Dr Alan Barclay
Why you don’t need special ‘diabetic foods’
Browse through your average diabetes magazine and you will find a special range of biscuits and cookies, cakes, ice cream, chocolate, lollies and candies that are sugar free or have no added sugar prominently advertised for people with diabetes. As our stalwart myth-buster Nicole Senior says: ‘If you ask anyone walking down the street what they think a diet for people with diabetes should include, chances are the first thing they’ll say is “no sugar”. It’s one of the most pervasive and persistent myths about diet and health ever, I reckon. Yet it is a myth.’ Where did it start?
Back in the 1920s, research by Dr Fred Allen on pancreatomised dogs (very unfortunate dogs whose pancreases were removed) led to the conclusion that glucose was more rapidly absorbed than starch. Not long after, this principle was expanded to include all sugars. Based on this research, low sugar diets were recommended to people with diabetes throughout the world for most of the remainder of the 20th century and doctors began recommending high fat diets for their diabetic patients, because they knew that fat didn’t break down to become blood glucose. Unfortunately, most of the fats that were commonly used were animal fats – high in saturated fat and cholesterol that only hastened the development of heart disease, the most frequent cause of death among people with diabetes. But that’s another story.
Back to diabetic foods, a growth industry. In order to make these foods taste sweet, manufacturers use a range of nutritive sweeteners (e.g., maltitol, mannitol, xylitol, etc...) and non-nutritive sweeteners (e.g., aspartame, sucralose, stevia, etc...). Indeed, with careful formulation they can make these products taste much the same as the regular sugar-sweetened alternative. And to be fair some of them do contain less kilojoules/calories than their counterpart, but usually at a cost – a dollar cost or because they have side effects like wind, bloating diarrhoea, or unpleasant after tastes and unusual textures.
Most diabetic foods, however sweetened, should be saved for special occasions just like other special occasion foods. Just because a food is low in sugar or contains no added sugar does not automatically make it a healthy choice. In fact, many of these foods are still high in kilojoules, saturated fat and highly refined starches, so they will still contribute to weight gain, elevated blood cholesterol and glucose levels just like their regular biscuits/cake/cookie counterparts if eaten regularly and/or in excess.
In terms of both your health and mental wellbeing, it makes much more sense to enjoy a small amount of traditionally sweetened food on an occasional basis and to really enjoy its full flavour and texture, than consuming large amounts of a poorer quality substitute on a regular basis. The most recent food and nutrition position statement from the American Diabetes Association says ‘… intake of sucrose and sucrose containing foods by people with diabetes does not need to be restricted because of concern about aggravating hyperglycemia [high blood glucose]. Sucrose can be substituted for other carbohydrate sources in the meal plan or, if added to the meal plan, adequately covered with insulin or another glucose lowering medication.’
What to do? Read the ingredient list and remember Michael Pollan’s key food rules: ‘Don’t eat anything your great grandmother wouldn't recognise as food (rule 2); Avoid food products containing ingredients no ordinary human would keep in the pantry (rule 3); Avoid food products containing ingredients a third-grader cannot pronounce (rule 7).’
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For more information about the GI Symbol Program
Dr Alan W Barclay, PhD
Chief Scientific Officer
Glycemic Index Foundation (Ltd)
Phone: +61 (0)2 9785 1037
Mob: +61 (0)416 111 046
Fax: +61 (0)2 9785 1037