This has been source of confusion for a very long time.
I remember asking questions about it when I was a brand new post op in 2001, more than 20 years ago - and even today there are many questions as to whether or not we are making the right choices when it comes to sugar when we are talking dairy.
Remember asking this next question?
"My doctors office told me to get sugar free yogurt, but all the yogurt has sugar, even the plain kind!"
or "OMG, canned tomatoes are NOT sugar free... now what?"
I am going try and make this easy so no ones's head explodes - we have enough to learn as new bariatric post-ops. Food labels lump together all forms of sugar under Carbohydrates.
There are two forms of sugar in the food we eat.
There is *natural sugar* in fruits and even vegetables called fructose and in dairy products called lactose - then there are ADDED sugars - white, brown or powdered sugar as well as high fructose corn syrup, maple syrup or honey in many processed or convenience foods. You can tell them apart by reading the list of INGREDIENTS on the label just under the Nutrition Facts box.
Locate the *Ingredients* list on the food label. Trick is to differentiate between ingredients that add sugar (high fructose corn syrup or sucrose) and ingredients that have natural sugar that is inherent in the raw or base food.
A can of HUNTS TOMATOES will show grams of sugar on the label even though it only contains only tomatoes because tomatoes have natural sugar. It's okay to eat 10g of sugar in a tomato but its NOT okay to eat 10g sugar in candy - see the difference there?
It may take some learning on your part to recognize sources of added versus natural sugars and may be a bit confusing at times because fructose is also used as an added sugar. (when you see grape juice concentrate as first ingredient in a Bolthouse Farms 100% Juice Blueberry drink, that would be fructose used as an *added sugar* and that's not cool)
When you look at the label of a container of yogurt, pull the source of that sugar by looking at the Nutrition Stats and then Ingredients to determine whether that 11 grams of sugar is natural sugar from the milk, OR added high fructose corn syrup OR sugar added as a sweetener. Plain Greek yogurt can contain 8 to 15 grams of natural sugar from the lactose - often called milk sugar - in the milk used to make it, however it also brings 10 to 15 grams of protein to the party and therefore is a good food choice.
As bariatric patients we are trying to avoid added sugar. This is why blueberries cooked and lightly sweetened with Truvia are perfect to blend into our super high protein Greek yogurt even though the blueberries contain some natural sugar. The 2 tablespoons of homemade cooked blueberry sauce will contain 4 grams of natural sugar but the antioxidant value and nutrients make it a great choice to sweeten and flavor our plain Greek yogurt.
A glass of fat free milk used to be looked at as poison back in the early bariatric days... but over time it has come to light that the vitamin D and natural form of Calcium provided by the milk, makes it a good choice for the 100 calories one spends by drinking it. The 11 grams of sugar is not added sugar - it is once again the lactose, the natural sugar in milk. A cup of milk a day is not the bad thing we once thought and said it was. It's not calorie free, but it brings nutrition to the party!
Its all balance. Empty calories are a NO, but nutrient rich calories are a yes!