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Debunking The Sugar Myth ~ Again!! Reprinted from Cinnamon
Hearts
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Editor’s Note: Over and over again, we receive regular mail and Email letters questioning our use of sugar in Cinnamon Hearts diabetic recipes. It’s hard to believe that so many people with diabetes are still receiving inadequate information about managing their condition by avoiding sugar. New nutrition guidelines were issued by the American Diabetes Association over eight years ago (1994), yet many people with diabetes still believe that there is something called a “diabetic diet.” In response to this misconception about what people believe about eating and diabetes, Joslin Diabetes Center began a campaign in November 1998 to educate diabetics, as well as the general public, about what the nutrition issues really are for people with diabetes. Hopefully, this article and explanation will help to clarify the “new” 1994 nutrition guidelines and any other concerns you may have about diabetes and food! Marilyn Helton, Editor
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According to Julie Rafferty, Director of Communications at the Joslin Diabetes Center in Boston, MA, the most frequent request her office receives from people with diabetes who call, w rite or Email, is to be sent a “diabetic diet,” or “lists of foods they can and cannot eat.” “If asked for more detail, they will frequently state that they believe that having diabetes chiefly means they have to avoid sugar-containing foods such as cakes, cookies and candies,” says Rafferty, whose office answer 40 to 50 Emails, plus dozens of phone calls and letters each day from people all over the U.S. who contact Joslin looking for help with their diabetes. Unfortunately, for many people with diabetes -- both those who have had the disease for a while, and for newly diagnosed patients -- the new concepts around eating and diabetes are still not widely known. “Simply stated, with proper education and within the context of healthy eating, a person with diabetes can eat anything a non-diabetic eats,” says Karen Chalmers, R.D., M.S., C.D.E., Director of Nutrition Services at Joslin in Boston. In November of 1998, Joslin Diabetes Center began a campaign to educate people with diabetes -- and the general public -- about what the nutrition issues are for people with diabetes. This campaign includes a web-based discussion group hosted by Chalmers at www.joslin.org, that will answer questions about diabetes and diet. Anyone can pose a comment or question to the discussion group. What’s the Truth About Diabetes & Diet? New guidelines for people with diabetes were issued in the Spring of 1994 by an American Diabetes Association committee on nutrition, co-chaired by Joslin Vice President Edward S. Horton, M.D. Those guidelines state that it is okay for people with diabetes to substitute sugar-containing food for other carbohydrates as part of a balanced meal plan. This liberalizes the eating guidelines that people with diabetes had been following for most of the 20th century! Prevailing beliefs up to 1994 were that people with diabetes should avoid foods that contain so-called “simple” sugars and replace them with “complex” carbohydrates, such as those found in potatoes and cereals. The committee, which published its new recommendation in the May 1994 issue of Diabetes Care, noted that there was relatively little scientific evidence to support the theory that simple sugars are more rapidly digested and absorbed than starches, and therefore more apt to produce high blood sugar levels. Instead, the emphasis over the past four years since these guidelines were issued has evolved so that now, many patients are being taught to focus on how many total grams of carbohydrate they can eat throughout the day at each meal and snack, and still keep their blood sugars under good control. Well-controlled blood sugars are a top priority because other research studies have shown conclusively that all people with diabetes can cut their risk of developing diabetes complications such as heart disease, stroke, kidney and eye disease, nerve damage and more, by keeping their blood sugars as closely controlled as possible. What Does This Mean for People With Diabetes? This means that patients who have worked with their dietitian and diabetes treatment team to figure out how many grams of carbohydrate they can eat throughout the day, can decide at any given meal what they will eat. Those with diabetes, who are not on insulin, need to focus on keeping the amount of carbohydrate they eat consistent throughout the day. Those on insulin can decide both what and how much to eat at a given meal, as long as it doesn’t exceed their daily allotment, and can then adjust their insulin accordingly. “There aren’t any foods that are ‘off-limits,’” says Chalmers. “Rather, the patient just needs to learn how to spend their grams of carbohydrate wisely over the course of the day.” Patients then use regular home
blood sugar monitoring to keep track of the effects of their meals and activity levels on
their blood sugars. They work with their health care team to make adjustments in their
food intake, exercise program and medications to keep their blood sugars as close to
normal as possible. Not A Do-It-Yourself Project “Obviously, using nutrition as part of an overall diabetes treatment plan is to an entirely do-it-yourself project,” notes Chalmers. “That’s why we can’t just send people preprinted diets. You need to work with a dietitian to determine whether carbohydrate counting, fat gram counting, a combination of both, or the older exchange meal planning system will work best for you. And you have to work with a dietitian to develop what your meal planning parameters are --- how many grams of carbohydrate, how many grams of fat, etc., you can eat each day.” “But then, the rest of it is pretty much up to you,” she adds. “You get your meal plan ‘budget,’ and then you decide how to spend it at each meal. Just as a non-diabetic can’t eat cookies and cakes all day long and expect to be healthy, if you have diabetes, you have to eat a balanced diet to remain healthy. But within limits, and with proper education, you can eat whatever anybody else does, even if you have diabetes.” Source: Diabetes News, Joslin
Diabetes Center
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