Now that we have food scientists working to make "forbidden" foods available for everyone there are even more challenges in keeping our patients on track. We know that increasing vegetable consumption along with lean meats is a great way to stay full and reduce carbohydrates. But what about all those new foods and the ways that they are marketed? What can you do to help your patients to see through the food label maze?…
The first place that our patients get tripped up is serving size. There are no regulations in the U.S. as to what a serving size has to be, so manufacturers have learned to use them to their advantage.
Since many people think that a 20 oz. bottle of soda is a single serving, they will assume it has 27 grams of carbs but really it is 2.5 servings so 70 carbs. The large muffin you get at Starbucks or Panera or a grocery store is 35 grams a serving but the nutritional information says 3 servings or 105 carbs.
Fiber measurements is often manipulated on a food label. Fiber has long had a reputation as a nondigestable food and so many of us, myself included, encourage our patients to eat high fiber foods. However that does not necessarily mean that it makes the food lower carb.
That 1 cup of raisin bran has 8 grams of fiber and 46 grams of carbs, so the net effect is still 38 grams of absorbable carbs. To put this in perspective 1 cup of Lucky Charms has only 28 grams or 25% less. And although people say
there is less sugar in the raisin bran there is actually 45% more sugar in the raisin bran. The highest fiber pasta has 5 grams of fiber and a net of 37 grams of carbs in a one cup serving.
In addition patients will often buy fiber to add to their food and then subtract the "fiber carbs" not realizing that every gram of fiber has a gram of carbs as well.
Sugar Alcohols also get a lot of attention when food labels are read. In simple terms a sugar alcohol is a sugar that has an H molecule removed and an O-H molecule attached, purportedly making it almost impossible to absorb in the body. These were introduced for weight loss as early research showed that they did not cause a release of insulin
and so there would not be weight gain. It made some sense that this would be beneficial to diabetes patients as they would not have a rise in glucose levels and many foods are introduced each day that have these sugar alcohols in them.
Experiences shared by patients and educators have shown that for all patients this is not necessarily true, and some professionals only let patients discount one half of the total.
"Processed to reduce carb absorption" is another label phrase that can present problems. Some wheat containing products often tout that you can’t absorb the carbs that are there. Interestingly enough the majority of patients cannot absorb the carbs in the Dreamfield pasta.
Currently we are using 3 ways that your patients can use to find out how these "fake or altered" altered foods affect glucose:
- They can test their glucose before they eat and then two hours later and see if there is a glucose spike. This is how we tested the Dreamfield pasta. We gave 6 patients 2 cups of regular pasta and found an average increase of 70 mg/dl and when we gave the same 6 patients 2 cups of Dreamfield pasta the average increase was only 32 mg/dl.
- We can use Diastix or other glucose urine testing strips to evaluate spillover of glucose in the urine. Glucose will overflow into the urine only when the blood glucose level is high, that is, too high for the kidneys to stop it spilling over into the urine. In most people, blood glucose levels above 180mg/dl will cause your patients to reach the ‘renal threshold’ for glucose. This urine reading is usually 2 hours behind your blood glucose levels but is a great indicator of the effects of food.
- For products that say they are sugar free, you can verify that by using urine glucose testing strips. The process recommended by Dr. Richard Bernstein and used by many of our patients is to chew on the supposedly carb or sugar free food and then touch the testing stick to the saliva and compare the color change to the back of the bottle.
As you can see as food scientists have become savvier at their work it can be very hard to help our patients get through the nutritional label maze.
Copyright © 2013 Diabetes In Control, Inc.