SUGAR ALCOHOLS AND RESISTANT STARCH

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SUGAR ALCOHOLS AND RESISTANT STARCH

            Common food carbohydrates are sugars, starch and fibre. The number of factors influences glycemic responses to foods, including the amount of carbohydrate, type of sugar (glucose, fructose, sucrose, lactose) nature of the starch (amylase, amylopectin, resistant starch) cooking and food processing (degree of starch gelanitization, particle size, cellular form) and the food form, as well other food components (fat and natural substances that show digestions, lactin, phytates, and tennins and starch proteins and starch lipid combinations).
            In persons with type II diabetes, on weight maintenance diets, replacing carbohydrate with monosaturated fat reduces post prandial glycemia and triglyceridemia. Low glycemia index diets may reduce postprandial glycemia. Sugar alcohols produce a lower postprandial glucose response than fructose, sucrose, or glucose and have lower available energy values. The use of sugar alcohols appears to be safe, however, they may cause diarrhea especially in children.
            Foods containing naturally occurring resistant starch (corn starch) or foods modified to contain more resistant starch (high amylase corn starch) may modify postprandial glycemic response, prevent hypoglycemia, reduce hyperglycemia and explain differences in the glycemic index of some foods.
Recommendations
  1. Foods containing carbohydrate from whole grain, fruits, vegetables and low fat milk should be included in a healthy diet.
  2. With regard to the glycemic effects of carbohydrates the total amount of carbohydrate in meals or snacks is more important than the source or type.
  3. Sucrose does not increase glycemia to a greater extent than isocaloric amounts  of starch, sucrose and sucrose containing foods do not need to be restricted by people with diabetes, however they should be substituted for other carbohydrated sources or if added covered with insulin or other glucose lowering medications.
  4. Nonnutritive sweeteners are safe when consumed within the acceptable daily intake levels established by FDA.
  5. Individuals receiving intensive insulin therapy should adjust their premeal insulin based on the carbohydrate content of meals.
  6. Low glycemic index foods may reduce post prandial hyperglycemia
  7. Consumption of dietary fiber is to be encouraged.
  8. Individuals receiving fixed daily insulin doses should try to be consistent in day to day carbohydrate intake.
CONCLUSION:
            Carbohydrates and monosaturated fat together should provide 60-70%^ of energy intake. However, the metabolic profile and need for weight loss should be considered when determining the monosaturated fat content of the diet. Sucrose and sucrose containing foods should be eaten in the context of a healthy diet.
REFERENCE:

            Clinical Practice Recommendations, ADA

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