March Madness: Nutritional Final Four Tips

Final Four Exit: “Cane Sugar > HFCS”

Many voices in the health community advocate for reducing added sugar overall, often positioning cane sugar as the superior alternative. This is because it is perceived as more “natural” and less likely to be found in ultra-processed foods. It’s also the source of the popular notion that Mexican Coke is more favorable, as it uses sucrose instead of high fructose corn syrup (HFCS). But is it really healthier?

Not quite.

Chemically speaking, cane sugar (sucrose) consists of equal parts glucose and fructose, bonded together. In contrast, HFCS—specifically HFCS-55, the version commonly utilized in beverages—contains about 55% fructose and 45% glucose, but these sugars are unbound. Your body breaks down sucrose into the same two components, making the metabolic effects very similar.

But why is HFCS often vilified?

Part of the reason is rooted in history. Early animal studies suggested that high fructose consumption could negatively impact metabolism, raising significant alarms. However, human physiology differs from that of rodents, and when controlled trials in humans were conducted, these metabolic disparities were not present.

A notable example is a rigorous, double-blind 2021 clinical trial funded by the NIH, where healthy adults consumed drinks sweetened with either HFCS or sucrose. Both groups showed similar adverse effects, such as increased liver fat and decreased insulin sensitivity. The study confirmed that there was no significant difference between the two sweeteners. This is one of the most rigorous comparisons available.

While concerns regarding high fructose intakes are valid—linking it to issues like obesity and Type 2 diabetes—the idea that HFCS is uniquely harmful compared to cane sugar doesn’t hold up against controlled data.

Final verdict: it’s the same game dressed in different labels.

Thus, the “Cane Sugar > HFCS” argument exits the bracket.

Final Four Exit: “Fewer Ingredients = Healthier”

A popular mantra among health advocates is the call to eat “real food” and steer clear of ultra-processed items. I wholeheartedly agree! However, there seems to be little consensus on what precisely constitutes ultraprocessed food. Defining it by ingredient count is one approach. If a food has fewer than a certain number of ingredients, it qualifies as real food; otherwise, it falls into the ultraprocessed category. Yet, this is a slippery slope.

Take sandwiches, for instance. They range from simple two-ingredient combinations (like bread and cheese) to elaborate creations with numerous components. A more complex sandwich might have far more than a handful of ingredients, and that can often be a positive thing. A sandwich with fewer than five ingredients might be considered rather disappointing.
True enthusiasts may even argue that each sandwich component should contain fewer than a certain number of ingredients, leading us down an endless rabbit hole. Now, consider a single ingredient, like an apple. While it appears straightforward,an apple contains a myriad of naturally occurring compounds (such as catechin, epicatechin, and even cyanide). If we counted all these, it would appear highly processed by our earlier definition.

Moreover, the idea that fewer ingredients equates to higher quality overlooks the fact that some single-ingredient items can be harmful. Arsenic, lead, or hemlock are all examples of “natural” compounds. Even cyanide can be found in that seemingly innocent apple mentioned earlier.

While the concept of fewer ingredients may sound appealing in theory, the argument weakens significantly upon closer examination.

Consequently, Team “Fewer Ingredients = Better” makes its Final 4 exit.  

Runner-Up: Protein Maxxing

The average American consumes sufficient protein, and tangible evidence shows that protein deficiency is rarely a widespread issue in the U.S. That said, discussions arise regarding specific needs for certain individuals, like athletes or those on weight-loss medications.

“Concerns about protein intake typically surface in cases of undereating or when someone is on a weight-loss regimen. Individuals on restrictive diets or medications often skip meals, resulting in insufficient protein intake and greater muscle mass loss, which is not the desirable type of weight loss.”

—Kristi Wempen, RDN, LD, Mayo Clinic Health System

While protein marketing has exploded into some odd products (hello, Protein Cold Foam Coffee!), trends come and go, and companies often cash in on these fads. Most individuals consume adequate protein, so it’s essential to question whether you need to spend extra on protein-enhanced items. In most cases, the answer is no. However, given that this trend promotes eating balanced meals rich in fruits, vegetables, and lean proteins, it is relatively harmless.

Though a commendable contender, Protein Maxxing cannot take the crown. It finishes as the runner-up.

Champion: Fiber Maxxing

At its essence, “fiber maxxing” involves deliberately increasing dietary fiber intake, which comprises plant parts that our bodies cannot digest but are loved by our gut microbes. This includes foods like oats, beans, lentils, fruits, vegetables, nuts, seeds, and whole grains. Unlike other contenders, this approach is rooted firmly in science.

The average American consumes roughly 15–18 grams of fiber daily, whereas recommendations suggest around 25 g/day for women and 38 g/day for men. This discrepancy is part of the reason fiber has been identified as a public health concern.

Fiber wins the bracket due to its remarkable array of benefits:

• Gut health: nourishes beneficial microbes, enhancing the microbiome
• Metabolic health: stabilizes blood sugar and boosts insulin sensitivity
• Heart health: reduces LDL cholesterol and improves overall blood lipids
• Satiety: promotes feelings of fullness, aiding in energy management
• Digestive function: encourages regularity and lowers the risk of constipation

Mechanically, fiber’s benefits stem from properties like viscosity (creating gels that slow digestion) and fermentability (feeding gut bacteria to produce beneficial compounds like short-chain fatty acids).

Numerous meta-analyses consistently demonstrate that higher fiber consumption correlates with lower risks of cardiovascular disease, type 2 diabetes, certain cancers, and even overall mortality.

A comprehensive umbrella review covering 33 meta-analyses and about 17 million participants provided compelling evidence linking high fiber intake to reduced cardiovascular mortality, a decreased risk of coronary heart disease and type 2 diabetes, and suggestive reductions in several cancers and strokes.

Of course, nuances exist, as fiber is not universally beneficial. Some individuals with conditions such as irritable bowel syndrome or inflammatory bowel disease may need to recalibrate their fiber types or amounts, particularly during flare-ups. Transitioning abruptly from very low to high fiber intake can lead to symptoms like bloating.

However, these situations require careful adjustment rather than justification for eliminating fiber altogether.

Final verdict: Fiber Maxxing is not merely a trend—it represents a unique alignment of scientific research and popular enthusiasm.

Congratulations to this year’s champion: Fiber Maxxing!