So What’s Low Carb? Chapter 4 Part 4

Articles - Dr. Bernstein Shares His Insights

Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S has part 4 of the So What’s Low Carb for you

The Diabetes Diet
Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S.

Chapter 4
HOW DO PEOPLE REACT TO THE NEW DIET?

Most of my patients initially feel somewhat deprived, but they are also grateful to feel more alert and healthier —sometimes more so than they have in years. I fall into this category myself. My mouth waters whenever I pass a bakery shop and sniff the aroma of fresh bread, but I am also grateful simply to be alive and sniffing.

Part 4 of Chapter 4
See all parts here

So What’s Low Carb?


Artificial Sweeteners

Using artificial sweeteners other than “to taste” can be a little tricky. Such products can range from 30 times as sweet as sugar (cyclamate) to 8,000 times (neotame). Some break down in cooking, such as aspartame, which should be added after cooking or used only with cold food or drink. And some break down partially — Splenda retains 90 percent of its sweetness. Since none have the bulk of table sugar, in their powdered form they often are bulked up, frequently with dextrose (glucose) or maltodextrin, which are other sugars.

Some have an aftertaste, but sensitivity to it seems to vary from person to person. I like stevia, but you may find saccharin more appealing. Many people who cook with artificial sweeteners recommend blending them with saccharin to keep costs down.

Some desserts or treats are easy to make to taste, but others, particularly anything you’re investing time in or that requires elegant presentation, really requires a level of predictability. When I make my pumpkin pie filling dessert with cinnamon and stevia, I do it to taste — I put the ingredients together and add stevia until its sweetness suits my palate.

The best advice I can give is that if you have a sweet tooth, use the rules of thumb presented below, and experiment. Until you are certain you have repeatable results, have some of the sweetener handy when you serve your treat in case it doesn’t quite live up to your mouthwatering expectations. (The wavy equal sign @ means “approximately equal to.”)

Aspartame. Equal tablets are said to be about 300 times as sweet as table sugar, and they have no added bulking agent, such as maltodextrin or dextrose (although the powdered form in packets does). Tablets are equivalent to half the sweetening power of the packets and come in a 100-tablet dispenser that can fit in purse or briefcase.

1 Equal tablet @ 1 teaspoon sugar in sweetening power

Acesulfame-K. Sunette or The Sweet One is said to be about 200 times sweeter than sugar, but it is not available in a liquid or tablet form. The powder contains the usual dextrose or maltodextrin additives for bulk. Its lack of availability without added sugar and its somewhat controversial status as a potential carcinogen make it less desirable than others. (Saccharin has been around for more than a century and has never been associated with cancer.)

Stevia. Stevia is the extract of an herb known by a variety of names, such as sweet herb. It comes in powder or liquid forms and is the only noncarbohydrate powdered sweetener that does not have added dextrose or maltodextrin. Extracts may vary in their sweetening power, depending on the maker.

Green stevia is less expensive than white, but to me the green has an unpleasant taste. If you can grow sweet herb, drying the leaves and using them in your tea, for example, can be a low-cost option.

Cyclamate. Cyclamate is said to be 30 times sweeter than sucrose. Available in other countries under brands such as Sucaryl, cyclamate contains no calories. Sucaryl tablets and liquid, from Abbott Laboratories, contain cyclamate and saccharin.

1 Sucaryl tablet @ 1 teaspoon of sugar in sweetening power

Saccharin. Saccharin is currently the least expensive of the artificial sweeteners. Saccharin is more than one hundred years old and so is available under a number of brands, in 1/2-grain and 1/4-grain tablets and in inexpensive bottles of up to 1,000 tablets. You can also get bottles of saccharin liquid. Both 1/4-grain tablets and the liquid form are available under the Sweet’n Low brand name.

1 Sweet’n Low tablet @ 1 teaspoon sugar in sweetening power
10 drops Sweet’n Low liquid @ 1 teaspoon sugar in sweetening power
2 tablespoons Sweet’n Low liquid @ 1 tablespoon sugar in sweetening power


Sucralose (Splenda). Like other tabletop sweeteners except stevia, Splenda granular and packet products contain bulking ingredients — dextrose and/or maltodextrin, which are sugars. Splenda concentrate is available in the United States only to bulk manufacturers; the Splenda that sweetens Da Vinci syrups has no added dextrose or maltodextrin.

Da Vinci Gourmet Syrups
Da Vinci Gourmet makes a wide variety of sugared and sugar-free syrups. You can use the sugar-free variety (sweetened with Splenda) for everything from flavoring and sweetening yogurt to adding some pizzazz to your coffee, to adding flavor to your salad dressing or recipes. In my opinion this is the best product of its kind on the market. It’s available from several Web distributors, including www.netrition.com and www.davincigourmet.com, and from Trotta’s Pharmacy. Internet prices range from $7.49 to $8.95 for a 750 ml bottle. Da Vinci currently produces a wide variety of flavors, including banana, blueberry, caramel, cherry, chocolate, coconut, cookie dough, pancake, cola, vanilla, peanut butter, watermelon, and many more. I like to sometimes mix the toasted marshmallow syrup into my morning omelet. For a list of distributors, phone Da Vinci Gourmet, Ltd., at 800-640-6779. The product is certified kosher.

Flavor Extracts
There are numerous flavor extracts (vanilla, rum, orange, etc.) used in baking that you can use to make your food more interesting. They usually can be found in small brown bottles in the baking supply aisles of supermarkets. Read carbohydrate content from the label. Usually it’s zero and therefore won’t affect your blood sugar.

Mustard, Pepper, Salt, Spices, Herbs
Most commercial mustards are made without sugar and contain essentially no carbohydrate. This can readily be determined for a given brand by reading the label or by using the Clinistix/Diastix test. Pepper and salt have no effect upon blood sugar. Hypertensive individuals with proven salt sensitivity should, of course, avoid salt and highly salted foods (see page 439 in Dr. Bernstein’s Diabetes Solution, 2003 edition). Most herbs and spices have very low carbohydrate content and are used in such small amounts that the amount of ingested carbohydrate will be insignificant. Watch out, however, for certain combinations such as powdered cinnamon with sugar. Just read the labels.

Too Be Continued in Part 5 (Low-Carbohydrate Salad Dressings, Nuts, Sugar-Free Jell-O, Chewing Gum, and Truly Low Carbohydrate Desserts, Diet Sodas, Coffee and Alcohol) will be discussed)


We would like to thank the publisher Little Brown and Company and Dr. Richard K. Bernstein, for allowing us to provide excerpts from The Diabetes Diet.

Copyright © 2005 by Richard K. Bernstein, M.D.
All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without permission in writing from the publisher, except by a reviewer who may quote brief passages in a review.

Author’s Note
This book is not intended as a substitute for professional medical care. The reader should regularly consult a physician for all health-related problems and routine care.

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Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S.

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Richard K. Bernstein, M.D., is recognized as one of the foremost experts on diabetes and its complications. His private practice in Mamaroneck, New York, is devoted solely to diabetes and prediabetic conditions.

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