Problem Foods
Avoid all ‘stressor’ foods that rob the body of nutrients rather than providing nourishment for it. These include sugars, soda pop, refined grains and flours, pastas, processed fats, hydrogenated fats (trans fatty acids), and all processed foods, including white rice. These foods disturb the physiology of the body, they inhibit the normal essential fatty acid metabolism, they affect liver function, and they alter cholesterol levels.
High Glycemic Sugars
Sucrose
Avoid refined sugars (sucrose) because they increase blood sugars rapidly, decrease immune functioning, increase heart disease, promote dental caries, provide no nutrition, and contribute to hyperactivity in children. In addition, soda pop is high in phosphates, thus depleting calcium and contributing to osteoporosis.
Glucose and Dextrose
Dextrose is a form of glucose. Both are commonly listed on food labels. Glucose has a higher glycemic value than sucrose, and is used as a benchmark value of 100 on glycemic indexes. Both dextrose and glucose should be avoided in order to control blood sugars.
High Fructose Corn Syrup
This high glycemic sweetener is manufactured from corn starch. It is found in a wide variety of commercial products and should be differentiated from fructose, which is a low-glycemic sweetener. There is some controversy as to the safety of consuming large amounts of high fructose corn syrup over time. Many of the negative studies of fructose used high fructose corn syrup, rather than pure fructose. This sweetener cannot be recommended for diabetics.
Lactose
Also known as milk sugar, lactose falls about halfway between sucrose and fructose on the glycemic index. It should be avoided in adults because of the prevalence of lactose intolerance.
Honey
Formed by an enzyme from nectar, honey is a combination of fructose, sucrose, glucose, and maltose. It not a low-glycemic sweetener. Although honey contains trace amounts of minerals and vitamins, it should be used only sparingly by diabetics.
Fructose
Fructose, also known as fruit sugar, is actually sweeter than table sugar, but the glycemic value of pure fructose is only 20 (compared to 100 for glucose). Fructose metabolizes at a slow rate, helping to control insulin surges. However, there is some concern that excessive use of fructose (more than 20% of total energy intake) may lead to elevated triglycerides. Recent research indicates that some people may be intolerant to fructose resulting in diarrhea. This reaction is common after the consumption of large amounts of fruit.
Sugar Cravings
Sugar cravings are often associated with disease conditions and nutrient deficiencies or imbalances:
- Candida albicans (chronic fungal infection) in the gastrointestinal tract, vagina, or skin
- Other chronic infections
- Eating the wrong fats
- Grains eaten without prior soaking
- Eating too few or too many animal foods resulting in an imbalance of protein and carbohydrates
- Mineral deficiencies
- Using MSG, aspartame, or too much salt
- Eating too many high glycemic index foods
- Stress and adrenal gland problems
- Imbalanced thyroid function
Clinical Studies: Artificial Sweeteners, Stevia, and Sugar Alcohols
Artificial Sweeteners
As North Americans continue to consume pounds and pounds of sugar, diabetics are constantly searching for alternative sweeteners that won’t affect their blood sugar levels. Unfortunately, the most heavily endorsed sweeteners in North America have all been associated with health risks, and many have since been removed from the market. Even aspartame, currently touted as a safe sweetener, has been linked to a variety of side effects, including migraine headaches, memory loss, slurred speech, dizziness, mood disorders, stomach pain, and seizures. Its chemical component is further known to affect brain cell function and may be connected to the development of brain tumors.
To produce sucralose, another artificial sweetener, chlorine molecules are substituted for sucrose hydroxyl groups. Although sugar is used as its base, sucralose is actually a chemically-altered non-caloric sweetener. Because of its chlorine content, this sweetener raises concerns. There are no studies of its safety in long-term consumption by humans.
Stevia
Amid this controversy, a centuries-old natural herb called stevia is emerging as a safe sweetening option. This non-caloric herb is considerably sweeter than sugar – as much as 400 times – but has no effect on blood sugar levels.
Native to Paraguay and Brazil, stevia is now cultivated around the world. It is widely available in health food stores and most supermarkets. A variety of products are now available using stevia as a sweetener, including teas, syrups, toothpastes, and powdered protein supplements. Pure stevia is available in powdered and liquid forms. It is a heat-stable replacement for other sweeteners in recipes. Stevia-specific recipes and cookbooks are available for those individuals interested in exploring its use in cooking and baking.
In North America, stevia is categorized as a dietary supplement, which is the reason that it is not commonly used as a sweetener in drinks and food products. However, there is mounting support for its widespread approval as more and more people become aware of its long history of safe use as a non-caloric sweetener.
Stevia and its derivative, stevioside, are nontoxic. There is no evidence of any adverse effects of stevia use. One study examined the effects of stevia on rats over a 2-year period. When tested for growth, food utilization and consumption, general appearance, and mortality, there was no difference between the group that was given stevia and the control group. Another study examined if there was any carcinogenic effect associated with the use of stevia. For 108 weeks, stevia was added to the diets of rats of both sexes. The researchers concluded that stevioside had no carcinogenic effect on the rats. Additional studies have revealed that stevia has a very low toxicity risk and that it is allergy-free.
Stevia offers a number of additional therapeutic advantages to sugar and artificial sweeteners. Researchers in Denmark supplemented the meals of 12 Type II diabetics with stevioside and concluded that stevioside reduces postprandial blood glucose and may offer enhanced glucose metabolism. An earlier study indicated that insulin secretion could be stimulated by stevioside’s effect on beta cells, offering promising potential in the treatment of NIDDM.
One group of researchers examined the mechanism by which stevia regulates blood sugar. Their results indicate that stevioside regulates blood glucose levels by enhancing insulin secretion and insulin utilization. This may be linked to a decreased PEPCK gene expression in the liver by stevioside’s action of slowing down gluconeogenesis. More research in this area is warranted.
Sugar Alcohols
Sugar alcohols, also know as polyols, are commonly used as sweeteners and bulking agents in processed foods. They occur naturally in natural plant products, such as fruits and vegetables. Although they share a similar name, sugar alcohols and alcoholic beverages do not have the same chemical structure. Sugar alcohols do not contain any ethanol, which is found in alcoholic beverages.
Some examples of sugar alcohols are the hydrogenated monosaccharides (for example, sorbitol, mannitol, xylitol) and the hydrogenated disaccharides (for example, isomalt, maltitol, lactitol). Sugar alcohols have been designated by the U.S. Food and Drug Administration (FDA) as safe for use as food additives, termed Generally Recognized as Safe (GRAS). Most sugar alcohols are approximately half as sweet as sucrose; however, maltitol and xylitol are similar to sucrose in their sweetness. They are commonly found in food products labeled “sugar-free,” including hard candies, cookies, chewing gums, soft drinks, and throat lozenges. Sugar alcohols are also frequently used in non-food items, such as toothpaste and mouthwash.
There are a number of advantages to sugar alcohols for diabetics. As a sugar substitute, they provide fewer calories (about ½ to 1/3 fewer calories) than regular sugar, thereby promoting healthy weight management. Their calorie content ranges from 1.5 to 3 calories per gram compared to 4 calories per gram for sucrose or other sugars. Perhaps more importantly, they are converted to glucose slowly, and require little or no insulin to be metabolized. In studies, ingestion of sugar alcohols (50 g) by healthy and diabetic individuals produced lower postprandial glucose responses than ingestion of fructose, sucrose, or glucose. In addition, sugar alcohols are not acted upon by bacteria in the mouth, and therefore won’t cause tooth decay. In fact, xylitol has been found to inhibit oral bacteria, and has been shown to prevent tooth decay.
Unfortunately, sugar alcohols are associated with some side effects, the most common being bloating and diarrhea when consumed in excessive amounts. There is evidence that sugar alcohols, much like fructose in fruit and fruit juice, can have a laxative effect. The American Dietetic Association advises that greater than 50 g per day of sorbitol or greater than 20 g per day of mannitol may cause diarrhea.
Over-consumption of sugar alcohols may also contribute to weight gain. This may be the result of a wide misconception (promulgated by many manufacturers) that all sugar-alcohol-containing products are ‘sugar-free’ foods and therefore free of calories. In reality, many of these products contain significant amounts of carbohydrates.
Some diabetics have also observed that their blood sugars rise if sugar alcohols are eaten in excess amounts.
Sugar Alcohols Analysis [B]
| Sugar Alcohol | Glycemic Index | Calories per gram | Approximate sweetness (compared to sucrose at 100%) | Typical food applications |
| Sorbitol | 9 | 2.6 [or 2.5] | 50% to 70% | Sugar-free candies, chewing gums, frozen desserts, and baked goods. |
| Xylitol | 13 | 2.4[or 3] | 100% | Chewing gum, gum drops and hard candy, pharmaceuticals and oral health products, such as throat lozenges, cough syrups, children’s chewable multivitamins, toothpastes and mouthwashes.Used in foods for special dietary purposes. |
| Maltitol | 36 | 2.1[or 2.7] | 75% | Hard candies, chewing gum, chocolates, baked goods, and ice cream. |
|
Mannitol MannitolSyrup: Regular Intermediate High |
0
52 53 48 |
1.6[or 1.5]
3 3 3 |
50% to 70% | Dusting powder for chewing gum, ingredient in chocolate-flavored coating agents for ice cream and confections. |
| Erythritol | 0 | 0.2 | 60% to 80% | Bulk sweetener in low calorie foods. |
| Hydrogenated Starch Hydrolysates (HSH) | 39 | 3[or 2.8] | 25% to 50% | Bulk sweetener in low calorie foods, provide sweetness, texture and bulk to a variety of sugarless products. |
Clinical Trials: Alcohol and Diabetes
Since diabetics are at a higher risk for heart disease than the general population, it makes sense that they should imbibe in the occasional alcoholic drink, which is known to promote heart health. The American Diabetic Association recommends that well-controlled diabetics follow the same guidelines offered for non-diabetics. This means moderate consumption limited to one drink daily for women or two for men.
One study published in the Journal of the American Medical Association found that alcohol not only offers heart protection, but also decreases insulin resistance in Type II diabetes. Although researchers were unable to identify the particular component responsible, this is promising news for diabetics who have been avoiding alcohol since their diagnosis. It is also possible that alcohol has a direct insulin-sensitizing effect on muscle and assists in obesity control.
When choosing the type of alcohol to consume, it is a good policy to choose beverages with high antioxidant content. These include dark beers (such as stouts), red wine, and drink mixes that are low/moderate on the glycemic index and contain a high antioxidant content (such as unsweetened cranberry juice). These high antioxidant choices have the added benefit over other types of alcoholic drinks in helping prevent long-term diabetic complications. If you enjoy chocolate, you might also be interested to know that unsweetened (or minimally sweetened) dark chocolate (at least 70% cocoa) has also been shown to contain high amounts of antioxidant polyphenols similar to red wine and green tea.
Grains
Avoid eating high glycemic index grains, especially if they are processed, not whole, because they may result in rapidly rising blood sugar levels with subsequent high insulin release. Eating grains may also help to create food cravings and resultant mood swings.
Following a meal of high glycemic grains, people with insulin resistance or Type II diabetes will find their blood glucose levels rising quickly, stimulating the pancreas to release insulin in order to lower blood sugar levels. Insulin in the blood sends a message to store this carbohydrate as fat. A chronic problem may ensue, blocking stored fat from being used by the body. Insulin blocks glucagon, which promotes the burning of fat and sugar. Insulin also blocks the production of human growth hormone, important in many important bodily functions, including helping to build muscle and to sleep well.
Higher insulin release or needs as a result of grains in the diet may cause an imbalance in the ratio of omega-6 to omega-3 fatty acids since insulin affects the enzymes that metabolize fatty acids. Mineral balance and vitamin D metabolism are also negatively affected.
Gluten Sensitivity
Approximately 15% of the general population have a gluten sensitivity (gluten is only found in certain grains). It is reasonable to assume that at least this percentage of the population with diabetes has the same sensitivity. Rates of gluten sensitivity have been found to be much higher in people with auto-immune disease, such as autoimmune thyroid problems (Hashimoto’s disease). Gluten sensitivity is often diagnosed as irritable bowel syndrome (IBS), fibromyalgia, or chronic fatigue syndrome. People are often addicted to the food they are sensitive to; typically, after complete withdrawal from grains, all physical cravings for them stop.
Detrimental Effects of High Insulin Levels
- Cause feelings of hunger shortly following a meal
- Raise blood pressure
- Raise triglycerides and lower good (HDL) cholesterol
- Cause weight gain that is difficult to lose by dieting
- Raise the risk of heart attack and stroke
- Deplete the body of important nutrients
- Increase incidence of osteoporosis by causing the blood to be more acidic, thus drawing calcium from the bones in the body’s attempt to reduce the acidity of the blood
- Cause Type II diabetes as the cells of the body become resistant to high insulin levels
- May be a part of the picture in the development of auto-immune problems and cancer
Condiments
Avoid commercially prepared sauces, condiments, and broth. Bouillon cubes, for example, usually contain MSG or hydrolyzed vegetable protein and related substances, not necessarily listed on the label because they come under the category of natural flavorings or spices. Commercially prepared and bottled salad dressings are full of bad oils, preservatives, stabilizers, artificial colors and flavors, and sweeteners. They also often contain MSG or hydrolyzed vegetable protein or similar substances listed under natural flavorings or spices.
Preserved Foods
Nitrates
Avoid nitrates in cured meats and smoked fish because they are carcinogenic and contribute to birth defects. Nitrates are also formed when high heat is applied to protein and in fresh green juices if allowed to sit.
Sulfites
Avoid sulfites or sulfur dioxide found in dried fruits, unless marked otherwise, and often sprayed on fresh greens. These sulfur compounds especially affect those with asthma.
Soy Foods
Avoid certain soy foods because they are difficult to digest, unless they are predigested through natural fermentation. The substances in soy foods impeding digestion include phytic acid, which blocks the absorption of minerals; protease inhibitors, which block protein digestion and can create a swelling of the pancreas; and isoflavones, which can block thyroid function and cause hormonal changes. When soy foods are fermented, these problems no longer exist. Traditional fermented soy foods include miso, tempeh, natto, and naturally fermented soy sauce. Soy yoghurt is also available.
Excitotoxins
Avoid excitotoxins, such as aspartame (Nutrasweet and Equal), MSG, and hydrolyzed protein, because of their allergen potential. Some symptoms of sensitivity to excitotoxins include rashes, depression, nausea, ringing in the ears, vertigo, insomnia, loss of motor control, loss or change of taste, memory loss, blurred vision, blindness, and seizures. MSG is often found in fast food, processed foods and packaged foods. Sensitivity symptoms include headaches, flushing, tightness in the chest, nausea, and heart palpitations.
