Is marketing perpetuating a myth about diabetic products, diet?
Total carbohydrates should be focus, not trying to avoid sugar
Is marketing perpetuating a myth about diabetic products, diet?

By Janet Helm

Published: June 18, 2008

Diabetes has become a full-blown epidemic in this country — and it's getting worse.

Every day in the U.S., 4,100 new cases of diabetes are diagnosed. The Centers for Disease Control and Prevention predicts one in three Americans born in 2000 will develop diabetes.

These alarming rates have sparked educational campaigns to help prevent Type 2 diabetes, the most common form of the disease, which is closely tied to being overweight.

The growing problem also seems to be shaping the food aisles.

In the past four years, about 6,000 new sugar-free products hit store shelves, said Lynn Dornblaser, a new-product analyst with Mintel, a market research company in Chicago. Beyond sugar-free, new diabetes-friendly foods such as snack bars, shakes and cereals are being promoted to people with diabetes.

Despite the growing popularity of "diabetic foods,” however, some experts believe the marketing simply perpetuates a myth.

"What is a diabetic food?” asked dietitian Hope Warshaw, a certified diabetes educator and author of "Diabetes Meal Planning Made Easy” (American Diabetes Association, $14.95). "There are no special foods that people with diabetes need to eat. We do a disservice to people by having them think they need to run out and buy special foods.”

Warshaw said the nutrition recommendations for people with diabetes are the same as the general public — no rigid diet and no need to limit your selections to sugar-free foods.

Sugar? Yes, people with diabetes can still have sugar. The no-sugar myth is one of the biggest misconceptions about diabetes, according to a new book "16 Myths of a Diabetic Diet” (American Diabetes Association, $14.95), by registered dietitians Karen Chalmers and Amy Campbell. This easy-to read book busts the most common myths about diabetes and cleverly compares the old and new methods for managing diabetes.

"Gone are the days when sugar is strictly off limits,” co-author Campbell said in a phone interview. "All carbohydrates break down into glucose in the same way. Your body doesn't recognize whether the carbohydrate is a cookie, slice of bread or a potato.”

Sugar has always been intrinsically linked to diabetes. In fact, the disorder was once called "sugar diabetes,” and people mistakenly believed that eating too much sugar was the cause.

For years, people with diabetes were advised to avoid sweets because they were thought to overload the blood with glucose much faster than starches. Now researchers recognize that sugar has an effect on blood glucose that is similar to other carbohydrates. It's much more important to keep track of total carbohydrates than to focus on avoiding sugar, Campbell said. "Totally eliminating sugar is unnecessary and impossible.”

Even if all carbohydrates affect blood glucose levels in similar ways, they do differ nutritionally. Experts still advise choosing more starches or "complex” carbs — whole grains, fruits, vegetables and legumes — in place of concentrated sweets or "simple” carbs.

Sugary foods and beverages can add a lot of empty calories and make it more difficult to manage your weight. Sweets also are typically high in fat, which can aggravate heart disease risk.

However, instead of feeling guilty about eating sugar and trying to avoid it at all costs, Campbell encourages people with diabetes to find ways to fit reasonable portions into their eating plan — and enjoy them. Sugar-free options (particularly beverages) may help with calorie control, but they're no longer a mandate for diabetes. Some may not even provide a significant advantage, Chalmers said.

Many sugar-free candies, cookies, cakes and ice creams contain about the same amount of calories and carbohydrates as their real sugar counterparts. That's particularly true for sugar-free foods made with polyols or sugar alcohols (such as sorbitol, mannitol and xylitol).

Although it has been many years since the nutrition guidelines for diabetes have changed, people still hold on to the belief that sugar is forbidden. Even some physicians still tell newly diagnosed patients to "stay away from sugar,” Chalmers said. Unfortunately, that's often the only message they're left with, she said.

Instead, Chalmers encourages people to sit down with a certified diabetes educator and get the updated facts. She said the goal is to "fit diabetes into your lifestyle rather than fitting your lifestyle into your diabetes.”

McClatchy-Tribune Information Services

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