Diabetes and sugar-free products

Non-communicable diseases such as cardiovascular diseases, chronic respiratory diseases, high blood pressure, and diabetes are rising the world over and India is no exception. This is the result of rapid urbanization leading to unhealthy lifestyles and eating habits. Some other factors are pollution, a rise in the aging population, and bad habits like smoking and drinking. Amongst the NCDs, Diabetes is spreading like an epidemic in India. Controlling these diseases will have a great financial burden on individuals and governments.

Diabetics have impaired carbohydrate metabolism. Because of insufficient insulin production or insulin resistance, there is a rise in blood glucose levels. Diabetes is also termed a silent killer. Outwardly, the person with diabetes looks normal. But if this is not controlled properly, it can lead to other long-term complications like cardiovascular diseases, neuropathy, high blood pressure, renal failure, or impairment of vision. Therefore, it becomes very critical that the sugar levels be controlled. There is no cure for this disease and controlling sugar levels is the only solution. The sugar levels can be controlled by having discipline by strictly following four things: taking regular medicine, keeping track of sugar levels all the time by checking at regular intervals and adjusting the dosage of medicine as recommended by the physician, regular physical activity such as walking and the most important is the “diet” which will not lead to a sudden rise in blood glucose levels.

The nutritional needs of diabetics are not different than that of normal individuals. Carbohydrates are the major source of energy. Normal Indian diets are generally high in carbohydrates, providing approximately 60 – 65 % of the calorie requirement. To keep the blood glucose level under control, diabetics should eat a balanced diet containing complex carbohydrates that are good in fiber like whole grains, permitted fruits and vegetables, good quality proteins, and fats. They should take daily carbohydrates in four to five equal parts to avoid the peaks in their blood sugar levels. It is advisable to avoid foods that contain high sugar. That means they should avoid the use of direct sugars, sweets, honey, cakes and pastries, sweetened juices, soft drinks, and any food that will suddenly raise the blood glucose level. Such foods are also called high Glycemic Index (GI) foods. As this is a chronic ailment, diabetics should have such diet restrictions throughout their lives. They are always worried about what to eat and miss eating sweet things. Naturally, at times they want to indulge in eating sweets or products that are sweet.

Food scientists and product developers have responded to this need of diabetics and the industry has developed a range of products that are claimed to be sugarless or with no sugar and taste like equivalent normal products. The challenge while developing such products is that they should not lead to a sudden rise in blood sugar and mimic all the sensory properties. In normal understanding, sugar means sucrose. Sugar plays two important functions in a food product. It imparts a sweet taste and gives a mouthfeel or body to the product. When trying to quickly find out what are products available it will be amazing to know diabetics can virtually enjoy all these specially developed sweet-tasting products, that they can eat without worrying so much about blood sugar levels. These products are of wide range like low GI rice, diabetic atta, multigrain snacks, nutrition health drinks, millet flakes, cookies and biscuits, low GI vermicelli or noodles, hard-boiled candies, coffee premix, chocolates, ice cream, carbonated beverages. Indian traditional sweets like high protein ladoo, sugar-free chikki, sugar-free Gulab jam, Mysore Pak, and kaju katali are also available in the market. Local sweet shops also sell a sugar-free range of sweets including Dry fruit burfi.

It will be interesting to know how these products are developed that mimic the original products in sensory attributes at the same time do not raise the blood glucose levels. Polyols such as Isomalt, Xylitol, Maltitol, Sorbitol, Isomalt, and Erythritol have sweetness ranging from 45 to 100 as compared to Sucrose if Sucrose is considered as 100. They will also give body and mouthfeel to a product like sugar does. Therefore, polyols along with permitted artificial sweeteners Stevia, Sucralose, and Aspartame are used to develop mouthfeel and sweetness. Another advantage of polyols is that they have low GI ranging from zero in Erythritol to nineteen in Sorbitol vs sixty-nine in sucrose. This is helpful because they will not raise blood glucose levels. Sometimes FOS (fructo-oligosaccharides) is also used. FOS has an additional benefit in that it also works as soluble fiber and its presence in the product helps to reduce the peak of sugar in the blood.

These products are termed as sugar-free or no sugar added. The precaution that should be taken while consuming these kinds of products is that product labels need to be read carefully. Although polyols have so many advantages for making products for diabetics, the main drawback is they have a laxative effect and cause abdominal discomfort, nausea, and bloating if consumed in excess. The advice is moderate consumption. Sometimes products available in the market are claimed to be sugar-free but contain Jaggery or honey. Jaggery or honey has high GI and is equally bad as sugar in its ability to raise blood glucose and one needs to be extra careful as many times these products are not adequately labeled.