How Decreasing Your Sweets May Sweeten Your Mood!

Last Updated: 29 Jan 2021
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Sugar may be sweet, but it’s also sneaky. It goes by many names, and it can disrupt our stability and well-being.

sugar mood bipolar disorder

The Dark Side of Sugars & Sweeteners

We all know the bad news about sweet stuff, but many of us continue to consume too much sugar. Some estimates suggest each American eats more than 100 pounds of sweeteners a year! Sweeteners include common table sugar plus a range of substances that have calories and add a sweet flavor to food. (Examples are honey, syrup, high-fructose corn syrup, and those listed in the sidebar below, “Sugar, Sweeteners, and Their Other Names.”)

The reason this isn’t so sweet is that 30 percent of Americans are obese, and a diet with a lot of refined foods and added sugars has been shown to pave the road toward obesity and diabetes, a disease that causes the body to have difficulty metabolizing sugar and can lead to blindness, kidney disease, nervous system damage, strokes, and heart attacks.

A study by R. S. McIntyre, MD, and colleagues at the University of Toronto and the University Health Network, Canada, published in the Annals of Clinical Psychiatry found that those who have bipolar disorder may be three times more likely to have diabetes than those in the general population.

Excessive weight gain puts people at risk for developing diabetes. Since some prescribed antipsychotic medications have been linked to weight gain, it is important to exercise and follow a healthy diet that is low in sugar and high in fruits, vegetables, whole grains, beans, soy, lean meat and poultry, low-fat dairy, and healthy fats like the omega-3s—as found in salmon and walnuts.

Sweet Emotions?

Perhaps not. A study published in Depression and Anxiety has shown that countries with a higher sugar intake appear to have a higher rate of depression. A. N. Westover, MD, University of Texas Southwestern Medical Center, Dallas, Texas, and L. B. Marangell, MD, Baylor College of Medicine, Houston, Texas, compared data from the major depression and bipolar disorder study with sugar consumption rates and found that countries with a higher sugar intake appear to have a higher rate of depression. If you are struggling with bipolar depression, it may be time to take a closer look at your diet. A decrease in the amount of the sweet stuff may improve your mood.

Sweet Nothings…

Excess sugar and sweeteners commonly used in processed foods have been linked to not only tooth decay, abnormal triglycerides (which are blood fats associated with heart disease), obesity, bone loss, and fractures, but also an inadequate diet. Sugar has basically no vitamins or minerals, yet it has calories, since it is a simple form of carbohydrate. And beware: Sugar and sweeteners come in various forms and sneaky names (see sidebar), none of which have ever been known to enhance health and prevent disease, yet quite often have been implicated in contributing to poor health.

Sugar, Sugar, Everywhere!

According to the dietary guidelines issued by the US Department of Health and Human Services, “the greater the consumption of foods containing large amounts of added sugars, the more difficult it is to consume enough nutrients without gaining weight.” A study in the Journal of the American Dietetic Association ranked the various sources of added sugar and sweeteners in the diet.

The main contributor is regular soft drinks, followed by table sugar, candy, cakes and cookies, fruit and sports drinks, sugary dairy products like ice cream, sweetened yogurt and flavored milk, and grains with added sugar such as cereals and cinnamon bread. Indeed, regular soft drinks account for 33 percent of all added sugar consumed.

In an important study by Shanthy A. Bowman, PhD, of the US Department of Agriculture, published in 1999 in Family Economics and Nutrition Review, study participants were divided into three groups based on the amounts of added sugar in their diets. It was found that the group eating the most sugar had the lowest intakes of important nutrients such as vitamin A, vitamin C, folate, vitamin B12, calcium, phosphorus, magnesium, and iron. Furthermore, according to Betsy Oriolo, MS, RD, LD, CDE, a registered dietitian who has conducted an intensive review of the science supporting a good diet for those who have bipolar, many of these nutrients are necessary for good nutritional management of bipolar.

High Fructose Corn Syrup = Calories

One of the most commonly used substitutes for cane sugar is high fructose corn syrup as it is less costly, and according to the Corn Refiners Association, offers enhanced shelf stability, a softer texture, and superior browning in baked goods. It is made from corn and used as a sweetener in many soft drinks and many processed foods. A recent study published in 2005 in the American Journal of Clinical Nutrition with lead author Sharon Elliott, PhD, El Dorado County Public Health Department, California, found that the consumption of fructose, which is a component of added sugars and high fructose corn syrup, leads to decreased production of leptin in the body. Leptin signals the brain that we are full after eating. Hence, an increased consumption of fructose in processed foods and sodas, can lead to weight gain because there is less leptin produced to signal to the body that feeling of fullness as it would after a meal consisting of fiber, vitamins, and minerals.

Sweet Advice from Registered Dietitians

In a 2005 Australian study, Sherryn Evans, a dietitian at Frankston Hospital in Australia, and colleagues reported that those taking a frequently used atypical antipsychotic drug to treat bipolar disorder, who received six nutrition counseling sessions gained much less weight than those taking the same drug but who did not receive nutritional counseling. Seeking the advice of a registered dietitian can help you develop a healthy eating plan to help prevent or reduce weight gain. Following are some tips from registered dietitians:

Kathryn Fink, RD, LD, a senior nutritionist at Timberlawn Mental Health System in Dallas, Texas, says that her new clients have diets containing a lot of sugar and sweeteners. She emphasizes portion control and shows clients that if they do nothing different but cut out excess sugar, their weight could go down by as much as two to three pounds a week, depending on the volume of the beverages and snacks consumed. She also cautions against drinking excess juice, since the calories can add up quickly.

Drink water or dilute your beverage,” she says. Mixing a quarter cup juice with three quarters cup plain or carbonated water can give you lots of taste satisfaction with a fraction of the calories.

Fink explains that sugar can affect mood and describes a roller-coaster effect from eating sugary foods: A sugar high is temporarily felt and this can result in the jitters or a temporary energy surge followed by an energy drop and feelings of lethargy. For those who have bipolar, she says, “This can accentuate their mood symptoms and make them feel worse.” She notes that some people are more sensitive than others to sugar and that those with a poor diet (i.e., low vegetable and fruit intake and high junk food consumption) tend to be more sensitive.

Over the past year, Karen Terrell, a stay-at-home mom who has bipolar, followed Fink’s advice, losing 35 pounds of the 60 pounds she gained since her diagnosis in 2000. She now consumes less sugar and soda, drinks more water, and reports that she has a much better mood most of the time. As for using artificial sweeteners, Fink recommends that moderation is key.

Mary Emerson, MS, RD/LD, clinical dietitian of Spring Harbor Hospital in Maine, notes that some medications to treat bipolar may cause “dry mouth,” leading many to drink sugary beverages. She suggests eating moist low-calorie foods, such as an orange or a piece of fruit, to help treat this medication side effect. The orange adds filling fiber as well as a range of vitamins and disease-preventing phytochemicals (plant nutrients), without the added calories of sugary beverages.

When cutting down on one type of soda, Emerson suggests switching to a diet soda of a different color or flavor. She also notes that switching to Pepsi One (which is low in calories), or other diet drinks sweetened with Splenda (or sucralose) may be helpful if you are a cola drinker.

To lower sugar intake, Emerson instructs her clients to focus on eating structured meals and making sure they are getting enough protein. She says, “A bag of chips is not a meal and the fewer processed foods in the diet, the better.” She advises having quick healthy choices available like low-sugar cereals (such as Kashi brand), and prepared fresh vegetables, which are lower in sugar and cost and higher in fiber. She also feels cost savings is a great motivator, saying “Water is free, soda will cost you money!”

Emerson has noticed that when her clients cut out sugar they feel better. She shares a success story of one of her clients who has bipolar and developed diabetes. He is a construction foreman who cut down on sugar and gave up his six-pack-a-day cola habit. He lost 35 pounds over four to five months and reported a tremendous change in how much better he feels.

Terry Girard, MS, RD, LDN, a nutrition consultant to mental health facilities, has noticed that the quality of diet may be impacted by certain medications that increase hunger. There is a tendency to eat whatever is easy to pick up in a convenience store— items that are generally high in sugar and

fat. To ensure a balanced meal, she encourages clients to follow the Food Guide Pyramid [this has since changed to My Plate]. She also recommends taking a multivitamin, which is a good starting point when beginning a healthy eating regimen.

Girard points out that sugar (and sweeteners, such as high fructose corn syrup) are listed in the ingredient label based on weight. If it is one of the first few ingredients on the list, be careful, this food may not be the optimal choice for your health. Keith M. Carmany, RD, CD/N, nutrition services administrator, at St. Lawrence Psychiatric Center in New York, believes that 85 percent of the population he sees has a higher sugar intake than the general population. Carmany believes that a caffeine-and-sugar combo in caffeinated regular soda can have a noticeable negative effect on behavior. He urges not eating candy for breakfast, or cereal that has marshmallows or chocolate in it, as that also spells candy. Carmany recommends eating a high-fiber breakfast food, such as hot oatmeal. One client on a sugar roller coaster due to lots of caffeinated regular soda and junk food (at one time devouring an entire package of Oreo cookies), began following Carmany’s recommended 1,800-per-day-calorie weight loss diet that included no sweets, no seconds, and caffeine only once a day. She increased her fruit and vegetable intake, and has since lost weight and attributes feeling much better to following this diet.

Artificial Sweetners

Switching to products with artificial sweeteners such as aspartame, saccharin, sucralose (Splenda), acesulfame potassium, and neotame, can help decrease the sugar and calories in the diet. However, it is important to use them in moderation as they are contained in processed products, and the key to a healthy diet is eating more foods, such as fruits and vegetables, that are natural, have healing properties, and contribute to optimum health.


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Sugar, Sweeteners, and Their Other Names

Pure white sugar is made from a sugar cane or sugar beet plant, but don’t let the word “plant” mislead you—we are not talking about vegetables here. Sugar goes through a lengthy refining process that includes physical manipulation, adding a chemical, evaporating, and boiling. Other sweeteners are made from other sources. However, they share the similar properties of having empty calories: basically calories and carbohydrates with little or no vitamins or minerals. Look at your labels and try to minimize foods that are high in the sweeteners listed below. Ingredient labels are based on weight, so the sooner you see one of the following ingredients in the list the more you are consuming.

Names of Sweeteners That Appear on Nutrition Labels

Brown rice syrup • Brown sugar • Confectioner’s sugar • Cane sugar • Corn sweetener • Corn syrup • Dextrin • Dextrose • Evaporated cane juice • Fructose • Fruit juice concentrates • Glucose • High fructose corn syrup • Honey • Invert sugar • Lactose • Maltose • Malt syrup • Maple syrup • Molasses • Raw sugar • Sucanat • Sucrose • Sugar • Turbinado sugar

Sugar alcohols*:

  • hydrogenated
  • starch hydrolysates
  • isomalt
  • lactitol
  • maltitol
  • mannitol
  • sorbitol
  • xylitol

*Sugar alcohols are often seen in “No Sugar Added” products and are lower in calories than sugar, but harder to digest and cause digestive discomfort in sensitive individuals.

One Sweet Soda Per Day Leads to 15 Pounds of Weight Gain Per Year

One 12-ounce can of soda a day adds up to more than 50,000 calories a year. In other words, if you were to add one soda a day

to your diet without changing your eating or exercise habits, you would gain about 15 pounds over the year.

So if you are overweight, and consuming soda, sugary drinks, or snacks, cutting back can certainly help you win the battle of the bulge.


Printed as “Sugar: Is It Really That Sweet?” Spring 2006

About the author
Tricia Silverman, RD, MBA, is a registered dietitian and owns Tricia Silverman Wellness, a nutrition and business consulting firm in Dedham, Massachusetts.
8 Comments
  1. Such useful tipps

  2. This is an excellent, well sourced article. So much of the advice, especially about water, diluting juices and sodas is the same as has been given to my by my renal dietitian. I was diagnosed with chronic kidney disease 14 years ago. For many years before that, I had been taking lithium as a mood stabilizer for BP I. I didn’t like the side effects and when some newer medications (Lamictal, etc) were approved, my doctor agreed to switch me. I had been off the lithium for at least five years but my nephrologists (kidney specialists) have attributed my CKD to it the lithium. I had no other common indicators such as high blood pressure or diabetes.

    I was a diet Coca-cola addict, often drinking 6 or more cans a day. Dark sodas, sugar or not, were among the first things my renal dietitian made me stop consuming. It was less the sugar and more the high phosphorus, which is a kidney killer. Phosphorous isn’t required to be placed on nutritional labels in the U.S. I was also told not to drink fruit juices without diluting them -for many of the reasons in the blog but also for the high phosphorous content.

    It’s really, really difficult to change eating and drinking habits, but when you are at the precipice of a dangerous comorbidity like CKD, you have to make difficult choices. In general, a CKD meal plan must consist of low sodium, low phosphorous, low potassium and low protein (in my case about 50g/day). And the mantra is DRINK WATER. It’s what your body craves. Living in the desert has been a pretty good reminder of that for me, too. If you are thirsty, your body is already dehydrated.

    Please, if you are on any psychotropic medication/s, make sure that you have blood drawn at least 3 times a year, especially to monitor your eGFR, which is a measurement of kidney function. Discuss it with your primary care provider. If you have a CKD diagnosis and are in stages 3-5, insurance is required to pay for you to see a nephrologist and dietitian.

  3. Excellent article. I forget about the importance of a good diet and how it helps with Bipolar.

  4. I have added 20 pounds over the course of years on medications. And I’m ok with that – because it’s the best alternative.
    Great article Tricia – serves as a reminder that reduction in salt, oils and sugar is difficult. In my situation – replacing SOS with healthy alternatives has been a lifesaver. It was difficult at first because of the addictive nature of each.
    I’ve replaced oils by instead using natural moisture of vegetables to do the job. Giving up processed foods and cheese was difficult because I love a good sandwich. There are plant based alternatives that actually are satisfying and tasty as well. Sugar is a highly addictive substance and is found in nearly everything. My advice is to be mindful by eliminating processed foods as best you can.
    Portion size – eating breakfast like a prince, lunch like a king and dinner a like a pauper is a strategy and works for me.
    My cousin is a leading contributer in the world of vegan lifestyle. I’d be happy to provide more information on his website where other links may be available that offer insight for health and nutritional wellness..

  5. Thank you for an extremely timely article. I have bipolar disorder with an emphasis on depression. I can really see when I eat too much sugar or carbs that my depression gets worse. I am about to join Weight Watchers, which I heard is great, to.lose 30 pounds and get healthier. I am very excited! Best wishes and congratulations to everyone who makes the decision to change their eating habits and get healthy. Happy New Year!

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