Rates of type two diabetes have rocketed in recent years, with poor diet and a lack of exercise largely to blame. But as dietary guidelines for people with diabetes are the same as for the general population, and the FDA doesn't think diabetics need 'medical foods ', how should the food industry respond?
One person eminently qualified to address this question is pediatric endocrinologist Dr Francine Kaufman, director of the diabetes clinic at Children's Hospital Los Angeles and a past president of the American Diabetes Association.
She has also helped developed the successful Extend range of bars, snacks and shakes that have been shown in clinical trials to “help control blood sugar for up to 9 hours”, and says there is no question that products such as these are helpful for people trying to avoid blood sugar spikes.
But they are "not medical foods, apart from in the sense that they are supported by clinical evidence", says Dr Kaufman, who stresses that general dietary advice for diabetics and non-diabetics is exactly the same: Move more, eat better.
If everyone was a healthy weight, type two diabetes wouldn’t go away, but it would probably return to the levels it was at before the obesity epidemic took off
She adds: “Are there ‘diabetic ‘foods? No.
"But are foods with more vitamin and other nutrients, more complex carbs and less fat and simple sugar better for diabetics? Yes, and for everyone else. We should also look carefully at portion sizes and eat more fruits, nuts, berries and roots."
“Above all we should try and maintain energy balance (calories in, calories out) in order to stay at a healthy weight.
“Managing this equation appears to be easier for some people that others for a variety of metabolic reasons that are still unclear, but in general, if everyone was a healthy weight, type two diabetes wouldn’t go away, but it would probably return to the levels it was at [before the obesity epidemic took off].”
And as such, weight management is key, says Dr Kaufman, who didn’t invent the term ‘diabesity’, but certainly helped put it on the map in 2005 following the publication of her best-selling book: ‘Diabesity: The Obesity-Diabetes Epidemic That Threatens America - and What We Must Do to Stop It’.
If you want to do one thing, you should avoid drinking sugar
While not everyone with a high BMI gets diabetes, says Dr Kaufman, if you’re overweight or obese, you’re at greater risk of dyslipidemia, high blood pressure, systemic inflammation, and high blood sugar. And in turn, you are more likely to develop type 2 diabetes.
“Blasting Oreos off the planet isn’t going to solve the problem, however; diet is just part of a complex ecological system that has led us to where we are today. Physical exercise is also key.”
But while homing in on sugar as the root of all evil is just as unhelpful as blaming any other individual factor/nutrient for our expanding waistlines, there are certain foods and beverages that should really come with a health warning, she claims.
“Reducing added sugars in foods is key, so having added sugars listed on the Nutrition Facts panel [as recently proposed by USDA] would definitely be helpful.
“But if you want to do one thing, you should avoid drinking sugar. We should all eat more fruits and vegetables, but fruit juice is really one of the worst things. You might as well drink Coke."
[Click HERE to see a response from the Juice Product Association, which takes issue with Dr Kaufman's comments and says juice can play a role in a healthy diet].