10
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.
carob
honey
saccharose
corn syrup
lactose
sorbitol
dextrin
levulose
sorghum
dextrose
maltodextrin
treacle
dulcitol
maltose
turbinado
fructose
mannitol
xylitol
glucose
mannose
xylose
molasses
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.
Get Adobe Acrobat Now