Is one better or worse for diabetes? For weight loss? An expert explains

Jamie Pittrick, Drake University

(THE CONVERSATION) Wandering through the grocery store, it’s easy to get overwhelmed by the numerous brands and dozens of sugar substitute health claims. It can be especially confusing for people with diabetes or pre-diabetes who must keep their blood sugar in check and manage their weight.

With the prevalence of diabetes and obesity, there is a growing awareness of the use of added sugars in food. The latest edition of the U.S. Dietary Guidelines for Americans recommends keeping added sugars to less than 10% of his calories burned.

This is because “added sugars” add sweetness and flavor, but little nutritional value. Because of this trend, the food industry has embarked on a quest to find or develop the perfect substitute for sugar that tastes the same but has no calories that lead to weight gain.

As a pharmacist who is also certified in Advanced Diabetes Management, I talk to my patients every day about how to control their blood sugar and diabetes. They often ask me if they’ve found a perfect replacement for sugar. Here’s the long answer.

Sugar substitutes can be divided into two main groups: sugar alcohols and intense sweeteners. Sugar alcohols include sorbitol, xylitol, lactitol, mannitol, erythritol, maltitol. High intensity sweeteners include saccharin, aspartame, acesulfame potassium (Ace-K), sucralose, neotame, advantame, stevia, Siraitia grosvenorii Swingle fruit extract (SGFE).

Sugar alcohols are commonly found in toothpaste, chewing gum, and some “sugar-free” foods. They are carbohydrates with a chemical structure similar to sugar, but it is also the component that makes them alcohol. They are about 25-100% sweeter than sugar and taste similar. But there are pitfalls here. They are not calorie free. Most have 1.5 to 2 calories per gram. Now compare the calorie count to sugar, also known as sucrose, which has four calories per gram, which is double that.

Sugar alcohols contain few calories, but they can raise blood sugar levels in patients, especially when consumed in excess. However, when compared to sugar, the effects are less dramatic. It depends on how it is handled. This is measured using the glycemic index.

The glycemic index is a measure of how quickly foods are broken down and absorbed. The higher the number, the faster the food is broken down and the faster the sugar enters the blood. Sucrose has a glycemic index of 65. On the other hand, sugar alcohols such as xylitol have a glycemic index of about 7. This means that sugar alcohols are difficult to digest and have a slow and low rise in blood sugar after meals. This is usually better for people with diabetes.Since sugar alcohols are difficult to break down in the body, some of them stay in the intestines and if you consume too much, you can experience gas, cramps, diarrhea and other digestive upsets. There is a possibility

Another drawback of foods containing sugar alcohols is: They are often high in fat and salt to compensate for the low sugar content.

High intensity sweeteners are zero or low calorie sugar substitutes. They are made from a variety of sources and are 100 to 20,000 times sweeter than sugar. Some have a bitter or metallic taste. His two new substitutes for stevia and his SGFE are plant-derived and are sometimes referred to as “natural” substitutes.

According to the American Diabetes Association’s 2019 guidelines, using high-intensity sweeteners can reduce your calorie and carbohydrate intake. However, these “free” calories cannot be replaced with calories from other food sources. Blood sugar control and weight loss benefits are lost.

Researchers have seen this in several studies of high-intensity sweeteners. Weight loss is maintained in other studies where intake is more appropriately adjusted and patients do not replace these free calories with other high-calorie foods.

All sugar substitutes are labeled as food additives and are regulated by the U.S. Food and Drug Administration. A recent trend is to label some of the sugar substitutes as “plant-based” or “natural”. Not a thing. Side effects such as bloating and diarrhea may still occur if overused.

Some concerns have been raised by researchers about high-intensity sweeteners (saccharin and aspartame) and cancer. To date, the National Cancer Institute has concluded that there is no clear evidence that any of the high-intensity sweeteners are associated with an increased risk of cancer.

As a pharmacist specializing in advanced diabetes, I talk to patients on a daily basis about controlling blood sugar levels and diabetes. He has three main ways to do that. Medication, increased activity, and diet. The last two are probably more important in the long run.

It’s really hard to help patients lower their blood sugar if their diet and activity level stay the same. This creates the potential for side effects. So being able to persuade patients to change their diet, such as switching to sugar-replacement drinks, can make a big difference in controlling blood sugar levels and medication dosages.

The overall focus of diabetes management should be on reducing consumption of sugar-sweetened drinks and foods. But the best is to consume foods and drinks that are not highly processed and have no added sugar.

This article is reprinted from The Conversation under a Creative Commons license. Read the original article here: https://theconversation.com/sugar-substitutes-is-one-better-or-worse-for-diabetes-for-weight-loss-an-expert-explains-118571.