16 Myths of a Diabetic Diet. Karen Hanson Chalmers

product will be individually listed, but often listed under an alias that most consumers do not recognize as sugars. The sugar listed on the label could include any of the following:

Brown sugar	Honey
Confectioners’	Invert sugar
sugar	Lactose
Carob	Maltose
Corn syrup	Maple syrup
Dextrose	Molasses
Fructose	Sucrose
Galactose	Turbinado
Glucose

      Some sugars listed in the ingredient list, but not necessarily listed next to sugar on the upper part of the label, include the sugar alcohols—hydrogenated starch hydrolysate, sorbitol, mannitol, maltitol, isomalt, and xylitol. The manufacturer is not required to list these sugar alcohols on a food label unless the food product clearly states that the food is “sugar-free.” These may be listed next to “Other” or “Sugar Alcohols,” directly under “Sugar,” or they may be found only in the ingredient list. However, all sugars must be added to the grams of Total Carbohydrate. So overall, it is more important to look at grams of Total Carbohydrate than the grams of Sugar.

      Some of the foods listed below will give you an idea of what one serving of a “sugar” food can look like:

2-inch square brownie	1 Tbsp 100% fruit spread
1/2 cup nonfat chocolate	1/2 cup regular gelatin
milk	1 Tbsp regular syrup
2-inch square unfrosted	(no fat)
cake	1 granola bar
1/4 cup sherbet or	1/2 sweet roll or Danish
sorbet	1/2 cup light or regular ice
2 Tbsp light syrup	cream
(no fat)	2 sandwich cookies

      WHY DO WE NEED IT?

      We don’t really need sugar; however, sugar is found in many healthy foods and it tastes good. Natural sugars, such as those found in fruit, vegetables, and milk, make up about one-half of the sugar intake in the U.S. Added sugars, such as those found in cookies, soda, cakes, and candy, make up the other half of our sugar intake.

      THE UPSIDE AND THE DOWNSIDE OF SUGAR

      Sugar has received bad press for many years. Aside from the sweet taste that sugar adds to food, the only proven information that we have about sugar is that it contributes to tooth decay if eaten in excessive amounts. But we also know that, if eaten in moderation, when blood sugar control and weight are maintained, sugar is not necessarily harmful to our health. Let’s clear up some of the confusion about sugar by looking at the upside and the downside of this controversial carbohydrate.

      The Downside

       Extra calories

      Many empty-calorie foods such as candy, cake, and ice cream give you fuel and pleasure but none of the benefits of vitamins, minerals, fiber, and protein. If you are taking in 15–20 grams of carbohydrate from a candy bar instead of from a piece of fruit, then you will not only be taking in more calories (from fat), but you are also trading a healthy food for a not-so-healthy food. Even the fat-free versions of many of these empty-calorie foods will give you extra calories, because food manufacturers have to add more carbohydrate (sugar and/or starch) to stabilize the product when the fat is removed. Therefore, dessert foods should not replace healthier foods on a regular basis, regardless of whether you have diabetes.

       Small portion sizes

      Often if you eat a food that has a lot of its carbohydrate coming from sugar, you may have to eat a smaller quantity. For example, 1 cup of Cheerios contains about 22 grams of total carbohydrate:

      1 gram comes from sugar

      3 grams come from fiber

      18 grams come from starch

      However, if you decide to eat 1 cup of Frosted Cheerios instead of the regular Cheerios, you will get 25 grams of total carbohydrate:

      13 grams come from sugar

      1 gram comes from fiber

      11 grams come from starch

      So, if you are taking in 30 grams of carbohydrate from a cereal, you could have about 1 3/4 cups of Cheerios but only 1 1/4 cups of the Frosted Cheerios. You can leave it up to your appetite to decide which one you want.

       Dental caries (cavities)

      The digestive process begins in the mouth as soon as we start chewing food. Both sugar and starch break down into glucose in the mouth and equally contribute to tooth decay. Bacteria in the mouth thrive on food and ferment the sugars in carbohydrate foods. During the fermentation process, the bacteria produce and leave behind an acid that eats away at tooth enamel. The whole decaying process actually depends on how long the food stays in the mouth. However, regular brushing and flossing along with limiting large amounts of sticky carbohydrate foods will help prevent dental cavities.

      The Upside

       Moderation is the key

      Moderation is the key When eaten in moderation, sugar does not cause health problems such as obesity, hyperactivity, diabetes, and heart disease. However, sugar can contribute to weight gain and obesity if eaten in excess. It has actually been documented that obese people eat less sugar than do thin people.

       Sugar does have positive traits as an additive

      Sugar serves as a food additive to enhance and balance flavor and aroma by adding color and texture (that brown, crusty texture in baked goods). Sugar also acts as a preservative by keeping foods fresh. It adds bulk to ice cream and baked goods, helps to retain air in light-textured products, balances acidity, and lowers the freezing point of foods. Sugar also softens acidity and prolongs shelf life.

      HERE’S WHAT YOU CAN DO

      1. Use sugar as part of your total carbohydrate intake. This does not mean that you should eat unlimited amounts of sugar or dessert foods, but rather eat these foods in moderation. Totally eliminating sugar is unnecessary and impossible.

      2. Reduce the amount of sugars and dessert foods in your diet, whether you have diabetes or not. Relate the amount of these foods in your diet to your level of activity and exercise.

      3. Read food labels to determine how much of that food’s carbohydrate is coming from sugar and if the food is nutritious rather than just an empty-calorie food. For instance, instead of chocolate cookies, eat oatmeal cookies; instead of frosted cereals, eat plain-type cereals and add berries for sweetness.

      4. Use the Serving Size as your guide when eating high-sugar foods. Most average-size cookies list one or two cookies as a serving size, whereas ice creams list 1/2 cup as a serving size. Most people eat at least twice as much.

      5. Be sensible, but enjoy your new food choices. You are not “cheating” if you eat foods that have sugar in them as long as your meals are within