The New Diabetes Formulation Paradigm

The recent trend of developing diabetes-specific products that are mainstream and safe enough for regular consumption could transcend all healthy food and beverage categories.

By Kantha Shelke, Ph.D.

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Processors are seeing the old model of manufacturing special foods for persons with diabetes give way to several approaches. Actively, processors seek to include ingredients in formulations to tailor a food toward having a reduced glycemic impact. Fiber, fiberlike starch fractions and bioactive nutraceuticals are all being employed to this effect.

From the other direction, portion control is the chosen path. Since nearly 90 percent of the 15 million or so Americans with type 2 diabetes are overweight - most simply because they eat too much - this uncomplicated approach is popular. It also has the added benefit of being more inclusive.

Even persons without diabetes, but facing weight management or blood pressure problems, benefit from foods re-packaged to help with portion control. Since the formulation itself need not be changed, processors benefit from the wider appeal and marketability. Value-packed miniaturization is proving to be especially appealing to consumers, especially with premium and indulgent foods.

Sugar by Any Other Name is Still as Sweet

Sugar – the amount, the timing, the type and (when necessary) avoidance of intake – often challenges individuals managing blood glucose levels. The old paradigm of formulating for diabetes was mostly a matter of simply substituting sugar with a noncaloric sweetener. This approach is still viable, and the 21st-century substitutes are far more sophisticated.

Sugar ranks next to fat and calories in the information consumers seek on food packages. Consumers with diabetes are concerned about sugar and particularly about its replacement – the artificial sweeteners. Focus on satiety does not bode well for sugar-free formulations, however. Numerous studies suggest sugar-free products do not satiate a person's appetite, actually making the products a liability to some persons managing caloric intake.

Diabetes cover story: healthy beverage photo, courtesy of Palatinit
Sweeteners that are low in calories, glycemic index and insulin response are a boon to sugar-free beverage manufacturers. Photo courtesy of Palatinit Food Ingredients.

Removing sugar can be complicated, especially when it comes to baked goods and dairy products such as yogurt. These foods often rely on sucrose and other simple sugars for taste and texture. Makers of baked goods, confectionery, dairy products and beverages have responded by collaborating with sweetener companies to create treats that specifically address consumer demand for perfection in sugar-modified foods.

Palatinit Food Ingredients, Morris Plains, N.J., offers two popular examples of nutritive sweeteners for such applications. Palatinose is a caloric sweetener yet is very low-glycemic and low-insulinemic. It acts as a functional carbohydrate sweetener, and Isomalt is a low-calorie, very low-glycemic bulk sugar replacer.

Some research suggests sugar avoidance may even increase the threshold for satiety. For this reason, processors are focusing on every stage of formulation, from reducing the amount of sugar, replacing a portion of the sugar with a non-nutritive sweetener (so-called "fractional" products) to making products that are completely sugar-free.

Nutritive sweeteners, regardless of type, break down in the body into simple sugars to be used for energy. Non-nutritive sweeteners created specifically for their lack of calories and nonglycemic attributes are hard to market due to some consumers' negative perceptions. For example, according to Linda Gilbert of HealthFocus International, Atlanta, one in five parents actively seeks out no-sugar-added children's products. A majority of parents tend to shy away from artificial sweeteners in children's foods altogether.

Future Sweet

Two nonglycemic sweeteners currently labeled by FDA as dietary supplements (as opposed to food additives) are available in consumer retail markets but may not be used by U.S. food processors. Both are very stable under high temperatures and are being used to sweeten processed foods and beverages in other countries.

Stevia is a natural sweetener that comprises 40 percent of the sweetener market in Japan. Mesa, Ariz.-based Wisdom Natural Brands claims stevia and other natural sweeteners are healthier than artificial sweeteners for individuals with diabetes. The company cites scientific research demonstrating stevia to be effective in helping the body reduce fat in addition to achieving and maintaining proper glucose balance.

Stevia is available in the U.S. market as ground leaves and as stevioside, a highly refined white powder for use without restriction by consumers in foods, beverages, cooking and baking. The Coca-Cola Co., Atlanta, incorporates stevia in its Diet Coke products in Canada and Japan.

Lo han kuo is another natural nonnutritive sweetener. Derived from a sweet gourd and about 200-250 times as sweet as table sugar, lo han kuo has been used in Asia for generations. At one calorie per gram, it provides a natural and ultra-low calorie sweetness in foods and is very stable under high temperature, thus suitable for cooking and baking. It is commonly mixed with xylitol. Xylitol itself is a flavorless nonnutritive sweetener ideal for foods and beverages. It is a polyol occurring naturally in many fruits and vegetables and is commercially produced by Danisco Sweeteners, Ardsley, N.Y.

The difficulty of replacing sucrose with a single substitute has prompted ingredient blenders such as Minneapolis-based Cargill Inc. to develop application-specific blends. Cargill's Eridex natural nonnutritive sweetener erythritol is blended with dextrins to yield a virtually calorie-free (0.2Kcal/g) bulk sweetener for formulations. The blend is used commercially in Hershey's Sugar Free Pot of Gold Truffles and reduced-calorie, all natural Light Smoothies from Stonyfield Farm, Londonderry, N.H.

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