Category Archives: Diabetes

Are Zero-Calorie Sweeteners Safe?

I often get asked about zero-calorie artificial and natural sweeteners.  Many people view them as a way to kick a sugar craving without breaking the calorie bank, but questions and concerns about their safety abound.  It’s easy to think that artificial sweeteners were designed for those looking to lose weight, but the truth is that they were actually created for an entirely different population – diabetics.  While zero-calorie sweeteners can theoretically help with weight loss due the fact that they’re virtually calorie-free, studies show that people who consume beverages and other foods containing these sweeteners sometimes consume more sugar, and more calories, throughout the day.  Artificial sweeteners can actually increase cravings for sugar (when you consume a food/drink containing these sweeteners, your tongue thinks you’re consuming sugar, but your brain knows you’re not and any cravings it has don’t go away) which in turn can increase sugar consumption.  These sweeteners can also disrupt metabolism, which may affect the way your body burns calories.  The body just wasn’t designed to process anything “artificial;” something similar to a chemistry experiment occurs in your body every time anything artificial is consumed.

That being said, some artificial sweeteners have better safety records than others.  Sucralose, commonly sold as Splenda, has been shown to have the fewest side effects and negative health consequences than its counterparts, so it can technically be considered the “safest” of the bunch.  Other sweeteners, like saccharin (Sweet ‘n Low) and aspartame (Equal) have been shown in studies to have negative health consequences; aspartame is known to be metabolized into formaldehyde, which seems like reason enough to avoid it.  If you’re a diabetic and looking for an alternative to sugar, sucralose is probably your best bet.

Zero-calorie sweeteners that are derived from plants, like stevia (Truvia) and monk fruit extract, have been gaining in popularity due to the fact that they’re considered “natural.”  However, these sweeteners were only recently approved by the FDA, and they’re so new to the market that isn’t enough research out there to prove that they’re safe.  If you’re looking for a more natural way to sweeten your food and beverages, stick to small amounts of sweeteners like honey, maple syrup, molasses, or agave.  Although they do contain calories, they taste sweeter, and keep blood sugar more stable, than regular sugar, so you won’t need to use as much of them to feel satisfied.  And if you’re willing to use it in moderation, real sugar only contains 16 calories per teaspoon, so it can still have a place in a healthy, balanced diet.

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Take a Walk to Stabilize Blood Sugar

If you have diabetes, you know how important it is to manage your blood sugar.  Even if you’re not a diabetic, you’ve probably experienced at least one episode in which your blood sugar got a little too low or a little too high and caused unstable hunger, energy, and mood levels.  In many cases, blood sugar levels are directly affected by the food and beverages you do (or don’t) consume, but food isn’t the only factor that can have an effect on how high or low your blood sugar gets.

Engaging in regular physical activity helps your body’s cells become more efficient at using insulin, resulting in better blood sugar control and lower A1C levels.  If you have type 2 diabetes, the American Diabetes Association and the American College of Sports Medicine recommend you get 150 minutes a week of moderate-to-vigorous aerobic exercise, which should be spread out over at least three days of the week.  However, if working out at even a moderate intensity proves to be too challenging, there is good news on the horizon.  New research is showing that exercise, even if it’s of the low-impact variety (e.g., walking), can help reduce blood sugar levels for an extended period of time.  A 2013 study found that walking for 15 minutes after each meal can decrease blood sugar levels for up to 24 hours.  This study also found that these quick post-meal walks, if done after breakfast, lunch, and dinner, were more effective at reducing blood sugar than taking one 45-minute walk a day.

This study brings great news for diabetics and non-diabetics alike, as it proves that all it takes is a little movement to reduce and stabilize blood sugar levels.  No matter the type or intensity of activity you choose to perform, know that getting moving – after meals or at any point during the day – can have beneficial effects on your blood sugar levels for hours and days after your workout is over.

Understanding the Glycemic Index

I’ve given quite a few presentations on diabetes prevention and management in the past few weeks, so it’s no surprise that I have the Glycemic Index (GI) on my brain.  The GI is a measure of how fast a carbohydrate-containing food raises your blood sugar.  Foods are rated on a scale of 1-100 based on how fast they raise blood sugar compared to a reference food, usually white bread or pure glucose: 

<55 = low GI (good)

55-69 = moderate GI

>70 = high GI (bad)

Foods with a low GI raise blood sugar slowly, meaning they provide a steady source of energy that helps keep blood glucose levels stable.  Foods with a high score raise blood sugar quickly, and cause it to drop just as fast, leading to unstable glucose levels.  Blood sugar fluctuations can be dangerous in diabetics, and can cause issues such as increased hunger in between meals, lack of energy, and moodiness in most people.   Therefore, it’s important to choose foods with a low GI as much as possible in order to keep blood sugar stable throughout the day.  If you must reach for a high-GI food, try to pair it with a low-GI one to avoid blood sugar fluctuations.  GI values for over 100 foods can be found here.   

Several factors can affect GI, so the aforementioned GI chart is just a guideline.  Be aware of the following GI influencers: 

  • Fat and fiber content.  Foods that contain fat or fiber take longer to digest, so they can help stabilize blood sugar.  Choose foods that are made with heart-healthy unsaturated fats (rather than saturated or trans fats), and contain at least 3g of fiber per serving.
  • Ripeness and storage time.  As fruits and vegetables ripen, the starches they contain are broken down into simple sugars, thus increasing their sugar content.  Therefore, the riper the fruit or vegetable, the higher its GI.  A ripe banana has a GI of 62, which is bordering on high.  A slightly under-ripe banana, however, will keep blood sugar much more stable.
  • Processing.  There is only one ingredient listed on the carton of orange juice I drink most mornings:  oranges.  One would think that an orange and orange juice would have exactly the same GI, but processing actually increases the GI of most fruits.  When fruits are juiced, they lose their skin, seeds, and other components that provide most of the fiber they naturally contain (and many of the nutrients, as well).  When fiber is lost, there is not much left to help slow down digestion, so blood sugar – and GI – rises more rapidly in “processed” foods like fruit juice.
  • Cooking Time/Method.  Al dente is the preferred way to cook pasta in Italy, but most Americans like their pasta slightly softer.  However, just like slightly under-ripe fruits and veggies have a lower GI, so do many slightly under-cooked carbohydrate-containing foods, like pasta.  Again, this has a lot to do with starches being broken down into sugars, so cook your pasta according to the directions for “al dente” in order to give it a slightly lower GI. 

All of this being said, while GI is important, the amount and type of carbohydrate you’re eating also matter.  Be sure to choose complex carbs like fruits, veggies, and whole grains more often, and limit your intake of refined carbs like those made with white flour in order to help keep your  blood sugar levels where they need to be.