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For those trying to lose weight or “get in shape” for the New Year (number one resolution), a better understanding of the role sugar plays in your diet and overall health may be valuable. You have probably noticed a lot of attention being paid to sugar lately. Many television stars, like Ellen DeGeneres, have shared their experiences using a “sugar cleanse” when they need to lose a few pounds and get healthier.  I have had several patients and friends tell me the same thing.

For 4-6 weeks these people decide to avoid all refined sugars with the goal of losing weight and improving their health and wellness. Well, what is all the fuss about? Terms like simple sugars and simple carbs, which are purported to be bad, and complex carbs, suggested to be good, are being used ad nauseam. While medical research does not support the value of a short term “sugar cleanse,” it may have value for another reason. For example, it would be very beneficial if one engages in a “sugar cleanse” for the purpose of changing their palate with the hope of developing long term healthy eating habits, especially for those with diabetes.

So, with this in mind, I decided to find the answers to some simple questions about the fuss over sugar. What is a simple sugar? What is a complex sugar? Which sugars are good for you?


Sugars, along with starches and fibers, are one of three types of carbohydrates (also referred to as a carb). A carb is “simple” or “complex,” based on its chemical composition and how it is processed in the body. It gets a little complicated because some foods have both simple and complex carbs.  Typically, simple carbs are chemically more “simple” and basic, and therefore they are broken down more easily and serve as a quick source of energy. Some of these carbs are naturally simple (like fruit and milk) while others are processed or refined sugars such as those used in candy, soda and baked goods.

It is Good Sugar or Bad Sugar?

To determine if a food product has good or bad simple sugar, you must also know how much fiber, vitamins and minerals are in the food. A food with a higher sugar content combined with a low fiber, vitamin or mineral content will be worse than  a food with the same sugar content but high fiber and vitamins or minerals. For example: a candy bar, which is high in sugar without fiber or vitamins or minerals, is not as healthy as a fresh orange, which contains fiber, vitamins and minerals along with its simple sugar (fructose).

Examples of simple carbs:


Complex carbs have a more complicated chemical makeup and take more time for the body to break down for use as energy. Therefore, these are considered “good” carbs because they provide a more even distribution of energy for the body to use during activity. They cause a more consistent and gradual release of sugar into the blood stream (as opposed to peaks and valleys caused by simple carbs) and provide energy to function throughout the day. Additionally, “good” carbs have the added benefit of providing vitamins, fiber, and minerals that are missing from simple carbs.

Examples of complex (carbs):


Remember that carbohydrates fuel the body and are an important source of energy, especially for active and athletic people. However, carefully selecting the type of carb you eat is critical to peak function and performance.

Simple Carbs

Complex Carbs


Sources:;; Mayo Clinic

Visit your doctor regularly and listen to your body.

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”  

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.

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82 million adults spend an estimated 28 billion dollars on gym memberships each year! WHY? There are many reasons we exercise. Some people exercise to prevent illness such as cardiovascular disease or osteoporosis. Others exercise for mental health and as a stress release; others do it to improve strength, flexibility, and endurance to prepare for a sport. However, the number one reason people exercise is TO LOOSE WEIGHT!

When it comes to losing weight, patients have asked me a wide variety of questions over the years. However, certain questions are consistent. “What exercise is the best to burn calories?” “Even though I exercise 2-3 times per week, why can’t I lose weight?” “What is BMR?” “If I eat a Snickers bar, how much exercise do I need to do to burn it off?” “Are there any tools that I can use to help me track my calories and exercise output?”

Which Exercise is the best to burn calories?

Have you ever heard people say that they never felt better or burned more calories as they did when they ran? Well, they may be right! The following numbers are based on the average male weighing 150 pounds: running 6 miles per hour will burn 700+ calories (11-12 calories per minute); vigorously skipping with jump rope or fast cycling will do the same; vigorous walking at 4 miles per hour and moderate biking will burn 600+ calories (10 calories per minute). The 400-500 calorie club includes the following activities: slow jogging, swimming, football, basketball, baseball, tennis, skiing, and moderate walking (3.5 miles per hour).  Light gardening burns more calories than golfing using a cart (250 vs. 180).

Why you may not lose weight even though you exercise? What is BMR?

How many times have you heard people say, “It is hard for me to lose weight because I have a slow metabolism?” What does that mean? To explain this in detail you first must understand BMR. BMR is basic metabolic rate. It is the number of calories that your body requires to operate basic body functions that you don actively control, such as continuing to breathe, and keep your cells and organs working each day. The BMR is influenced by age, height, gender, body fat, and fitness level. BMR is inherently different (high or low) in each individual. While you can’t change your gender or height, you can influence some things to influence your BMR and burn more calories at rest. One, exercise for longer durations, with greater intensity and more frequently. Two, lower your body fat by eating less calories, especially fat and carbohydrates in your diet. Simply, eat less calories than you burn! Three, improve you muscle/fat ratio by weight training.

Basic Metabolic Index (BMI):

BMI:           < 18.5  = Underweight

BMI:   18.5 – 24.5  =  Normal Weight

BMI:    25.  -  29.9  =  Overweight

BMI:            >30.    =  Obestiy

For example, I am a 57 year old male, weighing 150 pounds at 5 feet 8 inches tall with a BMI of 22.8

*Calculate you BMI by entering you gender, height and weight and find how many calories per food item at:

Are there any tools for tracking calories and exercise?

There are several tools available for free online to help with tracking calories and exercise visit Prevention Magazine at: or try the App “Lose It”

BMI Calculator – to calculate your BMI

Calorie Burner – to calculate how many calories are burned with various activities

Daily Calorie Calculator – Find how many calories are in specific foods and what you need to do to loose or gain weight.

So remember, the number one reason we exercise is TO LOSE WEIGHT! But depending on exercise alone to lose weight is an exercise in futility. Losing weight is an intelligent and consistent combination of a balanced diet with portion control, proper nutrition, adequate exercise and activity grounded in lifestyle changes.

Read Dr. Mackarey’s Health & Exercise Forum – every Monday

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor  in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.