sugar levels are often high, insulin levels are also high, and the tissues become resistant to insulin. This means that glucose is not entering the cells (as fuel), so then the body thinks it's starving and reacts by adding more glucose into the bloodstream, as well as fatty acids. Overtime, this is how type II diabetes develops (and metabolic syndrome). Type II diabetes was formerly known as adult-onset diabetes, but nowadays it is a growing problem among US adolescents and children. It's no wonder why:

• Kellogg's frosted flakes - milled corn, sugar, malt flavoring, HFCS...
• Dannon fruit blends yogurt (cherry) - cultured grade A reduced fat milk, sugar, cherries, HFCS...
• Woodstock Farms organic tomato ketchup - organic tomato concentrate, organic sugar, organic vinegar...
• Silk soymilk - filtered water, whole organic soybeans, naturally milled organic evaporated cane juice

But to avoid all forms of sugar in the top 3 ingredients? Personally I think you must use your best judgment. I am guilty of this. I love having cupcakes, and I panic when I'm out of ketchup. Read labels and compare with other items on the shelf - perhaps you can make a better choice.

Remember that sweeteners are not all the same. I understand what Michael Pollan's point is, but my recommendation is to avoid highly processed sweeteners, instead opting for the sweetener that is closest is how it's found in nature. These may contain minerals, vitamins, and enzymes to help the body, like honey (which is also used in Chinese medicine). And did you know that maple syrup has an even higher concentration of minerals than honey? The grain-based sweeteners (like barley malt) contain a large percentage of complex sugars, which takes longer to digest than simple sugars. Stevia is often recommended for diabetics because is it 300x the sweetness of sugar with little effect on blood glucose levels.

What about agave? There's been controversy on agave recently. It's a manmade sweetener from cactus, which undergoes a complicated chemical refining process to yield fructose. What, fructose? Well if you read yesterday's post, you'll understand why fructose is bad for you. Some companies claim that not all agave syrup is made equally - some companies do minimal processing. Until there's better regulation and labeling of agave on the market, it's best to avoid.

And artificial sweeteners? First, these are highly processed. Second, there are varying results of the long-term side effects of these substances.

For now, be safe and stick to this rule and, if you must, don't choose the refined and highly-processed varieties