meals

Diabetic Diet: High Calorie Drinks & Eating More, Acidic Foods, High Fiber Drinks

David Mendosa Health Guide May 08, 2008
  • The debate on whether the calories that people with or without diabetes drink help to make us feel full isn't over. But the evidence that they don't is mounting.

    My preliminary article, "
    Drinking Calories," appeared here last September. At that time I reported on the finding of obesity researcher Barbara Rolls. “Calorie intake increased significantly when people drank a beverage containing 150 calories with lunch, compared to when they had a calorie-free beverage.”

    Now researchers are learning even more about how the calories that we drink don't promote satiety. Even the country's top nutrition expert,
    Walter C. Willett, M.D., of the Harvard School of Public Health, is on board. MEDLINE credits him for more than 1,000 professional articles. But his work that really impressed me was his non-technical book, Eat, Drink, and Be Healthy (Simon & Schuster, 2001).


    "There does seem to be something about drinking calories in the form of sodas that just doesn't generate the stop signals," Dr. Willett says in the film "King Corn" that I just reviewed here. This is of course his opinion, not evidence. But it was a powerful enough statement to raise the hackles of the Corn Refiners Association, a lobbying group that supports the manufacturers of high-fructose corn syrup that Americans now consume in massive amounts.

    But note how carefully the association weasels its reply. "No credible research has demonstrated that HFCS affects calorie control differently than sugar," it says.  "A recent study by Pablo Monsivais, et al. at the University of Washington found that beverages sweetened with sugar, HFCS, as well as 1% milk, all have similar effects on feelings of fullness." That sounds to me like a politician's answer to a different question than the one anyone asked.

    Here too is an outrageous case of conflict of interest. The study that the Corn Refiners Association cites in its defense is one that the association paid to be published.

    The authors of the study by "Pablo Monsivais, et al." were in fact Pablo Monsivais, Martine M. Perrigue, and Adam Drewnowski. Usual academic practice (followed in this case) lists the lead author, Drewnowski, last.

    And while Drewnowski's day job is at the University of Washington, he moonlights for the Corn Refiners Association. The article that he wrote failed to reveal his financial tie to the Corn Refiners Association. But Melissa Allison of the Seattle Times discovered his conflict of interest, which the organization Integrity in Science noted.

    That's the evidence that the Corn Refiners Association has been able to finance in favor of high-fructose corn syrup. But real researchers continue to find real evidence that beverages, whether sweetened with high-fructose corn syrup or other sweeteners, do not satisfy our hunger.

    The form of the food we eat matters. "Food rheology exerts an independent effect on energy intake," say Purdue University scientists.

    The term "food rheology" was a new one for me. The dictionary definition is the "Study of deformation and flow of materials; in food technology it involves plasticity of fats, doughs, milk curd, etc. It provides a scientific basis for subjective measurements such as mouth feel, spreadability, pourability."


  • The research by the Purdue scientists, which The International Journal of Obesity published in November, concludes that "Dietary compensation for beverages is weaker than for solid food forms of comparable nutrient content. Thus, they pose a greater risk for promoting positive energy balance."

    So you sure won't catch me drinking any calories, except an occasional ounce of single-malt Scotch whisky (about 60 calories). Of course, I only drink it for my health.

    That's also the reason why I add a little "Santa Cruz Organic Lemon Juice" to my sparkling water, which I have been drinking -- instead of the Scotch -- as I write this.  Lemon and other acidic foods are a proven way to help those of us with diabetes to control our blood glucose. While I used to add a little non-caloric sweetener to this drink, I don't like the fact that they raise our level of circulating insulin. And I now actually prefer the tartness of unsweetened lemon.

    Drinking a high-fiber beverage can actually increase satiety, according to a study that the American Journal of Clinical Nutrition published in December. Researchers from the University at Buffalo's department of exercise and nutrition sciences found that "Consumption of a postingestion, calcium-gelled fiber beverage twice daily reduced energy intake in overweight and obese women."

    Other high-fiber drinks may well work just as well. "I am finding for myself that a beverage that contains viscous fiber and protein significantly raises satiety," my favorite Certified Diabetes Educator tells me. Her choice of fiber is glucomannan, which like other soluble fibers, including psyllium and guar, also reduce cholesterol.

    "The glucomannan is so hydrophilic that when mixed with liquids, it quickly turns into a soft solid," she says. "So technically it is no longer a beverage. I spoon it onto my vegetables. Based on all the research we've read, that combo has to be high in satiety, and it sure does seem to decrease my caloric intake."

    Fiber and lemon juice have of course few if any calories. So if we have to drink -- and we do -- they can help us control our diabetes and our weight even better than pure water. They are certainly a lot better for us than any beverage sweetened with high-fructose corn syrup.