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Episode 49: Sugar's Dangerous Link to IBD and IBS

Sugar's Dangerous Link to IBD and IBS

You and your friends both go to the same BBQ joint, and a few hours later one of you is hunched over the toilet revisiting your lunch, while the other is totally fine. What happened? How can the same “bad” food cause such different reactions?

On this “Straight From The Gut” episode of The Microbiome Report Andrea and Afif talk through new research on the mechanisms of how “bad” bacteria can overrun the existing microbiome to make you sick (like making their own food in your gut!)

The rest of the episode dives deep into skincare and sugar, including a recent study that implicates sugar in intestinal bowel diseases. Andrea also gives a rundown of all the shocking ways sugar can hide in our modern diets, and the two discuss a new company, Symbiome, that claims to be the first microbiome-focused skincare brand to market.

Have your own questions or resources that you’d like the team to discuss on-air? Email them to, or reach out on Instagram @DreEats or @BIOHMHealth.

Approximate Timestamps:

Andrea Wien is joined by BIOHM CEO, Afif Ghannoum. In today’s episode, they discuss a new study that shines light on the mechanisms for how food poisoning happens (3:00), Andrea and Afif break down the legitimacy of a new company “Symbiome” and their claim as the first microbiome beauty line (10:37), and how the “big” brands may respond (14:19), Afif discusses the challenges involved and marketing hype (15:14), plus, prebiotics in skincare lines, (22:04), the use of fake skin to mimic real skin (25:09), a study on how sugar influences IBD (27:50), and the surprising amount of “hidden” sugar in our diet (30:28).

Mentioned On This Show:

ultimate gut health guide


Andrea Wien: Welcome back to The Microbiome Report. I am your host, Andrea Wien. And today, I have Afif Ghannoum, the CEO of BIOHM back on the show to do a Straight From the Gut episode. These Straight From the Gut episodes talk about research that's been coming out, different companies that we're seeing coming out into the space in the microbiome space, and just general what ifs and where is the industry going as a whole?

So on this episode, we talk about how certain bacterias can make their own food to colonize the gut and take over the microbiome that you already have existing in your gut. These are things like E. coli in the case of food poisoning, how much do you actually have to eat in order to get sick? And what are some of the factors that are at play with whether you get food poisoning or whether you don't?

We also talk about a new company called Symbiome that is making skincare products like lotions, moisturizers, oils. We talk about how they're using different fermentations and whether that's legit, can live bacteria even live in skincare? What about prebiotics when we talk about skin microbiome? And where is that whole beauty industry headed? What do we see for the future?

We also get into a study about sugar and its influence on the microbiome. And again, we've known for a long time that sugar has a hugely detrimental effect on the microbiome. But in this study, we're talking specifically about how it can lead to very serious complications, things like intestinal bowel diseases and the like. So this episode, like all of these episodes, bounces around quite a bit. We go down some rabbit holes, which are always fun and it's a great time.

I also want to remind you that BIOHM is offering 10% off any product on their website to podcast listeners. You can go to and use code BIOHM10 to get that discount. Again, their website is B-I-O-H-M, for BIOHM. Okay. Let's get to the show.

Afif, how's it going?

Afif Ghannoum: It's good. Crazy election day, but I think that part of my microbiome stress should be hopefully alleviated over the next few days.

Andrea Wien: One would hope. Yeah. Hopefully when we are listening, everyone's listening to this episode at the end of the month, we have some definitive results.

Afif Ghannoum: I know, hopefully.

Andrea Wien: So yeah, we'll just move on from that as quickly as possible. Okay. So we have some really interesting stuff that popped up since we last talked. We'll start with the study about bad bacteria making their own food to colonize the gut. So I think we all understand in a sense how food poisoning happens, right? We eat something that has pathogenic bacteria on it, often E. coli, salmonella, and then our system responds to that, but we don't really understand how much you need to eat, why certain people get sicker, and this study really outlined why.

So essentially, what they're talking about is that the pathogenic bacteria get into our system. And if we have a dysbiotic microbiome, it's easier to overthrow it. So we can almost think about this like soldiers storming a castle and overthrowing the dictators that are in there. So if we have people on the inside who are already acting nefariously, then it's easier for those people from the outside to take over.

So that's kind of how I was thinking about this. But interestingly, the thing that this study really showed was our microbiota are also protecting us because they're eating the food that we're eating. So for example, if we're eating, like the study says protein sources from nuts and meats, the microbiota are eating those things, which limits the availability of nutrients that the pathogenic strains can eat. So instead of eating the food that we're eating, the pathogenic strains actually make their own food so that they have fuel to overtake the microbiome that's already there. Does that make sense? It's kind of a long-winded way of saying all that.

Afif Ghannoum: No, no, no. You're hitting on a critical thing that a lot of people don't realize when you talk about microbiome health. A lot of times people ask me like, "Hey, how do I find out exactly what's overgrown and what do I do to take care of that overgrowth?" So you're talking about E. coli, right? That's the wrong way to think about microbiome health generally and this study plays right into that, right? And what I mean by that is when the microbiome is in balance, both "good and bad" organisms are kept in check by each other.

And we don't exactly know why, but what that means is things that we think of as bad, like Candida is an easy one that comes to example. It actually, when it's in control, can have a very positive effect on digestion, right? And some other metabolism, some other factors in our digestive health, when it's in check. The problem is when the good guys are out of balance, Candida and other "bad" organisms, they can spiral out of control. And then it's a very aggressive impact.

So when we're trying to keep the balance, it's not that we're trying to control Candida individually or get rid of it, it's that, by keeping that homeostasis in the gut, for whatever reason, it ends up keeping everything under control. So what you're talking about, where there's food poisoning and E. coli gets into the system, if your system's already a little out of whack, it also introduce this, like you said, aggressive invaders, it can really flip the system out of control, right? Because it's already hard enough to balance the "bad guys" that are resident in your gut. So when these other guys are coming in, it's just piling on that negative effect.

So it's interesting the way they've done it. Now, when you're talking about that they're sort of feeding themselves, that's very much... A lot of these guys, it's just a survival mechanism, right? They're doing what they can to just grow and foster and be able to do what they want. So not only do we see that in them producing food, which I haven't seen that before in a study, but it's the same type of dynamic when these guys produce biofilms. When they get into the gut, their first inclination is, "How do we protect ourselves?" So you're talking about, they're creating a food source and then obviously biofilms, it's almost like a protective shield they're putting over themselves. So it's really fascinating to see that, again as we always talk about, we're just continuing to understand these nuances, but yeah, it's not really surprising, but it's really interesting.

Andrea Wien: Yeah. I just want to read this one section too, because it's so unique to what I've heard before. So again, our microbiota give us protection from infection, but themselves benefit from eating our food, including protein sources, like meat and nuts. A few pathogenic bacteria overcome competition with our microbiome for these same amino acids in the gut by making their own. So that's what we've already said.

To further test this theory, they fed the mice, this was a mouse study, a high protein diet and found that it helped the pathogenic bacteria to take over more readily. They note that under normal conditions, a little bit of pathogenic E. coli is not likely to make something sick, exactly what we were talking about. And then they talk specifically about antibiotics, they were discovered less than 100 years ago. The fact that it takes 1 million bacteria to gain an infection is an important part. And then they use germ-free mice and they found that 10 bacteria are enough to kill. So again, going back to this, if we have more diversity and more abundance in the gut, it takes more bacteria to overcome that. And again, that's why young children and infants lack some of this protection because they have immature microbiomes.

Afif Ghannoum: I want to emphasize something very important because it's not just about microbiota, but it's something that I think people get confused. Right? And so in the article it says just what you said, it's not enough to have one E. coli cell that gets into your body and, "Oh my God, you're going to be sick." Because again, we have pretty robust immune systems as a default setting, right? So your body's toned to take on pathogenic viruses when they're at low doses. Right?

So unlike a germ-free mouse that really, now you're talking about just needing a few, our bodies as a baseline, if we're able to limit the amount of pathogenic bacteria or viruses getting into the body, we're able to overcome it. But the correlation I want to tie it to is COVID, right? Because a lot of questions are around like, "Well, if I'm wearing a mask, not wearing a mask and if someone's got it, is it really going to make a difference? Because these masks are porous?" And this is a critical example of why it is actually important, right? Because if you're able to limit the dosing you're getting of COVID, or frankly flu or any other virus, you're giving yourself the best shot on goal for your immune system to catch up and overwhelm the virus before it overwhelms you. You know what I mean?

So again, even when you're talking about the elderly, obviously children, that's where they start running into problems, whether it's E. coli and food poisoning or the common cold, is if the virus or the bacteria is allowed to come in in high enough doses, that's where you're going to have a problem. Does that make sense? I thought it sounds like a weird connection, but it's this term that we call viral load. If it's a very high viral load, you're more likely to get overwhelmed in your immune system, than if you have a low viral load. It's not just that that organism is present, it's how much of it is present.

Andrea Wien: It makes a lot of sense. And it certainly goes back to the discussion of terrain or organism that's causing the problem, right? It's like, it's both. You have the organism at a high quantity that overwhelms the terrain, which may or may not be susceptible to infection.

Afif Ghannoum: Totally.

Andrea Wien: I think too, one thing, I guess before I move on from that, the fact that a high protein diet actually helped to feed those pathogenic strains, because again our microbiome is eating the protein that we're putting into it, but if we have more and they're not able to consume all of that, then the pathogenic strains can thrive on that. So maybe if you feel like, "Oh, I did eat something that wasn't ideal. Maybe I did eat some mayonnaise that was sitting out in the sun," or whatever the case might be, maybe stay away from eating protein-rich foods for the next 24 or 48 hours.

Afif Ghannoum: Yeah, no, that makes a lot of sense. Andrea Wien: Moving on, there was a new company that popped up that I got targeted for actually, I think on Instagram. And they are called Symbiome. So S-Y-M-B-I-O-M-E. And they're touting themselves as the first microbiome friendly beauty line, I guess. They have a cleanser, they have a cream, and a lot of jargon on their website. It all sounds very good. I don't know if you had a chance to look through it. I think we actually talked... They trademarked the term skin microbiome, which doesn't seem like it should be allowed to be done.

Yeah. So just an aside on that, USPTO, the US Patent and Trademark Office does not allow you to trademark what are called descriptive terms. Right? So oral antiseptic, so you're not supposed to be able to get a trademark on terms like that. So when you texted me and you're like, "Hey, did these guys really got a trademark on skin microbiome?" I haven't had a chance to look, but that would be pretty interesting to me if they were able to get that just because of what you were saying.

Andrea Wien: Yeah. So I mean, their whole business is essentially posited on the fact that over millions of years, our skin microbiome has evolved and compared with our ancestral human microbiome of the skin, we've lost 80% of its microbial diversity. And with that loss, we've also lost the capacity or reduced our capacity to produce nutrients. So these are vitamin A, D, E, K, all fat-soluble vitamins, CoQ10, So things that are really important for skin elasticity and appearance and just how our skin responds to stress. And so they talk a lot about that on their website and then what they say are some proprietary formulations and fermentations that make their products able to be more readily available to the skin and basically boost the microbiome of the skin.

So very interesting. Their website is gorgeous and their products look very interesting also. Their whole thing is less than 10 ingredients. So they're focused on high quality ingredients, but it'll be interesting to see how some of the big players respond to this, because obviously this is a smaller company and there was an article that I found with some of the head honchos from like L'Oreal and some of the other big makeup and beauty companies, the title is, "Live probiotics and cosmetics, an interesting concept, but is it worth the effort?"

So the thing that I thought was interesting about this is, few products have live bacteria in them because it's tough to make a shelf stable product, like a lotion, while also making sure that it's safe from other things growing or to have even the beneficial bacteria growing more. You think if you leave sauerkraut out from the fridge, it continues to ferment. You don't want that to happen in your skincare line.

So a lot of these big players from L'Oreal and some others were saying, it's an interesting marketing angle to say you have live probiotics in your formulations, but it might not be that doable. And then they were also saying that brands don't want to be differentiated in a refrigerator section. They don't want to be next to the orange juice when all the other products are in the beauty aisle. So is it even worth it to go down this path? And they also talked, and this was a question I wanted to ask you, the difference between live bacteria in a product versus stable bacteria in a product. So, can you talk about why that is relevant?

Afif Ghannoum: So, and just so I make sure I understand, you're saying the idea of [a phage 00:14:25], which is basically dead bacterial cells, versus live organisms. Is that what you're saying?

Andrea Wien: Yeah, I think so. So they're saying that those products, those are more stable, the dead ones. They still have benefit is essentially what they're... Here. This is the exact quote. "You don't want your bacteria to breed in the product. You want it to be stable, then do a little bit and die. So why not use stabilized bacteria? Those that have been titanized and have the same kind of effect."

Afif Ghannoum: So that's interesting. I haven't seen it talked in that paradigm yet. Bacterial phages are definitely something that are gaining prominence in the market for a couple of reasons. One, taking a step back, everyone, and this is a challenge when you're dealing with probiotics is, you'll hear a lot of people that don't want products with preservatives, right? And one of the challenges with probiotics is that if you use a preservative, that's because a preservative is put in there to kill bacteria and fungus from growing in the formulation, growing in the food we eat, because it's on shelf. Right?

So that becomes very difficult if you're trying to encourage live growth of probiotic organisms and something that has a preservative in it, because almost by definition, it will kill the live strings. Right? The problem is, if you're not careful with having even natural preservatives in there, you could end up with a cocktail of not just probiotic organisms, but frankly pathogenic as well, right? So a lot of companies now are trying to figure out, well, is there a way to get to your point, the same probiotic effect, but not have to deal with the whole live stream issue?

So I think the reality is, the jury is still out because the science is pretty young in this area. So it's constantly, and I don't know specifically about the companies that are talking about the state of their science, but especially in the beauty category, it's always an important thing to look at how they're making claims, right? What is the actual science behind these products that are making claims? Because there are a lot of things that theoretically make sense, but have they actually shown clinical evidence supporting that? And then the other thing I'd say to people is when you're reading these claims, the wording sometimes is hyper-specific on a regulatory front, but it's not actually saying what you think it's saying. And that's purposeful. The example, have I told you about this? [inaudible 00:17:22] about the whole eyebrow hair claim thing?

Andrea Wien: Yes. Yes. We talked about this in one of the other episodes, basically appears to be.

Afif Ghannoum: Yeah, I thought so, it's like my go to-

Andrea Wien: Yes. Yes.

Afif Ghannoum: Yeah. Yeah. So, just five second recap on that. You'll see a lot of products that say like, "Will enhance the appearance of thicker eyebrows," versus, "Will make thicker eyebrows." Because, "Make thicker eyebrows," is a drug claim. "Enhance the appearance of thicker eyebrows," is a cosmetic claim, right? So I always encourage people, be very careful looking at the claims. What are they actually saying they're going to do? You know what I mean? Because it's a lot of times not quite as strong as they want you to think it is. I think, again, in the skincare space, everybody's trying to get ahead of the curve and have the best claims and the most innovation, but the science isn't necessarily there yet. So I'm interested, but want of verified is sort of how I'd put it.

Andrea Wien: Yeah. And I guess maybe you can shed a little light on this. So for example, one of the creams that's on the Symbiome website is three ingredients. It's water, it has some leaf oil, and it has a lactobacillus ferment. That's it. And then in their little description, it says, "Beneficial metabolites are biomolecules produced by living microbes that promote health." So they're talking about post biomics is what they're calling it. "Symbiome's post biomics are created through a proprietary process with a unique blend of microbes that optimizes the number and bioavailability of nutrients in each product." So they're saying that this lactobacillus ferment, which we don't know what strain, is unlocking the benefits, the hidden nutrients in the oil that's in there?

Afif Ghannoum: Yes. Yes. So what they're trying to do is, a lot in the context of how people are talking about prebiotics, right? It's about encouraging the growth of the probiotic organisms and probiotic effects of the natural fauna, right? So you're now starting to see in postbiotics, what was the term you said? Post biomics?

Andrea Wien: Yeah. That's another one, I think, that they've trademarked. It's post biomics. So P-O-S-T B-I-O-M-I-C-S.

Afif Ghannoum: Again, I don't know anything about this company, but to me it's a little bit of an eye-roller anytime you see a trademark term for something that's trying to sound very scientific, because what that's telling me is, that's not a commonly used term because it's not in the medical literature, because by definition, you wouldn't be able to trademark it. So I just think it's probably a spin on postbiotics have been out for quite a while. It's just taking advantage of the natural fermentation processes and what they're trying to do. So it's an interesting spin. And again, we're just at the starting gate of claims around this stuff, especially in the skin microbiome, but yeah. We'll see.

Andrea Wien: Yeah. If they want to send me any other, if they're listening to this, I'll be sure to give it a try and we can rate it on the podcast.

Afif Ghannoum: Yeah, listen, the one thing I'll say is, it's oftentimes these smaller companies that are the ones to first introduce innovation because the bigger mega companies, they're just gigantic. You often see that, right? So it's not saying it's not plausible, it's just like, these are interesting claims that are certainly unique.

Andrea Wien: Sure. Yeah. Yeah. I think too then that led me down this path of, we talk a lot now about prebiotics really being the answer to a lot of things in the gut microbiome, but prebiotics haven't been discussed much when it comes to the skin microbiome. And in some ways, this article that I have found is talking about the skin should really be considered more of a desert when compared to the gut, because the skin is much drier, it doesn't have same pH, it's more acidic. So this article was really getting into, can we start to look at what might be able to be used as prebiotics for the gut?

Oligosaccharides are something that are really helpful fibers for gut microbiome and they've essentially said for skin microbiome, they don't really see a huge opportunity here. There's a hypothesis that they say could warrant something under further investigation, but then they also look at essential oils and things like CBD and Camphor and some of those chemical compounds that come from plant-based essential oils. So it's interesting to see how people are starting to think about, how do you feed the bacteria on the skin?

And this article did not make any claims that they figured out that, or that there's been studies that have shown that, or that the bacteria that they're feeding are necessarily good or bad. They just kind of said, "Here's some areas that we're looking into."

Afif Ghannoum: Yeah. Again, it's very logical. It will be interesting to see what... Because I'm seeing a lot of people starting to talk about prebiotics in skincare. And again, taking a step back, the theory is that if you're able to put a layer of good top soil on the skin, just like you use prebiotics in the gut, that you'll be encouraging the growth of these good organisms. Now, to what end is always the critical question, right? I think there's a number of manufacturing reasons to be excited about prebiotics and skincare, because you're not worried about anything dying, they're literally dietary fiber, right? So it should be a lot easier to manufacturer.

There's some interesting new, exotic prebiotics. So just like you would see dragon fruit antioxidant skin care five years ago where every iteration of an antioxidant was like some new Amazonian fruit as a source of a better antioxidant and more bioavailable, whatever. I think that's what we're going to start seeing in the prebiotics, because now it's going back into vegetables and fruits and different sources of prebiotics, like skincare industry loves that, because it's an easy story to tell, "Oh yeah, we have prebiotics from the-

Andrea Wien: The Amazon.

Afif Ghannoum: Yeah. Exactly.

Andrea Wien: Which is exactly what this Symbiome company is doing. They're saying that their proprietary formula is unlocking the benefits of these Amazonian antioxidants.

Afif Ghannoum: It's literally saying that?

Andrea Wien: It's literally, yeah, yeah. Exactly.

Afif Ghannoum: Oh, that's hilarious. Yeah. I was making that up. Yeah. So listen, they're doing something that's exactly out of the skin care playbook, good for them. It would be interesting to look at the science behind it. I did look up, I didn't find that they have a trademark around skin microbiome, I did find they have a trademark around post biomic, which is interesting, but that term I'm not familiar with. So I think that's just their take on it, which is, that's part of the growing of a brand.

Andrea Wien: Yeah, absolutely. And I looked at the website the day they launched. They're really new, I mean, within the last two or three weeks. And I did notice today when I just went back to it that the trademark symbol had been taken off of skin microbiome. So maybe it was just their initial website, their initial website designer had put that in there. But yeah, it looks like it's been taken off.

Afif Ghannoum: Interesting.

Andrea Wien: One thing before we move on, there's a company talking about all this prebiotic stuff on the skin called Lab Skin out of the UK. It really reminds me of Silence of the Lambs style, Lab Skin, I don't know. Something about it is a little creepy, but they have basically fake skin that mimics real human skin so they can test some of these microbiome reactions and it can be colonized with different skin micro floras. So it's pretty interesting. We think about 10, 15 years ago, that never was even in the scientific realm and now we have full companies that are dedicated to it. So it's pretty cool to see that that's-

So this is potentially a big deal. Now there's been a lot of efforts to test products without having to use animals, right? Especially in skincare, especially in pharma. Now, anytime you talk about animal testing, people rightfully so get unnerved because there was a long history of basically animal cruelty in the development of products. The problem is, we really have yet to find equivalent models, especially in pharmaceuticals, that are able to replicate the human body as closely as some animals do.

So, classic one in skincare is rabbits or pigs. So especially when you're talking about serious conditions, dermatological conditions like eczema, rosacea, some of these things. And again, when I say serious, like yes, they're serious skin conditions, I understand it's not some very, very serious medical conditions. I'm trying to take my foot out of my mouth with this. I'm trying to basically put it in its right scope.

My point is, a true pharma type product, I feel comfortable saying if not 100%, 99.9% of the time, they have to be tested in animals in order to get through FDA approval. So if there are companies starting to do this type of skin equivalent, which is not actually from animals, that's a big deal.

Now, the question always becomes, will FDA accept that? Will other countries' regulatory scheme accept that? Because you're competing against decades and decades of knowing how animals react in these tests. So very exciting if they're able to do it, but there's a lot... Because the problem is every company, when we're talking about testing, said they would love stuff like this. But at the end of the day, they have to use what FDA will actually accept. So it's pretty interesting. Big market, right?

Andrea Wien: Yeah, yeah, absolutely. For sure. Okay. So you sent me over a study about how sugar influences the microbiome. So obviously, this is something that we've known for a long time. High sugar can throw a microbiome into a dysbiotic state. If you want to support your microbiome, reverse things like yeast overgrowth, et cetera, et cetera, cutting out sugar is essentially step number one.

But this study went even further and found, I'll just read their findings. "Our findings strongly support the concept that intake of high sugar in the form of sucrose and high-fructose corn syrup might be a critical trigger for inflammatory bowel disease. Our study suggests that avoiding a high sugar diet is an option for the prevention of IBD and other inflammatory and metabolic diseases." So-

Afif Ghannoum: What did they do that study on?

Andrea Wien: This study was done on mice, I believe.

Afif Ghannoum: Right. Right,. My point-

Andrea Wien: Yeah. Yeah, yeah, yeah. Oh, yes, exactly. Exactly. Yes.

Afif Ghannoum: I think sometimes, because... Sorry, not to beat a horse, no pun intended, no horses were tested on, but I don't think you'll find a drug or these types of studies that are not done on animals. You know what I mean? So it's really everywhere. You know what I mean? So I just wanted to say that because I think a lot of times people, when they think of animal testing, they think of those old ads with rabbits being exposed to shampoo and stuff like that. It's just such a common part of drug development, scientific development that it's a thing I always want to kind of emphasize.

Andrea Wien: Sure. Well, and in a real sign of our times, there's a sentence in this that says, "Then scientists humanely euthanized the animals." So even in the presentation of how the scientific experiences is talked about, they're talking about, it was done humanely and it's just a necessary evil in some ways.

Afif Ghannoum: Yeah. And listen, it's changed so much, not to go down a rabbit hole of just talking about animal testing, but if you talk to people at medical schools, they'll tell you testing 10 years ago where the animals, even though they were treated unhumanely, they were just thought of as literal parts of the study. Now, they literally have scheduled playtime for the animals there. Because you've, probably not shockingly, they've found that animals that are treated well during the studies are more stable scientific subjects. I feel like this is going down...

Andrea Wien: Yeah. Let's bring it back to sugar.

Afif Ghannoum: Yeah. Yeah.

Andrea Wien: So I wanted to just quickly give some statistics on sugar, because I have a lot of clients that come to me and say, "Well, I don't eat a lot of sugar, right? I don't eat a lot of sugar in my diet. I'm not eating cakes and cookies and all those types of things." And the reality is that most people are getting so much more sugar than they think they are.

So the average American eats 152 pounds of sugar a year. So that's equal to three pounds a week or about six cups a week of sugar. And in this study that they were talking about the IBD, they say a 2015 survey published in the Lancet found that 68% of all packaged foods and beverages in the US supply chain contain caloric sweeteners, another way of saying sugar.

And my point with this is, food manufacturers get really tricky with their labeling. So when you look at a label, it doesn't say sugar most of the time, sometimes it might say cane sugar or something like that, but there's something like 70 different names that sugar can go by. And in our show notes, I can post a list of those if anyone's interested. I mean, everything from apple juice concentrate to dextrose, maltodextrin, these names that you just think are throw away words sometimes in lists of ingredients are sugar.

Afif Ghannoum: So even beyond that though, because to your point, there's just terms, they don't just plainly label it sugar. To me, what blew me away is how many foods I didn't realize had sugar. You know what I mean? Bread can have sugar, spaghetti sauce can have sugar. I read something like barbecue sauce is literally half sugar. So that's the part where, to your point, I just think, even if you're trying to be mindful about like, "Oh, I don't want to eat as much dessert or, oh, a sugary drink," it's incessant in things that you buy that are processed. That's the part that I personally didn't have an appreciation for it until after I read this article. I was like, "No, how many foods actually have this that I'm not even probably thinking about?" And it was shocking.

Andrea Wien: Yeah. It's really, when people really start paying attention, I can't tell you how many people have called me and emailed and said, "It's in everything. It's in everything that I eat." And I think consuming no more than 25 grams of sugar, which is about six teaspoons, which still seems, would you line up six teaspoons of sugar and just straight eat those? For men, it's nine teaspoons. I don't think many people would do that, but over the course of the day, that's how much we're actually getting a lot more. That's the recommended number. Most people are eating upwards of 10 to 20 times that much.

Afif Ghannoum: Yeah. So to your point, one thing that I'll just read, because it absolutely blew me away. "According to the USDA, if you have a full can of tomato soup, you can expect to eat 36 grams of sugar, the equivalent of two and a half blueberry muffins." Wow, it's insane.

Andrea Wien: Yeah, I mean it's insane. It's so easy to get to that number before you even finish breakfast, especially when we're eating like, "Oh, we're eating a healthy, wholegrain muffin." That's mostly sugar. And then I'm actually reading this book right now about kids. And this study was done, I think again, back in 2014 or even earlier, but 70% of child-friendly foods are sugar. So, they're packed with sugar. You even look at like those purees, people are like, "Well, it's a fruit puree." But flip that over and look at how many grams of sugar are on some of these things.

And most of those things, the fiber is not in there anymore because it's been taken out for the puree process. So, you're literally giving your child just straight sugar. And that's why we're seeing so many of these inflammatory bowel, auto-immune diseases. It's serious business that I think a lot of people don't realize that they're eating that much when they're trying to eat healthy.

Afif Ghannoum: It's really crazy. It just shows you, we'll talk to people, work on their microbiome, and you feel sorry for people because they're really trying to do the right thing. And the problem is, eating well now is not just making some easy choices. It's really navigating a minefield because these things you're thinking you're doing like, "Oh, I'm having a salad, a little bit of dressing." Dressing, packed with sugar. "Oh, I'm having peanut butter or a protein bar high in protein," packed with sugar. These are things that, despite your best efforts, are just sabotaging without you meaning to. So it's that much harder nowadays just to eat clean.

And that is such a loaded term sometimes, because I think people think eat clean means just eating raw whole foods. And that's not necessarily the case, but it's just so critical, mindful. Even I've been trying to eat a lot more fish versus red meat, and when I go out to restaurants, I find I have to be very specific. "Please don't add butter to the fish." They're like, "Oh, okay." You know what I mean? It's like, I just didn't realize that was the default. You know what I mean? You think you're ordering a healthy piece of fish, something like that. And then it's like, no.

And the problem is, that's why a lot of these things taste so good, because packed with salt, butter, sugar. So it's really, you have to proactively take the approach that when you're eating, you really have to approach it as fuel. You know what I mean?

Andrea Wien: Yeah.

Afif Ghannoum: It's like Laird Hamilton's wife, Gabby Reece, is that right?

Andrea Wien: That sounds right.

Afif Ghannoum: Anyway, I heard her on a podcast and she's like, "I've taught my kids that there's food and then there's fun. So candy, desserts, eating out, those things are fun, we can certainly do that, but that's not food." And I thought, that's the smartest way to think about it.

Andrea Wien: Yeah. The book that I'm reading right now, although I don't agree with a lot of the dietary advice, also has a similar bent of like, "These are growing foods. These are treat foods." They have that whole thing, that whole debate. It's called, It's Not About the Broccoli if anyone's interested in reading it.

But I mean that whole thing around low fat, when the whole low fat craze came out, essentially what they did is they took the fat out, but fat has a lot of flavor. It keeps you satiated. So in order to mitigate that, they just bumped the sugar way up. So we didn't see people... We don't look at the results, if the low fat diet didn't work. And if given the choice between butter and sugar, I'll pick butter every day in terms of a healthier option.

So it's interesting to see how a lot of these things swing back the other direction, but you have to question when something is low anything, how are they making up for that in the taste? So it's either-

Afif Ghannoum: Exactly.

Andrea Wien:…they're adding chemicals or they're adding some type of artificial or natural flavors. They are adding sugar, they're adding salt, they're adding fat. Those are the options. You can't have a packaged food without one of those typically being high.

Afif Ghannoum: Yeah. It's convenience or taste, you're giving something up. So if that thing is able to set shelf stable for years, there's a reason for that. You know what I mean? If it tastes excellent, there's a reason for that. So you're dead on.

Andrea Wien: Yeah. All right. We're out of time for today. We have some other stuff, but we'll bump it to next time. So Afif, this is always so much fun to do with you, so thanks for coming on. We will link to everything again in the show notes, We'll put all of the studies that we talked about and I'll drop in also that list of names that sugar hides behind.

Afif Ghannoum: All right. Talk soon.

Andrea Wien: Bye. As always, thanks so much for listening. As I said on the show, all of the show notes are available at I think I've given out a couple of different URLs recently, but that one definitely will get you to where you need to go. If you have any questions or any ideas that you want to bounce off of us or things that you'd like us to discuss on the show, please do not hesitate to email me. I'm at And also, you can hit me up on Instagram @dreeats. So either of those will get to me. I've also dropped a very easy to click link in the show description for ratings and reviews. So, if you could go click that if you've been listening to the show and leave us a rating and review, it would be so helpful. Until next time, I'm Andrea Wien. Thanks so much for listening.


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