Diet Guidelines Essential to the Treatment of All Diabetics
A new “natural artificial” sweetener, called tagatose (no brand name as of this writing), has been approved for sale in the United States. Derived from milk, it’s claimed to be 92 percent as sweet as sugar, with no aftertaste and no effect on blood sugars. This last claim—that it has no effect on blood sugars—remains to be seen. In many cases, what’s termed “no effect” or “negligible effect” usually has significant enough effect to make blood sugar control difficult.
Another new artificial sweetener, neotame, is being sold as an additive by the makers of NutraSweet. It is supposedly 8,000 times as sweet as table sugar. Its use as a food additive should pose no problems, but if it becomes available to consumers as a powder, it will probably be mixed with a sugar as in the instances cited above.
So-Called Diet Foods and Sugar-Free Foods
Because U.S. food-labeling laws in the recent past have permitted and thus encouraged products to be called “sugar-free” if they do not contain common table sugar (sucrose), the mere substitution of another sugar for sucrose has permitted the packager to deceive the consumer legally.Most so-called sugar-free products have been, for many years, full of sugars that may not promote tooth decay but most certainly will raise your blood sugar. If you’ve been deceived, you’re not alone.
I’ve been in doctors’ offices that have candy dishes full of “sugar-free” hard candies for their diabetic patients! Sometimes the label will disclose the name of the substitute sugar.
Here is a partial list of some of the many sugars you can find in “sugar-free” foods.
All of these will raise your blood sugar.
Some, such as sorbitol and fructose, raise blood sugar more slowly than glucose but still too much and too rapidly to prevent a postprandial blood sugar rise in people with diabetes.
Other “diet” foods contain either sugars that are alternates to sucrose, large amounts of rapid-acting carbohydrate, or both. Many of these foods (e.g., sugar-free cookies) are virtually 100 percent rapidacting carbohydrate, usually flour, so that even if they were to contain none of the above added sugars, consumption of a small quantity would easily cause rapid blood sugar elevation.
There are exceptions:
• Most diet sodas—with some glaring exceptions, so always check nutrition labels and look for 0 under carbohydrate;* so-called sugar-free Slice contains 40 percent “natural fruit juice”
• Sugar-free Jell-O brand gelatin desserts—the ready-to-eat variety, not the powdered mix (see page 157)*
• Da Vinci brand syrups (see page 155)
All of these are made without sugar of any kind. These you need not restrict. See “So What’s Left to Eat?” later in this chapter.
Candies, Including “Sugar-Free” Brands
A tiny “sugar-free” hard candy containing only 2½ grams of sorbitol can raise blood sugar almost 13 mg/dl. Ten of these can raise blood sugar 125 mg/dl. Since sorbitol, for example, has only one-third the sweetening power of sucrose, the manufacturer uses three times as much to get the same effect. This will raise blood sugars three times as much as, although more slowly than, table sugar.
Honey and Fructose
In recent years a number of “authorities” have claimed that honey and fructose (a sugar occurring in fruits, some vegetables, and honey) are useful to diabetics because they are “natural sugars.” Well, glucose is the most natural of the sugars, since it is present in all plants and all but one known species of animal, and we already know what glucose can do to blood sugars. Fructose, which is sold as a powdered sweetener, is often derived from corn (a grain) and is a significant ingredient in many food products (as in high-fructose corn syrup). Honey and fructose, “natural” or not, will raise blood sugar far more rapidly than either phase II insulin release, injected insulin, or oral hypoglycemic agents can bring it down. Just eat a few grams of honey or fructose and check your blood sugar every 15 minutes. You will readily prove that “authorities” can be wrong.
Desserts and Pastries
With the exception of products marked “carbohydrate—0” on the nutrition label, virtually every food commonly used for desserts will raise blood sugar too much and too fast. This is not only because of added sugar but also because flour, milk, and other components of desserts are very high in rapid-acting carbohydrate.
* Looking for 0 under carbohydrate may not tell you everything you want to
know. Also look in the list of ingredients to see if the product contains any of the
sugars listed. If it does, check your blood sugars after drinking, if you choose to drink them, and see what effect they have on you.
* Unfortunately, the manufacturers of sugar-free Jell-O brand gelatin recently started to add maltodextrin to the powdered version. I expect that they will soon add it also to the ready-to-eat version. A suitable substitute would be Knox unflavored gelatin with added liquid stevia and your choice of Da Vinci syrup for flavoring.
Bread and Crackers
One average slice of white, rye, or whole wheat bread contains 12 or more grams carbohydrate. The “thin” or “lite” breads are usually cut at half the thickness of standard bread slices and therefore contain half the carbohydrate. So-called high-protein breads contain only a small percentage of their calories as protein and are not significantly reduced in carbohydrate unless they are thinly cut. Brown bread, raisin bread, and corn bread all contain as much or more fast-acting carbohydrate
than rye, white, or whole wheat. Some diabetics with gastroparesis (Chapter 22) can tolerate the inclusion of 1–2 slices of thin bread or a few crackers as part of their low-carbohydrate meal limits.
Unfortunately, most of us experience very rapid increases of blood sugar after eating any product (bread, crackers, cereals, pastry shells, et cetera) made from any grain. This includes those made from less common grains, such as barley, kasha, oats, sorghum, and quinoa.
Rice and Pasta
Both pasta and wild rice (which is actually not a true variety of rice but another grain entirely) are claimed by some nutrition authorities to raise blood sugar quite slowly. Just check your blood sugar levels after eating them and you’ll again prove the “authorities” wrong. Alternatively, you might try the Clinistix/Diastix test described on page 136. Like wild rice and pasta, white and brown rices also raise blood sugar quite rapidly for most of us and should be avoided. The same is true of rice cakes.