Dr. Michael Goran of Sugarproof Kids: 5 Lifestyle Tweaks That Can Dramatically Improve Your Wellbeing
Keep it Simple and Build Your Own Version: Processed foods and health foods have both become so complicated, expensive and full of ingredients that are often mysterious even to informed consumers like myself. I will pick up and sometimes even try a new brand of a “healthy” breakfast cereal at the market for example.
As a part of my series about “5 Lifestyle Tweaks That Will Dramatically Improve One’s Wellbeing”, I had the pleasure of interviewing Dr. Michael Goran.
LA-based Dr. Michael Goran, PHD. is one of the world’s most widely recognized experts in childhood nutrition, obesity and metabolic health research, with more than 30 years of experience as a researcher, mentor, and educator. He has raised more than $50m to support his research and has published almost 400 papers and is the author of Sugarproof: The Hidden Dangers of Sugar that are Putting Your Child’s Health at Risk and What You Can Do (www.sugarproofkids.com)
He is a Professor of Pediatrics at the Children’s Hospital of Los Angeles and The University of Southern California, Keck School of Medicine.
Thank you so much for doing this with us! Our readers would love to “get to know you” a bit better. Can you share with us the story about how you first got involved in fitness and wellness?
In school I loved chemistry and biology and putting those together felt natural, so I ended up with a college degree in biochemistry. I was fascinated by the internal machinery of the body and how it regulates the thousands of reactions going on inside every cell. I then pursued a PhD., which allowed me to learn how to do research and to dive deeper into understanding how our bodies use nutrients for growth and development and how that process is affected by stress and extreme conditions.
After starting my career in the UK, I moved to the U.S. where I pursued various opportunities including fellowships at the Shriners Burns Institute in Galveston TX where I studied nutritional requirements of children recovering from burn injury, and in Burlington Vermont where there was a very active group of researchers studying nutrition, exercise and obesity. I’m forever grateful to my mentor there, Dr Elliot Danforth who gave me the opportunity to expand my tools and expertise. At this time (1989) there was extremely limited research on childhood obesity, so I saw my opening. I wanted to understand how and why children would develop excess weight at such a young age and how this would affect their health into adulthood.
After 5 years in the VT group, I was offered what my parents liked to say at the time was my first “real job”, as an Associate Professor and Director of a Division of Metabolism in the Department of Nutrition at the University of Alabama in Birmingham.
For this I am very grateful to the late Dr Roland Wensier who gave me that opportunity and became a great friend and mentor. The rest is history and after 5 years there, I followed my heart. I met my wife Lori in Birmingham, AL but on our first date she told me that her plan was to move to California, and we have been here in Los Angeles in the same house for 22 years.
Can you share the most interesting story that happened to you since you started your career?
One of the simplest studies we have done turned out to be one of the most talked about and controversial. We started with a simple question: “What exactly is in a can of soda”? In particular, we wanted to know the sugar composition of popular sodas and juices, especially ones made with high fructose corn syrup. How much fructose exactly, and how much glucose? This information might sound standard but it is impossible to tell from the food label and companies do not disclose their exact formulations on their websites either. We went shopping around town in grocery stores, purchased drinks from soda fountains at fast-food restaurants, carefully aliquoted them in the lab, and sent them to be analyzed in an independent laboratory that was blinded as to the details. We found that in many cases there was more fructose than expected. The food industry maintained that 55% of the sugars should be fructose but we found there was 60–65% in popular sodas and up to 70% in popular juices. This sounds like a trivial difference, but it was an important finding because research was also showing that more fructose was problematic, especially for growing children. For example, fructose is not registered as calories in the brain, and when consumed in higher amounts is converted to fat in the liver contributing to non-alcoholic fatty liver disease. This is a relatively new disease and is rapidly increasing even in children. It used to be that alcohol was the main factor contributing to liver disease but nowadays its sugar, and fructose in particular.
When our paper was published, I started to get correspondence from people and organizations I didn’t know who were very critical of our studies. I later learned that these were coming from food & beverage companies or their lobbying groups. On the one hand they said that the difference between our findings of 60–65% fructose and their claim of 55% fructose was so trivial that it didn’t warrant interest, yet on the other hand they wanted our findings retracted.
We repeated the study, this time sending samples to 3 different laboratories where we verified our results. So, as I often say, data talks louder than people.
Can you share a story with us about the most humorous mistake you made when you were first starting? What lesson or take-away did you learn from that?
I was working on a complicated grant focused on minority health disparities in children that involved dozens of colleagues and was probably worth close to $10million over 5 years. At the time (2006) it was the largest grant I had worked on and back then, you had to submit 12 hard copies by mail that had to arrive in Washington, DC by the specified deadline.
The day before the deadline we were checking all the documents when I realized that we had missed the FedEx deadline for overnight shipping. Now what!? Someone suggested we hand deliver, so we had to find someone willing to get on a red eye to Washington that night. We were lucky enough to find someone, but they couldn’t carry 12 copies so when they landed, they had to go find a copy shop. Despite the stress, we did get this grant funded! The lesson learned is never give up — there are always alternative solutions to problems.
Can you share with our readers a bit about why you are an authority in the fitness and wellness field? In your opinion, what is your unique contribution to the world of wellness?
My unique contribution is my focus on children, families, and vulnerable populations. There are many people promoting nutrition and wellness but very few are applying that to children and families. This is such a big need because we know nutrition is so important during critical periods of growth and development (pregnancy, infancy, childhood, adolescence); nutrition during these periods can affect development in ways that could have long lasting effects on future health, a concept known as “the developmental origins of disease”.
Also, through my research in underserved and understudied populations (low income, Hispanics, Blacks) we have come to a better understanding of why certain segments of the population are more vulnerable to health and disease and different types of interventions that may work better under different types of environments and contexts.
Most health & wellness experts as well as available strategies target more affluent, white adults but we need more focus on families and children. We also need to focus more on underserved segments of the population where there are major health disparities, which can include obesity, type 2 diabetes, non-alcoholic fatty liver disease and cardiovascular disease that can be prevented by good nutrition and exercise.
None of us can achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
I have been blessed with some great mentors along the way. These include my PhD mentor, Dr Keith Frayn who literally wrote the book on metabolic regulation and who taught me how to do research. Dr Robert Wolfe gave me the opportunity to come to the US and learn more about metabolic regulation in humans. Dr Elliot Danforth at the University of Vermont extended that learning to include an understanding of how we adapt to periods of overfeeding and underfeeding and then Dr Roland Weinsier at the University of Alabama at Birmingham, AL gave me the opportunity to lead and build a research group. I’m so grateful to these mentors and it taught me the importance and techniques of how to be a good mentor.
Throughout my career I have loved being a mentor — it’s a very rewarding aspect of my job, and I have directly mentored almost 100 students, fellows and junior faculty. I even co-authored my book Sugarproof with a former student who is now an expert in nutrition education and recipe development, Dr. Emily Ventura.
Ok thank you for all that. Now let’s move to the main focus of our interview. We all know that it’s important to eat more vegetables, eat less sugar, exercise more, and get better sleep etc. But while we know it intellectually, it’s often difficult to put it into practice and make it a part of our daily habits. In your opinion what are the 3 main blockages that prevent us from taking the information that we all know, and integrating it into our lives?
I have a good friend and colleague I work with Donna Spruijt-Metz who is a behavioral psychologist. One of her sayings is that she is on a mission to understand why “smart people make bad decisions”. Understanding why we choose to do the things we choose to is complex, and when it comes to food, we are up against very powerful signals in our brain that might compel us to eat something even though we know it might make us feel lousy, or to not go for a walk when we know it would help clear our minds. I was once having dinner with another psychologist and he ordered a burger & fries. He ate a couple of fries and then picked up his glass of water and poured them over the fries. It would have been nice if he had offered me one first as I do love fries. I asked him why he did that and he said they he only wanted a few fries and couldn’t bear to sit there and stare down the fries. This is an extreme example and am not suggesting everyone pours water over their fries, but the point is that we are often working against very strong intrinsic impulses.
Due to these strong internal drives, it’s important to make the environment work to help achieve whatever the goal is. So, for example, for families who want to give up soda, the first suggestion is to not bring it into the house and instead put bottles of water in the fridge. For me, I love tennis but having arranged games with partners makes it more of a “must-do” and holds me accountable.
The third issue is that we should feel that its ok to cut ourselves some slack and not be so rigid. With family dynamics and busy lifestyles, it’s not always possible to follow a set routine that many strategies call for. I treat recommendations as guidelines that can get implemented within the context of my own situation. We also need to be open to experimenting with different strategies. There is no one size fits all solution and everyone’s metabolism and response to nutrition can vary. The future is in personalized nutrition and it’s coming soon with the availability of things like continuous glucose monitors and gut microbiome analysis. Even without those tools, it’s important to listen to your body and learn to do what feels right. Observe your kids and work with them to be more mindful about how different foods and activities makes them feel.
Can you please share your “5 Non-Intuitive Lifestyle Tweaks That Will Dramatically Improve One’s Wellbeing”? (Please share a story or an example for each, and feel free to share ideas for mental, emotional and physical health.)
- Ditch liquid sugar: Sugar in liquid form is the most problematic for the body because of the way a sudden large bolus of sugar affects metabolism, especially if it is high in fructose. It’s also usually “empty calories” when consumed in soda, juice and energy drinks where the beverage really provides no nutrition. Liquid sugar is the largest source of added sugars for most people and can easily be cut way down. I gave up buying bottled beverages of any kind. As an alternative, I will often add chunks of frozen fruit, or some fresh squeezed orange, into a glass of sparkling water and find this very refreshing. Unfortunately, replacing with diet beverages are not the answer — the available sweeteners can have other effects on the body. They do not solve our craving for sweetness and studies show can end up consuming more calories throughout the day.
- Keep it Simple and Build Your Own Version: Processed foods and health foods have both become so complicated, expensive and full of ingredients that are often mysterious even to informed consumers like myself. I will pick up and sometimes even try a new brand of a “healthy” breakfast cereal at the market for example. They often will have proprietary blends of sweeteners, fats and grains and end up being expensive and often don’t even taste that good. A much better approach is to start simple and build your own according to your or your family’s preferences. For example, for breakfast cereal you can buy a very basic cereal and then add your own source of fiber (flax seeds, chia), protein (chopped nuts) and/or phytonutrients (berries, chopped fruit) and suddenly you have a personalized and nutrient dense breakfast. Apply the same principal with things like yogurt.
- Periodic Fasting: I fast several times a week, not necessarily on a rigid schedule but when my day allows me to skip breakfast (e.g., on a day I’m not playing tennis or I don’t have back-to-back meetings or when we aren’t doing a family breakfast/brunch). I’ll basically not eat after dinner till about 11 or 12 the next day which will give me a good 16 hour fast. The benefits for me are that I will feel more energy throughout the day, and I know (because I’ve worn a continuous glucose monitor to check) that on these days my blood glucose is much more stable. I also believe the science that shows benefits of periodic fasting to support cellular metabolism and brain health. I don’t recommend this approach for kids unless excess weight is an issue and is done under the guidance of your pediatrician.
- Invest in Gut Health with a Daily Shot of Kefir: For me gut health is important and I recently started taking a daily shot of kefir which provides a healthy dose of live cultures for my gut microbiome. You can also get your daily dose of live cultures from things like pickled veggies which are easy to make and a fun project for kids. This is a good example of how we can often get the nutrients we need from actual food rather than relying on supplements which can be more expensive and might not have the same degree of bioactivity.
- Involve the kids. Eating together as a family for our evening meal has always been important. We all enjoy cooking and deciding what to eat, and we have a routine in place. We talk a lot in Sugarproof about the importance of getting kids involved in deciding what to eat, meal preparation and the ritual of eating together can all go a long way to promote healthy eating habits. We encourage family-based solutions, which will inspire kids to adopt healthier eating habits and the ability to self-regulate sugar.
As an expert, this might be obvious to you, but I think it would be instructive to articulate this for the public. Aside from weight loss, what are 3 benefits of cutting down on sugar? Can you explain?
The benefits are so broad and often overlooked that I’m going to have to go with these 4 benefits:
- Stable Blood Glucose which means more stable focus and concentration: Studies in adults and children show that habitual consumers of sugar and sugary beverages have compromised performance on academic tests and memory tests. In our experience with kids, we can see extremes of kids who are either bouncing of the wall, rolling around on the floor or falling asleep in class. Studies show that these variations in kids’ behavior is explained by how much sugar they consumed and how blood sugar can quickly go from highs to lows. When we work with families and have them complete a 7-day no added sugar challenge, parents are often surprised to see their kids have more stable energy and more focused attention.
- Reduce Risk for Chronic Diseases Like type 2 diabetes, fatty liver disease and cardiovascular disease: This one can be a surprise because many people do not associate sugar with these outcomes which we are seeing more of in children. It’s all to do with the way sugar and especially fructose, which is high in fruit juice and fruit sugars, is metabolized in the body. When a lot of fructose is consumed all at once in liquid form, almost 90% of the fructose is taken up by the liver. The liver is like a giant filter that removes stuff from the blood that shouldn’t be there like toxins, drugs and alcohol. Include fructose in that list. In fact, the fate of fructose once taken up by the liver is exactly the same as alcohol. It is broken down in a process that creates pro-inflammatory side-products and creates newly synthesized fat molecules. Those fats can get stuck in the liver and cause fatty liver disease and eventually destroy the liver in the exact same way that alcohol does. Or, those fats can get pushed back out in the circulation and cause high amounts of fats in the blood, or dyslipidemia, which is the hallmark marker for future cardiovascular disease.
- Improved immune function: Sugar and processed foods (70% of which contain added sugar) are pro-inflammatory — they cause more inflammation. Removing sugar and processed foods usually means substitution with more of a whole food approach and the more whole fruits (not juiced) and vegetables you eat and the bigger the variety, the more likely you are to get the benefits from the inflammation fighting components of these foods. Professor Tim Spector from Kings College London says we should aim to get a variety of 30 different fruits, vegetables, seeds, nuts and spices a week. Go for more colorful varieties. This approach is also higher in fiber and fiber is good for gut health and 70% of our immune function is derived from the gut.
- Improved brain health: One of the most shocking things I learned while writing Sugarproof is that long term consumption of sugary beverages can shrink the brain and contribute to cognitive decline. You might be thinking that replacing sugary beverages with diet beverages might offset but unfortunately these chemicals that induce sweetness without calories can also be harmful to the body including similar effects on brain health.
Is there a particular book that made a significant impact on you? Can you share a story?
I kept a stack of my favorite’s “diet” books on my desk when writing “Sugarproof”. One that had a major influence on me was “The End of Overeating” by David Kessler. I love his writing style and his brutal honesty. His personal story in the opening Chapter about his mental battle with a cookie left a strong impression on me.
I also was inspired by “Salt, Sugar, Fat” by Michael Moss who gives an incredible behind the scenes insight into how food companies design new foods to achieve the “bliss point” and “The Case Against Sugar” by Gary Taubes because he always brings great historical perspective.
You are a person of enormous influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)
We need a strong movement to get kids more involved with all aspects of food and health and if we had to start somewhere it would be sugar reduction because sugar has become so ubiquitous in our food supply and has broad adverse effects on growing bodies. Sugarproof encourages families to take on a life-changing 7-Day No Added Sugar Challenge or a 28 Day gradual sugar reduction. Learning how to sugar-proof your life is an empowering journey for the whole family designed to identify and replace sources of hidden sugars, re-boot our overwhelmed preference for sweetness so that we can better taste and appreciate real food and bring sugar consumption down to a reasonable level. It’s not about giving up sugar but it’s about “rightsizing.”
I strongly believe we need to overhaul the food system so that we do a better job of feeding kids at school and we need more strategies to get kids involved with growing food and getting involved in the kitchen. School gardens have had some moderate success but it’s not enough.
I’d like to work with a variety of cookbook authors and recipe developers to adapt their approaches to be more kid friendly. Getting kids involved with what we eat at school, in restaurants and at home will go a long way to shaping the health of future generations.
Can you please give us your favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life?
I have two life lesson quotes I would like to share. The first is “Keep it Simple” and the other is “Show me the data”.
We are very blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them :-)
I’ll have breakfast with Michelle Obama, lunch with David Kessler and dinner with Giada de Laurentiis.
Michelle has done so much to promote child nutrition and I’d like her thoughts on how to continue that, especially for the underserved and for segments of the population at greater risk.
I’d like to talk to David Kessler (who I have briefly met once) and am a huge fan because he has done so much to promote population health through his roles including FDA commissioner and currently as head of President Biden’s Covid-19 response team. I’d like to get his thoughts on how we can be more effective at fighting back against big food companies and deploying healthy eating as a way to boost population immunity to better fight back against viral infections, which is especially important in vulnerable populations who were more severely affected by the pandemic.
And I’d like to have dinner with Giada because, well, I love her cooking style and approach. It’s so simple, delicious, versatile and health promoting. The title of her new book says it all “Eat Better, Fell better: My Recipes for Wellness and Healing, Inside and Out”. I’d love to talk to her about translating some of these ideas to children.
What is the best way our readers can follow you online?
For Instagram and Facebook: @sugarproofkids
Thank you for these fantastic insights. We wish you only continued success in your great work!