One noteworthy product line, from Russell Stover, includes DiabetX candy and snack bars. They’re fortified for people with diabetes and labeled as having low glycemic index (23), glycemic load (3), fortified with chromium, zinc and magnesium. “These products are a logical extension of Russell Stover’s original low-carb candies,” says Dornblaser.
Another meal/snack bar brand, Solo GI Nutrition, is being retailed with GI listed on the label. Many other products are also opting to list GI on their labels. These aren’t medical foods, although they may be sold in the nutrition section of the grocery store or drugstore.
ProImmune Co., an immunity technology company and maker of supplements and nutraceuticals, developed two formulations of the antioxidant glutathione. Research suggests glutathione helps via its antioxidant effects on elements key to blood glucose control. The formulations can be used as additives in ice cream, yogurt and other dairy products, sports drinks, fruit juices, nutrition bars and cereals.
National Starch Food Innovation’s (formerly National Starch & Chemical Co.) Novation Hi-maize resistant starch was shown in human clinical trials to reduce the glycemic and insulin response of persons with diabetes as well as in healthy individuals. Research also suggests Hi-maize increases insulin sensitivity.
Following the popularity of the low-carbohydrate trend, a number of products were introduced with higher levels of fiber, including whole grains and carbohydrate polymers that resist digestion because of their specific shape.
Digestion uses enzymes to cleave portions of the carbohydrate chain, and these are geared toward specific carbs. If the body doesn’t make an enzyme that reduces a particular carbohydrate, it isn’t broken down by digestion. It simply goes through the digestive tract, providing neither sugars nor calories.
One fiber product with about a third of the sweetness of sugar but no calories (GI is zero) is inulin, a polymer of fructose units (see “Inulin: The 'In' Fiber,” April 2005). Raftilose P95 inulin, marketed by Orafti, Malvern, Pa., is highly soluble, and synergistic with high-intensity sweeteners.
Hilary Hursh, Orafti’s food and nutrition scientist, notes inulin grew quite popular during the low-carb era, and consumers are aware of the differences between digestible and undigestible carbohydrates. “Consumers know fiber is a good thing,” says Hursh. “They’re learning about the functions of nondigestible carbohydrates. But they may not know inulin is a fiber or identify it from an ingredient statement as a fiber source. We think low-carb products will be around for a long time, but changed somewhat for the diabetic market.”
Hursh also notices a growing interest in GI among food companies, although she doesn’t believe GI will be common on food labels, at least for some time. “We use whatever measure our customers do — in this country, most persons with diabetes are still using the carbohydrate exchanges introduced years back by the American Diabetes Association. And most foods thought of as diabetic foods are sugar-free, although it’s not always as simple as that.”
Palatinose, made by Palatinit, Mannheim, Germany, is a slowly released carbohydrate with a natural, mild sweet taste. Made from sucrose, it is fully digested. Unlike sugar, however, it is noncariogenic and slowly digested, which leads to a low glycemic response and prolonged glucose supply for optimized energy. Palatinose is a viable component for foods and beverages.
Fat Intake and Diabetes
Persons with diabetes are at greater risk for elevated blood cholesterol and cardiovascular disease than nondiabetics. For that reason, doctors specializing in diabetes, obesity, and cardiac problems signed on to the National Institutes of Health initiative on cholesterol and triglycerides. They encourage persons with diabetes keep cholesterol under control with diet and exercise.
Because diabetes — especially Type II — is one aspect of a cascade of disease conditions that frequently includes obesity, other metabolism irregularities, kidney and cardiovascular disease, managing carbohydrates but letting fat consumption increase does not constitute proper diabetes management.
Some new fats were introduced recently. Two are Nextra and Nextra Gold, produced by Source Food Technology in Durham, NC. Nextra is a tallow-based, second-generation healthy fat with the cholesterol removed and plant sterols added, which reduce absorption of dietary cholesterol. The oil tastes similar to tallow, making it favored for French fries. Nextra Gold is vegetable-based (no cholesterol). Both are free of trans fats.
“Diabetic” foods are whatever foods a diabetic can eat and manage the total disease. There are a lot of holes in nutritional knowledge about diabetes, and until they are understood, keeping consumers with diabetes informed about nutrient content, and creating products particularly suited for them, is the sensible course.
What’s In a Label?
Persons with diabetes who successfully manage their condition with diet and exercise are must be made aware of the content, component amounts and types of foods they eat. This demands accuracy in label statements. Even those regulating their diabetes with insulin pumps must know the components of the foods they eat in order to adjust pump output accordingly. (To learn more about diabetes management and exchanges, check out the ADA Web site at www.diabetes.org.)
The American Diabetes Association recommends an exchange scheme that provides a balance between carbohydrates, fats, and proteins. This program is currently used by many persons with diabetes, so foods that are designed to appeal to persons with diabetes should provide information about exchanges so those on that program can select foods easily.