A holistic approach to pediatric care in Frisco and Plano, Texas

Award winning, top rated Pediatrician serving Frisco, Plano, Allen and North Dallas

Leave a comment


A sugar substitute is a food additive that duplicates the effect of sugar in taste, usually with less food energy. Some sugar substitutes are natural and some are synthetic.

Alternative sweeteners are highly consumed in America. According to research studies explained by The American Journal of Clinical Nutrition, in 2003–2004, Americans two years of age and older consumed 585g per day of beverages and 375g per day of foods with caloric sweeteners. Some commonly consumed foods with alternative sweeteners are diet sodas, cereals, and sugar-free desserts such as ice cream.

In the United States, seven intensely sweet sugar substitutes have been approved for use. They are stevia, aspartame, sucralose, neotame, acesulfame potassium (Ace-K), saccharin, and advantame. The food and beverage industry is increasingly replacing sugar or corn syrup with artificial sweeteners in a range of products traditionally containing sugar.

Aspartame: Aspartame is a methyl ester. More than 6,000 products contain aspartame. It is approximately 200 times sweeter than sucrose, or table sugar. The FDA reviewed its safety in 2007 and concluded that aspartame is safe at current levels of consumption as a nonnutritive sweetener. However, people with the genetic condition phenylketonuria

PKU cannot ingest it. And pregnant women shouldn’t since they have been linked to premature births. In a study done in 1979, the effect of aspartame ingestion on blood and milk amino acid levels in lactating women was tested and found a small effect on the milk aspartate levels. The consumer advocacy group the Center for Science in the Public Interest continues to promote the position that aspartame is not safe.

Sucralose/Splenda:Splenda is twice as sweet as saccharin and three times as sweet as aspartame. The actual energy content of a single-serving (1-g packet) of Splenda is 3.36 kilocalories, 31% of those of a granulated sugar (10.8 kcal). In the United States, it is legally labelled “zero calories”. Some studies have determined that sucralose is not a biologically inert compound, having possible toxic effects, including creation of dioxin-like compounds when sucralose is heated.

Saccharine: Saccharin was produced first in 1878. It is 300 times as sweet as sucrose or table sugar, but has a bitter or metallic aftertaste, especially at high concentrations. The basic substance is benzoic sulfilimine. Studies have shown saccharine causes bladder cancer is rats, which eventually prompted safety warnings on products containing saccharine. However, in 2001, the FDA reversed its position, declaring it safe for consumption.

Neotame: The chemical formula is similar to aspartame, but it is between 7,000 and 13,000 times sweeter than sucrose (table sugar). It’s the only artificial sweetener deemed “safe” by the consumer advocacy group Center for Science in the Public Interest.

Truvia: Truvía’s ingredients are erythritol. The calorie-free, low-carb sweetener comes from the shrub-like stevia plant. This sugar substitute is about 100 times sweeter than sugar. The FDA first rejected it in the 1990s for use as a food ingredient. High dosages fed to rats affected reproduction. But in 2008 the FDA granted stevia “GRAS” status, meaning it is “generally recognized as safe.”

Comparison of sweetness based on energy content is not meaningful because many artificial sweeteners have little or no food energy.

Name Sweetness (by weight) Trade name Approval Notes
Acesulfame potassium 200 Nutrinova FDA 1988 E950
Advantame 20,000 FDA
Alitame 2,000 approved in Mexico, Australia, New Zealand and China. Pfizer
Aspartame 160–200 NutraSweet, Equal FDA 1981, EU-wide 1994 E951
Salt of aspartame-acesulfame 350 Twinsweet E962
sodium cyclamate 30 FDA Banned 1969, approved in EU E952, Abbott
Dulcin 250 FDA Banned 1950
Glucin 300
Neohesperidin dihydrochalcone 1,500 E959
Neotame 8,000 NutraSweet FDA 2002 E961
P-4000 4,000 FDA banned 1950
Saccharin 300 Sweet’N Low FDA 1958 E954
Sucralose 600 Kaltame, Splenda Canada 1991, FDA 1998, EU 2004 E955, Tate & Lyle

Animal studies have indicated that a sweet taste induces an insulin response in rats.

A 2014 study by a collaboration from nine Israeli research institutes presented experimental evidence that artificial sweeteners may exacerbate, rather than prevent, metabolic disorders such as Type 2 diabetes.

Source: Wikipedia

Leave a comment


Data from the National Diabetes Statistics Report, 2014 (released June 10, 2014)

Overall Numbers, Diabetes and Prediabetes


  • Prevalence: In 2012, 29.1 million Americans, or 9.3% of the population, had diabetes. In 2010 the figures were 25.8 million and 8.3%.
  • Undiagnosed: Of the 29.1 million, 21.0 million were diagnosed, and 8.1 million were undiagnosed. In 2010 the figures were 18.8 million and 7.0 million.
  • Prevalence in Seniors: The percentage of Americans age 65 and older remains high, at 25.9%, or 11.8 million seniors (diagnosed and undiagnosed).
  • New Cases: The incidence of diabetes in 2012 was 1.7 million new diagnoses/year; in 2010 it was 1.9 million.
  • Prediabetes: In 2012, 86 million Americans age 20 and older had prediabetes; this is up from 79 million in 2010.
  • Deaths: Diabetes remains the 7th leading cause of death in the United States in 2010, with 69,071 death certificates listing it as the underlying cause of death, and a total of 234,051 death certificates listing diabetes as an underlying or contributing cause of death.

Diabetes in Youth

  • About 208,000 Americans under age 20 are estimated to have diagnosed diabetes, approximately 0.25% of that population.
  • In 2008—2009, the annual incidence of diagnosed diabetes in youth was estimated at 18,436 with type 1 diabetes, 5,089 with type 2 diabetes.

Diabetes by Race/Ethnicity

The rates of diagnosed diabetes by race/ethnic background are:

The breakdown among Asian Americans:

  • 4.4% for Chinese
  • 11.3% for Filipinos
  • 13.0 for Asian Indians
  • 8.8% for other Asian Americans.

The breakdown among Hispanic adults:

  • 8.5% for Central and South Americans
  • 9.3% for Cubans
  • 13.9% for Mexican Americans
  • 14.8% for Puerto Ricans.


Diabetes was the seventh leading cause of death in the United States in 2010 based on the 69,071 death certificates in which diabetes was listed as the underlying cause of death. In 2010, diabetes was mentioned as a cause of death in a total of 234,051 certificates.

Diabetes may be underreported as a cause of death. Studies have found that only about 35% to 40% of people with diabetes who died had diabetes listed anywhere on the death certificate and about 10% to 15% had it listed as the underlying cause of death.

Complications/Co-Morbid Conditions

  • Hypoglycemia: In 2011, about 282,000 emergency room visits for adults aged 18 years or older had hypoglycemia as the first-listed diagnosis and diabetes as another diagnosis.
  • Hypertension:In 2009–2012, of adults aged 18 years or older with diagnosed diabetes, 71% had blood pressure greater than or equal to 140/90 millimeters of mercury or used prescription medications to lower high blood pressure.
  • Dyslipidemia: In 2009–2012, of adults aged 18 years or older with diagnosed diabetes, 65% had blood LDL cholesterol greater than or equal to 100 mg/dl or used cholesterol-lowering medications.
  • CVD Death Rates: In 2003–2006, after adjusting for population age differences, cardiovascular disease death rates were about 1.7 times higher among adults aged 18 years or older with diagnosed diabetes than among adults without diagnosed diabetes.
  • Heart Attack Rates:In 2010, after adjusting for population age differences, hospitalization rates for heart attack were 1.8 times higher among adults aged 20 years or older with diagnosed diabetes than among adults without diagnosed diabetes.
  • Stroke:In 2010, after adjusting for population age differences, hospitalization rates for stroke were 1.5 times higher among adults with diagnosed diabetes aged 20 years or older compared to those without diagnosed diabetes.
  • Blindness and Eye Problems: In 2005–2008, of adults with diabetes aged 40 years or older, 4.2 million (28.5%) people had diabetic retinopathy, damage to the small blood vessels in the retina that may result in loss of vision.
  • Kidney Disease: Diabetes was listed as the primary cause of kidney failure in 44% of all new cases in 2011.
    •  In 2011, 49,677 people of all ages began treatment for kidney failure due to diabetes.
    •  In 2011, a total of 228,924 people of all ages with kidney failure due to diabetes were living on chronic dialysis or with a kidney transplant.
  • Amputations: In 2010, about 73,000 non-traumatic lower-limb amputations were performed in adults aged 20 years or older with diagnosed diabetes.
    • About 60% of non-traumatic lower-limb amputations among people aged 20 years or older occur in people with diagnosed diabetes.

– See more at: http://www.diabetes.org/diabetes-basics/statistics/#sthash.KpGrHK4M.dpuf

Leave a comment


Calorie-free artificial sweeteners are often chosen by dieters in part because they are thought not to raise blood sugar levels. In Wednesday’s issue of the journal Nature, researchers report that artificial sweeteners increase the blood sugar levels in both mice and humans by interfering with microbes in the gut.Increased blood sugar levels are an early indicator of Type 2 diabetes and metabolic disease.

Source: Nature

Leave a comment


QUESTION: Doctor: You often say avoid “Added Sugar”. It is bad for a growing child. What is your view about Products made with sugar substitutes? How about Diet Soda? Which sugar substitute is good for my child?


Children generally love sugary foods, and chances are the processed or packaged food your child eats has some amount of added sugar. The American Heart Association (AHA) recently released new guidelines limiting the amount of added sugar considered acceptable for a healthy diet. Per AHA,

  • Preschoolers with a daily caloric intake of 1,200 to 1,400 calories shouldn’t consume any more than 170 calories, or about 4 teaspoons, of added sugar a day.
  • Children ages 4-8 with a daily caloric intake of 1,600 calories should consume no more than 130 calories, or about 3 teaspoons a day.
  • As your child grows into his teen years, his caloric range increases to 1,800 to 2,000 a day, and the maximum amount of added sugar included in his daily diet should be 5 to 8 teaspoons.

However the reality per AHA study is

  • children as young as 1-3 years typically consume around 12 teaspoons of sugar a day!!
  • By the time a child is 4-8 years old, his sugar consumption skyrockets to an average of 21 teaspoons a day!

Obesity rates tripled in 30 years, and sugar-sweetened beverage consumption among children more than doubled in the last 2 decades of the twentieth century. Many children drink more sugar-sweetened beverages than milk. Sugar-sweetened beverages represent the largest category of daily caloric intake (7%–12%) for many demographic groups. Evidence suggests that increasing consumption of sugar-sweetened beverages raises weight and obesity rates.

This is why I recommend against “Added Sugar” in your child’s diet.

Now let’s look at Sugar Substitutes

Sugar substitutes provide sweetness to food without the calories of sugar. The FDA has approved five artificial sweeteners: saccharin, acesulfame, aspartame, neotame, and sucralose. It has also approved one natural low-calorie sweetener, stevia. How the human body and brain respond to these sweeteners is very complex. Of the above only Stevia is a natural sweetener. But just because something is natural does not always mean that it is safer. Sugar substitutes are found in most of the “light,” “reduced calorie” or “sugar-free” foods and drinks available today.

As the name says, Sugar substitutes are just as the name says – chemicals masquerading as sugar!

What does research say?:

  • Research suggests that Sugar substitutes may prevent us from associating sweetness with caloric intake. As a result, we may crave more sweets, tend to choose sweet food over nutritious food, and gain weight.
  • Animal studies suggest that artificial sweeteners may be addictive. In studies of rats who were exposed to cocaine, then given a choice between intravenous cocaine or oral saccharine, most chose saccharin.
  • Aspartame is also often anecdotally linked to brain disorders based on small animal studies, but human studies have not shown an association.
  • A lot of studies show that diet soda is linked with being overweight but there isn’t a clear answer as to why.

Due to limited studies in children, the American Academy of Pediatrics (AAP) has no official recommendations regarding the use of noncaloric sweeteners.

So the best advice I can give is probably to

  • avoid artificial chemicals in general (which is high in processed food);
  • limit both regular and diet soda consumption for optimal health, especially for children.

Also check out:







Wake up Pizza hut, stop feeding obesity and diabetes to our kids

Pizza Hut Inc. customers now can indulge in a slice of an eight-inch Hershey chocolate chip cookie after devouring their pizza.


A single six-inch Personal Pan Pizza is a whopping 850 calories. Now add 100 calories for each cookie slice, and you have an intake that

Is two times your daily recommended calorie count for a child.

Source: https://order.pizzahut.com/nutrition-information

Leave a comment


Growing sugar consumption, larger portion size, chemicals and other factors are increasing childhood rates of diabetes – a lifelong punishment.

German researchers analyzed glucose-insulin metabolism in 36 healthy young adults whose mothers experienced stressful “negative life events” (divorce, infidelity, a breakup, death of a loved one, severe financial problems, a father in denial, being involved in a car crash etc) while pregnant.

Being stressed-out during pregnancy has been associated with a number of problems, like lower birth weight and premature birth.

But this research concluded that

Stress could give birth to children with diabetes in early adulthood.


· Engage in mindfulness living: Mindfulness is about focusing on the present moment, without judgment, to avoid stressing over the future.

· Try the Yoga Alliance to find experienced instructors in your area.

· Try handful of almonds, pistachios, walnuts; a cup of skim milk; or old-fashioned oatmeal to distress.

If you like more of these, let me know and I will continue them.

1 Comment


STUDY: Preschool children who regularly have sugary drinks tend to pack on more pounds than other youngsters.

DETAILS: Journal Pediatrics

Researchers found that among the 2- to 5-year-olds they followed, those who routinely had sugar-sweetened drinks at age 5 were 43% more likely to be obese than their peers who rarely had those drinks.

Sugar-sweetened beverages are the largest source of added sugars in the diet of U.S. youth.

Childhood obesity has more than tripled in the past 30 years.

Obesity among children aged 6 to 11 years increased from 6.5% in 1980 to 19.6% in 2008.

Among adolescents aged 12 to 19 years, obesity increased from 5.0% to 18.1%

What Can You Do

Plenty of factors influence childhood obesity, including genes, overall diet and physical activity.

Although the study cannot prove it’s the beverages causing the added weight, experts said parents should opt for water and milk to quench preschoolers’ thirst.

U.S. kids would slash 235 daily calories from their diets if they swapped sugary drinks or 100 percent fruit juice for water.

Kids should

· Reduce their consumption of regular soda or pop, sports drinks, and other sugar-sweetened beverages.

· Increase their consumption of water and low-fat or fat-free milk.

· Drink limited amounts of 100% fruit juices.

Source: http://www.cdc.gov/features/healthybeverages/, Pediatrics Journal

Leave a comment


Improve your lifestyle to prevent Diabetes

Improving your lifestyle is equally important in treatment of type 2 diabetes. Some lifestyle changes which reduces risk of diabetes

· Avoid smoking

· Do exercise regularly

· Do not skip meals

· Prefer whole food instead of refined food

· Enjoy adequate sleep

· Avoid sugary drinks

· Spread meals throughout the day

· Manage body weight

· Do yoga – here is list of some good yoga for diabetes


For Adults

· Avoid alcohol

· Learn and practice meditation for emotional and mental balance

Leave a comment


Use glycemic index to help control blood sugar

P.J. Skerrett, Managing Editor, Harvard Health

A diabetic should know Glycemic index (GI). Even if you aren’t, know about GI as low glycemic index diets have been linked to reduced risks for cancer, heart disease, and other conditions. Glycemic index rates carbohydrate-containing foods by how much they boost blood sugar (blood glucose).

Carbohydrates are the main nutrient in bread, pasta, cereals, beans, vegetables, and dairy foods. All carbs are made up of sugar molecules. carbohydrate-containing food affects blood sugar depending on its sugar content and on how quickly the digestive system breaks the food into sugar molecules. The glycemic index measures how well a food boosts blood sugar compared to pure glucose. A food with a glycemic index of 30 boosts blood sugar only 30% as much as pure glucose.

GI and Health benefit


If you are diabetic, pay attention.

You can’t rely on the glycemic index alone for choosing a healthy diet. Some foods, like carrot and watermelon, have a high glycemic index, but a serving contains so little carbohydrate that the effect on blood sugar is small.

The glycemic index of a particular food can also be influenced by what it is eaten with.

There are three categories of carbohydrate-containing foods:

· Low glycemic index (GI of 55 or less): Most fruits and vegetables, beans, minimally processed grains, oats, pasta, low-fat dairy foods, and nuts.

· Moderate glycemic index (GI 56 to 69): White and sweet potatoes, corn, white rice, couscous, breakfast cereals such as Cream of Wheat and Mini Wheats.

· High glycemic index (GI of 70 or higher): White bread, rice cakes, most crackers, bagels, cakes, doughnuts, croissants, waffles, most packaged breakfast cereals.

Swaps High GI to lower GI food

Instead of this high glycemic index food Eat this lower glycemic index food
White rice Brown rice or converted rice
Cornflakes Bran flakes
Baked potato Pasta
White bread Whole-grain bread
Corn Peas or leafy greens
Fruit roll-up Whole fruit


The complete list of the glycemic index and glycemic load for more than 1,000 foods can be found in the article "International tables of glycemic index and glycemic load values: 2008" by Fiona S. Atkinson, Kaye Foster-Powell, and Jennie C. Brand-Miller in the December 2008 issue of Diabetes Care, Vol. 31, number 12, pages 2281-2283.

Leave a comment


Diabetes is a serious disease and the number of people affected with it has skyrocketed in the last couple of years. Here are few tips to help lower your chances of getting diabetes.

· Reduce your portion size

· Get physically active

· Add lots of whole grain in your diet

· Breakfast is the most important meal of the day. Don’t Skip.

· Avoid fatty foods and Sugary drinks

· Eat many veggies & Load up on Fiber

· Add Soy and Green tea to diet

· Try to lower stress level & Sleep well

· Drink a lot of water

· Soak in the sun

· Avoid diabetes with spices
According to a German research, adding spices to your diet especially cinnamon helps to activate the enzymes in your body, which helps to stimulate insulin receptor. Besides, it also helps to lower down cholesterol and reduces the risk of developing cholesterol.

· Pure cocoa help diabetes

· 15-min walk after meals cuts diabetes risk