Sweet choices available to people with diabetes

[Naveed Yaseen]

Shahina Maqbool
Diabetic individuals can safely enjoy a range of nutritive and non-nutritive sweeteners when consumed as part of a balanced and healthy diet, country representative of the American Overseas Dietetic Association and consultant nutritionist at Shifa International Dr. Rezzan Khan stated while talking to ‘The News’ on the occasion of World Diabetes Day.

Diabetic individuals have to exercise great care regarding their intake of carbohydrates, with special emphasis on sugar intake moderation. There are alternatives to sugar in the form of non-nutritive sweeteners. “Current research shows that it is the amount of carbohydrate eaten and the rate of its digestion that are the most important factors in blood glucose control. Carbohydrates, including sugars, should be spread evenly over the day, as part of slowly digested meals,” Dr. Rezzan informed.

Dr. Rezzan talked about two types of sweeteners namely, nutritive and non-nutritive. Nutritive sweeteners provide calories or energy, and include white and brown table sugar, molasses, and honey.

Alcohol sugars are another type of nutritive sweeteners that also provide energy. Some products may contain sugar alcohol including hard candy, chocolate, table syrups, chewing gum, jams, jellies and some cough syrups. Non-nutritive sweeteners, also called sugar substitutes or artificial sweeteners, do not provide calories and will not influence blood sugars. Five non-nutritive sweeteners with intense sweetening power have FDA approval (acesulfame-K, aspartame, neotame, saccharin, sucralose). “These can safely increase the palatability of nutrient-dense foods and beverages if intakes are below the Acceptable Daily Intake,” Dr. Rezzan informed.

The nutritionist also dispelled some myths around sweeteners. “Scientific evidence neither supports that intake of nutritive sweeteners by itself increases the risk of obesity, nor that nutritive or non-nutritive sweeteners cause behavioural disorders,” Dr. Rezzan said, adding, they do, however, have their downsides. Nutritive sweeteners, Dr. Rezzan said, increase the risk of tooth decay (dental caries) and high fructose intakes may cause hypertriglycemia (high blood fat) and gastrointestinal symptoms in susceptible individuals. Furthermore, current research shows that non-nutritive sweeteners are safe to consume during pregnancy. There is no reason to avoid foods and beverages with these sweeteners. Pregnant women with the rare genetic disorder phenylketonuria, or PKU, should avoid foods and beverages sweetened with aspartame because their bodies cannot break down phenylalanine, the amino acid aspartame contains. This is valid for all PKU patients and not just pregnant women.

Some people will obviously benefit from the use of non-nutritive sweeteners. Dr. Rezzan believes that consuming calorie-free soft drinks and candies needs to be balanced out with the consumption of more nutritious foods and beverages that are better choices, namely milk, fresh juice and water. “Sugar does provide some calories but foods or drinks made with artificial sweeteners may not always be low in calories. When used in moderation as part of a healthy and balanced diet, sugar substitutes can contribute to the enjoyment of eating. They are not, however, a miracle solution in achieving or maintaining a healthy weight nor managing diabetes,” she clarified.

Dr. Rezzan summed up the discussion with the good news that diabetic individuals can enjoy a range of nutritive and non-nutritive sweeteners, provided these are consumed as part of a balanced diet. It is also essential to consult a nutritionist or dietician for health and nutrition advice on such matters.

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