Diabetic? Overweight? Low energy? Irritable? Drowsy? Poor concentration? Cravings for sweet foods? We need to talk about sugar, and the bitter side of sweet.

Did you know that there are four teaspoons of sugar in a fruit yoghurt? Nine teaspoons in a can of Cola? 2.5 teaspoons per serving of jam? Glucose, sucrose, maltose, dextrose, fructose, maltodextrose, glucose, lactose, cane sugar, corn syrup, inverted sugar hydrolysed starch are all forms of sugar. It's hidden everywhere! In bread, canned tomatoes, sauces, cereals, bacon. ... Check some food labels and see how many forms of sugar are in the foods that you eat. Trust me ? it's scary stuff.

Diabetes is one of the biggest health concerns currently facing Bermudian adults, but did you also know that our society now has children as young as ten being diagnosed with "adult onset" (Type 2) diabetes? Previously, diabetes in childhood has largely been Type 1 ? associated with an immune disorder. However, the number of children developing Type 2 is rising ? and 85 percent of these children are obese. But if the big link is obesity, why am I so hung up on sugar, not fat? We all know that eating fatty food contributes to obesity, but so does sugar ? because sugar in the blood gets stored in the body as fat. This is why some low-fat options are not always as healthy as they seem. When food manufacturers take out fat, they often boost the taste by adding sugar ? some brands of low-fat yoghurt or cream cheese are a perfect example of this. In this way, low fat foods that contain sugar can still cause weight gain.

Excess sugar can also cause your blood sugar levels to fluctuate wildly during the day. Fluctuating, imbalanced blood sugar can contribute to diabetes and complicate its management, but it also has other symptoms. Check the table ? how many symptoms of blood sugar imbalance do you have? The good news is that there are so many ways to improve blood sugar balance, and the key trick is to understand how quickly carbohydrates break down into glucose in the body.

All digestible carbohydrates break down to glucose (sugar) in the body. We need this glucose; it provides us with energy for our body and brain. However, some carbs release their glucose too quickly and cause imbalance ? this excess of sugar in the blood is often followed by a big dip as the body struggles to regulate itself. Fast-releasing carbs are those that are clearly sugary, or those that have been processed or refined e.g. sugar, candy, cookies, cornflakes and white bread. Slow-releasing carbs provide energy over a more sustained period of time and don't cause such imbalance ? they include more natural, wholefoods e.g. fruit, vegetables, wholemeal flour and pasta, wholegrain cereals and brown rice.

So swapping fast-releasing carbs for slow-releasing carbs is one of the best ways to help balance out your blood sugar.

To help you reduce the sugar in your diet and avoid the bitter side of sweet, here are some of the tips that my patients have found useful:

Fast releasing: Sugar, candy, cookies, cornflakes, jam, jello, sodas, white bread, white rice, white pasta, croissants, crackers, pastry and chips.

Slow releasing: fruit, vegetables, wholemeal flour and pasta, wholegrain cereals and bread, ryvita, wholegrain oats, sugar-free museli, beans, lentils, sweet potatoes and brown/red/wild rice.

A healthy mid-morning and mid-afternoon snack helps to balance blood sugar. Adding protein to the snack (e.g. nuts) helps to further steady energy release. Here are some snacks that fit the bill:

natural (plain) yoghurt with berries, kiwi or grated apple

Sticks of pepper, carrot, celery or wholegrain toast with hummus

An apple or pear with a small handful of unroasted/unsalted almonds or brazils

Ryvita, oatcakes or wholegrain crispbread with cottage cheese

Raisins and pumpkin or sunflower seeds

? avocado with lemon juice and black pepper

? grapefruit with a small handful unroasted/unsalted cashews or pecans

Try diluting fruit juice with sparkling water or soda water. Fizzy and refreshing!

These are all stimulants that interfere with blood sugar balance. Try replacing some of your coffee, tea and cola with glasses of water, or naturally caffeine free herbal teas. Consider cutting down, or giving up smoking.

Look carefully at the foods you are buying and avoid those with added sugar.

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