TABLE 5.

Goals for Reducing Intake of Added Sugars

Goal: Assess total consumption of added sugars and types of foods and beverages.

Questions to ask:

1. List all of the beverages you drink (and the amounts) on a given day from the time you wake up until you go to sleep. (Follow-up: What do you add to hot and cold beverages such as coffee and tea?)

2. How many times a day (or week) do you eat sweets? (Follow-up: What types of sweets and in what amounts?)

3. Can you tell me what a few of the names are for added sugars on food and beverage ingredient labels? (Table 1 provides a list. Make this a handout and have a couple of representative products with nutrition facts and ingredient lists available to illustrate further.)

Goal: Assess knowledge and use of LNCS.

Questions to ask:

1. What are your thoughts about using LNCS (sugar substitutes) instead of sugar or other calorie-containing sweeteners? (If the response does not accurately reflect the science, attempt to offer accurate information.)

2. What are a few ways you could use LNCS to reduce the amount of sugars you eat and drink? (Use content in Table 4 to illustrate the calories and grams of carbohydrate saved when using LNCS rather than added sugars in beverages.) If the patient states that he or she does not use LNCS because they are not natural, you may note that there are now a variety of natural LNCS that may suit their product and taste preferences.

3. Tell me where you would find LNCS (sugar substitutes) in the supermarket?

4. What is the best way for you to find LNCS (sugar substitutes) that taste most like sugar?

Goal: Set a few small changes to reduce added sugars before the next appointment.

Question to ask:

1. What are two or three small changes you are willing and able to make to reduce the amount of added sugars you eat and drink?

Note: It is crucial to have patients write out or state their goals. PCPs should make a copy for or record their goals in their electronic health record. At the next appointment, ask about how successful they were with their goals. Having you spend a few minutes on this topic conveys an imperative to patients and sets expectations. Asking about their progress at the follow-up appointment increases this imperative.