'Diabetic' foods - Approaching 40 years

Abstract

Diabetic foods were first introduced in the 1960s when people with diabetes were advised to follow a diet low in starchy carbohydrates and severely restricted in sugar. This diet proved to be monotonous, especially for children who were denied cakes, biscuits and chocolates, and consequently, diabetic foods were considered valuable. During the 1970s dietary recommendations were beginning to be reviewed and such strict restrictions on sugar were deemed unnecessary. The 1982 British Diabetic Association recommendations concluded that glycaemic control could be enhanced if a diet rich in complex carbohydrate was consumed and that fructose and other bulk sweeteners had an important role to play in the provision of a varied intake of sweet-tasting foods. In 1984, the Ministry of Agriculture, Fisheries and Foods introduced Food Labelling Regulations which required diabetic foods to have half the amount of rapidly absorbable carbohydrate compared to a standard equivalent. This legislation covered specialist diabetic chocolates, sweets, jams, biscuits and other traditionally sucrose-rich foods. Although the regulations stated that these foods should not be higher in fat or calories when compared to standard equivalents, this was not met by all manufacturers and some products were higher. During the late 1980s, the BDA repeatedly clarified the role that diabetic products played - or did not play - as part of a healthy diet. The BDA pointed out that if diabetes control was poor, sugar substitutes had the same effect on blood glucose as sucrose and that they were lulling people into a false sense of security. In 1992, the BDA examined the diabetic foods on the market and in its report 'British Diabetic Association's Discussion Paper on the Role of 'Diabetic Foods' showed that there was no evidence to suggest that diabetic foods were beneficial. Since sugars taken in with other nutrients, particularly complex carbohydrate, did not provoke the hyperglycaemia shown by simple sugars alone, these foods were not necessary and in fact may be positively unhelpful in terms of fat, protein and energy content. In 1995, Cheshire County Council Trading Standards Officers carried out an investigation into diabetic foods and their report quoted a figure of £16 million being spent each year on diabetic food. In March 1995, all regulations governing diabetic foods were abolished from the Food Labelling Regulations of 1984. This meant that manufacturers could no longer call a food 'diabetic' just because it met the criteria for food labelling. In theory, this meant that they needed to justify their claim, but in practice it appears that they have been unable to do so. Certainly the foods on the market today do not seem to be in line with current recommendations for diabetes and the advice remains that people with diabetes should steer clear of these specialist products and instead include a variety of healthy foods as recommended by the BDA. Copyright (C) 2000 John Wiley and Sons Ltd.