Natural Low GI Fruit Sugar

References


1. INTRODUCTION

 

  • 1. Bernama Media, 2011. 2011 NHMS DISCOVERS THREE MILLION MALAYSIANS WITH DIABETES. [online] Available at: <http://my.news.yahoo.com/2011-nhms-discovers-three-million-malaysians-diabetes-112947444.html> [Accessed 17 October, 2013]

  • 2. International Diabetes Federation, International Working Group on the Diabetic Foot, 2005.  Diabetes and foot care: time to act [online] Available at: <http://www.idf.org/webdata/docs/T2A_Introduction.pdf> [Accessed at 17th April 2014]

  • 3. International Diabetes Federation, 2012. Diabetes Atlas. [online] Available at: <http://www.idf.org/diabetesatlas> [Accessed 24 October, 2013]

  • 4. International Diabetes Federation, 2013. COMPLICATIONS OF DIABETES. [online] Available at: <http://www.idf.org/complications-diabetes> [Accessed 22 October, 2013]

  • 5. Letchuman GR, Wan Nazaimoon WM., et al (2010) Prevalence of diabetes in the Malaysian National Health Morbidity Survey III 2006. Med J Malaysia 65(3):173-179

  • 6. Knowler WC, Barrett-Connor E., et al (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393–403

  • 7. Ministry of Health, 2009. Clinical Practice Guidelines (CPG) on. Management of Type 2 Diabetes Mellitus (T2DM). CPG Secretariat. 4th Edition: MOH.

  • 8. Persatuan Diabetes Malaysia, 2007. Diabetes Facts & Figures. [online] Available at: <http://www.diabetes.org.my/article.php?aid=110> [Accessed 22 April, 2013]

  • 9. The Malay Mail Online.com, 2013. Indians, Malays most at risk of diabetes and obesity, says health minister. [online] Available at: <http://www.themalaymailonline.com/malaysia/article/indians-malays-most-at-risk-of-diabetes-and-obesity-says-health-minister> [Accessed 28 October, 2013]

  • 10. The National Renal Registry. 20th Report of the Malaysian Dialysis & Transplant Registry 2013. Kuala Lumpur: The National Renal Registry, 2013

  • 11. The Star Online, 2010. Diabetes and blindness. [online] Available at: < http://www.thestar.com.my/story.aspx?file=%2f2010%2f3%2f10%2fnation%2f5826334> [Accessed 10 March, 2013]

  • 12. The Star Online, 2013. Dr Subra: Sugar subsidy should be cut to curb diabetes. [online] Available at: <http://www.thestar.com.my/News/Nation/2013/09/22/Dr-Subra-Sugar-subsidy-should-be-cut-to-curb-diabetes.aspx> [Accessed 22 September, 2013]

  • 13. The Star Online, 2013. Highs and lows of diabetes. [online] Available at: <http://www.thestar.com.my/Lifestyle/Health/2013/05/19/Highs-and-lows-of-diabetes.aspx> [Accessed 19 May, 2013]

  • 14. The Star Online, 2013. Malaysia is now the fattest country in SE Asia, says Liow. [online] Available at: <http://www.thestar.com.my/News/Nation/2013/01/18/Malaysia-is-now-the-fattest-country-in-SE-Asia-says-Liow.aspx> [Accessed 22 April, 2013]

  • 15. The Star Online, 2013. Number of diabetics in Malaysia alarming. [online] Available at: <http://www.thestar.com.my/News/Nation/2013/06/14/Number-of-diabetics-in-Malaysia-alarming.aspx> [Accessed 16 July, 2013]

  • 16. The Star Online, 2013. Obesity a big problem now in Malaysia. [online] Available at: < http://www.thestar.com.my/News/Nation/2013/11/17/Obesity-a-big-problem-now-About-three-million-Malaysians-are-obese-says-deputy-minister.aspx> [Accessed 17 November, 2013]

  • 17. Tuomilehto J, Lindström J., et al (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 344:1343–1350

  • 18. Wan Muhamud WN, Musa KI., et al (2011) Prevalence of overweight and obesity among adult Malaysians: an update. Asia Pac J Clin Nutr 20(1):35-41
  • Whiting DR, Guariguata L., et al (2011) IDF Diabetes Atlas: Global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pr 94:311-312

  • 19. World Health Organization (2009) Global health risks. Mortality and burden of disease attributable to selected major risks. Geneva:WHO

  • 20. World Health Organization, 2013. Obesity and overweight. [online] Available at: <http://www.who.int/mediacentre/factsheets/fs311/en/> [Accessed 17 April, 2014]

 

 

 

2. UNDERSTANDING CARBOHYDRATE

 

  • 1. Ministry of Health Malaysia, 2010. Malaysian Dietary Guidelines. Available online <http://www.moh.gov.my/images/gallery/Garispanduan/diet/KM1.pdf> [Accessed 17 April 2014]

  • 2. Whitney E & Rolfes S R (2008). Understanding Nutrition, Eleventh Edition. Thomson Wadswoth

 

     

     

    3. UNDERSTANDING THE MALAYSIAN DIET

 

  • 1. Ahn Y, Park S., et al (2013) Rice-eating pattern and the risk of metabolic syndrome especially waist circumference in Korean Genome and Epidemiology Study (KoGES). BMC Public Health 13:61.

  • 2. American Diabetes Association, nd. Glycemic Index and Diabetes. [online] Available at: < http://www.diabetes.org/food-and-fitness/food/planning-meals/glycemic-index-and-diabetes.html> [Accessed 27 November, 2013]

  • 3. De Munter JsL, Hu FB., et al (2007) Whole Grain, Bran, and Germ Intake and Risk of Type 2 Diabetes: A Prospective Cohort Study and Systematic Review. PLoS Med 4(8):e261

  • 4. Esposito K, Maiorino MI., et al (2009) Adherence to a Mediterranean diet and glycaemic control in Type 2 diabetes mellitus. Diabetic Med 26(9):900-907

  • 5. Fabricatore AN, Wadden TA., et al (2011) Targeting Dietary Fat or Glycemic Load in the Treatment of Obesity and Type 2 Diabetes: A Randomized Controlled Trial. Diabetes Res Clin Pract 92(1): 37–45

  • 6. Greenwood DC, Threapleton DE, Evans CE., et al (2013) Glycemic Index, Glycemic Load, Carbohydrates, and Type 2 Diabetes: Systematic review and dose-response meta-analysis of prospective studies. Diabetes Care 36(12):4166-71.

  • 7. Hu EA, Malik V, Sun Q (2012) White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ 344:e1454

  • 8. Maghsoudi Z, Azadbakht L (2012) How dietary patterns could have a role in prevention, progression, or management of diabetes mellitus? Review on the current evidence. J Res Med Sci 17(7): 694–709.

  • 9. Ministry of Health, 2009. Clinical Practice Guidelines (CPG) on. Management of Type 2 Diabetes Mellitus (T2DM). CPG Secretariat. 4th Edition: MOH

  • 10. Mirnalini K, Zalilah MS., et al (2008) Energy and Nutrient Intakes: Findings from the Malaysian Adult Nutrition Survey (MANS). Mal J Nutr 14(1):1 - 24

  • 11. Norimah AK, Safiah M., et al (2008) Food Consumption Patterns: Findings from the Malaysian Adult Nutrition Survey (MANS). Mal J Nutr 14(1):25-39

  • 12. Rossi M, Turati F., et al (2013) Mediterranean diet and glycaemic load in relation to incidence of type 2 diabetes: results from the Greek cohort of the population-based European Prospective Investigation into Cancer and Nutrition (EPIC). Diabetologia 56:2405–2413

  • 13. Salas-Salvadó J, Bulló M., et al (2011) Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet. Diabetes Care 34:14–19

  • 14. Shai  I, Schwarzfuchs D., et al (2008) Weight Loss with a Low Carbohydrate, Mediterranean or Low-Fat Diet. N Engl J Med 359(3): 229-241

  • 15. Slavin JL (2004) Whole grains and human health. Nutrition Research Reviews 17: 100–12.

  • 16. Stratton IM, Adler AI., et al (2000) Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 321:405–12

  • 17. Sun Q, Spiegelman D., et al (2010) White Rice, Brown Rice, and Risk of Type 2 Diabetes in US Men and Women. Arch Intern Med 170(11):961-969

  • 18. Tan SG, 2013. SUGAR: Early diabetes detection saves lives. [online] Available at: < http://www.nst.com.my/opinion/letters-to-the-editor/sugar-early-diabetes-detection-saves-lives-1.392277> [Accessed 05 November, 2013]

  • 19. The Star Online, 2013. Eat right with the new Malaysian food pyramid. [online] Available at: http://www.thestar.com.my/Lifestyle/Health/2010/11/06/Eat-right-with-the-new-Malaysian-food-pyramid.aspx [Accessed 21 November, 2013]

  • 20. Thomas D & Elliott EJ (2007) Low glycaemic index, or low glycaemic load, diets for obesity. The Cochrane Database of Systematic Reviews 2007 issue 3:CD005105.

  • 21. Thomas DE & Elliot EJ (2010) The use of low-glycaemic index diets in diabetes control. Brit J Nutr 104:797–802

  • 22. Villegas R, Liu S., et al (2007) Prospective Study of Dietary Carbohydrates, Glycemic Index, Glycemic Load, and Incidence of Type 2 Diabetes Mellitus in Middle-aged Chinese Women. Arch Intern Med 167(21):2310-2316
  • Whitney E & Rolfes SR (2008). Understanding Nutrition, Eleventh Edition. Thomson Wadswoth

  • 23. Yang L, Shu L., et al (2013) Long-term effect of dietary fibre intake on glycosylated haemoglobin A1c level and glycaemic control status among Chinese patients with type 2 diabetes mellitus. Public Health Nutr 24:1-7


 

 

4. CHOOSING CARBOHYDRATES WITH GLYCAEMIC INDEX (GI)

 

  • 1. Ministry of Health, 2009. Clinical Practice Guidelines (CPG) on. Management of Type 2 Diabetes Mellitus (T2DM). CPG Secretariat. 4th Edition: MOH


 

 

5. TYPES OF SWEETENERS

 

  • 1. American Dietetic Association (2004) Position of the American Dietetic Association: Use of nutritive and non-nutritive
  • sweeteners. J Am Diet Assoc 104(2):255-275

  • 2. Commission of the European Communities. Reports of the Scientific Committee for Food concerning sweeteners.
  • Sixteenth Series. Report EUR 10210 EN. Office for Official Publications of the European Communities, Luxembourg, 1985.

  • 3. Cozma AI, Sievenpiper JL et al., (2012) Effect of Fructose on Glycemic Control in Diabetes. Diabetes Care 35:1611–1620

  • 4. Earnest CP, Lancaster S L et al., (2004) Low vs. high glycemic index carbohydrate gel ingestion during simulated 64-km cycling time trial performance. J Strength Cond Res 18(3):466-72

  • 5. European Commission. Opinion of the Scientific Committee on Food on Erythritol [online] Available at < http://ec.europa.eu/food/fs/sc/scf/out175_en.pdf> [Accessed 3 March 2014]

  • 6. Evert A, Boucher JL (2014) Nutrition Therapy Recommendations for the Management of Adults With Diabetes. Diabetes
  • Care 37(1): S120-S141

  • 7. Fitch C & Keim K S (2012) Position of the American Dietetic Association: Use of nutritive and non-nutritive sweeteners. J Acad Nutr Diet 112:739-758

  • 8. Food and Drug Administration. Agency response letter GRAS notice no. GRN 000301. [online] Available at <http://www.accessdata.fda.gov/scripts/fcn/gras_notices/grn000301.pdf> [Accessed 28 February, 2014]

  • 9. Food and Drug Administration. Food additives permitted for direct addition to food for human consumption; acesulfame
  • potassium. [online] Available at <http://www.gpo.gov/fdsys/pkg/FR-2003-12-31/pdf/03-32101.pdf> [Accessed 28 February, 2014]

  • 10. Food and Drug Administration. Food additives permitted for direct addition to food for human consumption; neotame. [online]
  • Available at  <http://www.gpo.gov/fdsys/pkg/FR-2002-07-09/pdf/02-17202.pdf> [Accessed 28 February, 2014]

  • 11. Food and Drug Administration. Food additives permitted for direct addition to food for human consumption; sorbitol [online]
  • Available at <http://www.gpo.gov/fdsys/pkg/CFR-2010-title21-vol3/pdf/CFR-2010-title21-vol3-sec184-1835.pdf> [Accessed 3 March 2014]

  • 12. Food and Drug Administration. Food additives permitted for direct addition to food for human consumption; sucralose [online]
  • Available at <http://gpo.gov/fdsys/pkg/FR-1998-04-03/pdf/98-8750.pdf> [Accessed 3 March 2014]

  • 13. Foster-Powell K, Holt S HA and Brand-Miller JC (2002) International table of glycemic index and glycemic load values: 2002.
  • Am J Clin Nutr 76:5–56

  • 14. Hanover LM and White JS (1993) Manufacturing, composition, and applications of fructose. Am J Clin Nutr 58(suppl):724S-32S

  • 15. Joint FAO/WHO Expert Committee on Food Additives (JEFCA). Safety evaluation of certain food additives and contaminants.
  • Sixty first meeting. WHO Food Additives Series 52, p. 129. Geneva, 2004.

  • 16. Magnuson BA, Burdock GA et al., (2007) Aspartame: A safety evaluation based on current use levels, regulations, and toxicological and epidemiological studies. Crit Rev Toxicol 37(8):629-727

  • 17. RJ Whitehead, 2014. Obesity is a weighty issue for almost 1bn in developing world. [online] Available at: < http://www.foodnavigator-asia.com/Markets/Obesity-is-a-weighty-issue-for-almost-1bn-in-developing-world/?utm_source=newsletter_daily&utm_medium=email&utm_campaign=Newsletter%2BDaily&c=hnplBNJtxdf%2
  • F8bt9Fl0xeIFXox3MKjDe> [Accessed 06 January, 2014]

  • 18. Sherifali D, Nerenberg K et al., (2010) The Effect of Oral Antidiabetic Agents on A1C Levels. Diabetes Care 33:1859–1864

  • 19. The University of Sydney, 2013. GI Foods Advanced Search. [online] Available at: <http://www.glycemicindex.com/foodSearch.php> [Accessed 09 January, 2014]

  • 20. Varzakas T, Labropoulos A & Anestis S (2012). Sweeteners: Nutritional Aspects, Applications, and Production Technology.
  • CRC Press

  • 21. Wang DD, Sievenpiper JL et al., (2014) Effect of fructose on postprandial triglycerides: A systematic review and meta-analysis of controlled feeding trials. Atherosclerosis 232:125-133

Appendices


Appendix A

 

Carbohydrate
All carbohydrates are made up of 1 or more unit of sugar.



Carbohydrate Family

  1. Simple carbohydrate
  2. Complex Carbohydrate

Simple carbohydrates
Chemical structure

a. Monosaccharides
1 unit of sugar
Examples Fun Facts
Did you know?
Mild sweetness Glucose
  • Blood sugar/ dextrose
  • Different chemical structure

    gives a different sweetness intensity
    Sweetest Fructose
  • Fruits, honey
  • Low sweetness Galactose
  • Milk sugar
  • b. Disaccharides
    2 unit of sugar
    Examples Fun Facts
    Did you know?
    Maltose
  • Barley, pistachios, sweet potatoes, kiwis, dates, cherries, blueberries
  • Mono = 1, Di = 2
    Saccharide = glucose
    -ose = carbohydrate
    Sucrose/ Normal Table Sugar
  • Sugarcane, Apples, pears, bananas, grapes, citrus fruits, melons, berries
  • Sucrose contains
    50% glucose

    50% fructose
    Lactose
  • Milk & dairy products such as yogurt, ice cream, cheese 
  •                   
     

     

     

    Table 1                       

    Carbohydrate Family Tree& Examples of Simple Carbohydrate Containing Food

    Carbohydrate
    All carbohydrates are made up of 1 or more unit of sugar.

    Carbohydrate Family

    1. Simple carbohydrate
    2. Complex Carbohydrate
    2. Complex carbohydrates Chemical structure   Examples Fun Facts
    Did you know?
    c. Polysaccharides
    chains of 1 unit of sugar
         
      Glycogen

    Only some meats

    None in plants
    HUMAN body stores glucose as glycogen in the LIVER and MUSCLE
      Starches
    • Grains (wheat, rice)
    • Root crops & tubers (yams, potatoes)
    • Legumes (peas, beans)

    PLANT stores glucose as starches

      Fibres/ Non-starch polysaccharide
    - Soluble Fibers - Insoluble Fibers

    Oats, barley,legumes citrus fruits  

    Whole grains, vege

    Lowers blood cholesterol & glucose

    Promote bowel movement & constipation

     

     

    Appendix B

     

    Figure 1  - Rise of blood glucose in normal subjects after consuming various amounts of seven different carbohydrate foods, expressed as a percentage of the response using 50g glucose as reference point. WB#1, White Bread 1; WB#2, White Bread 2. [Adapted from Wolever. 2006]

    Wolever T M S (2006). The Glycaemic Index: A Physiological Classification of Dietary Carbohydrate. CABI

     

     

    Appendix C

     

    Table 2
    Sweetness Conversion Chart of Artificial Sweeteners to Sugar and Crystalline Fructose

    Ingredients

     

    Form Sweetness conversion chart
    Sugar Crystalline Fructose

    Aspartame (36mg),
    Acesulfame potassium

    Dextrose with maltodextrin

    1 Sachet (1g)

    1 sachet: 2 tab
    2 tsp 1-1½ tsp

    Aspartame (18mg),
    L-Leucine, Sodium carboxmethyl cellulose, Lactose (from milk)

    1 tablet (0.085g) 1 tsp ½ - ¾ tsp
    Aspartame (11mg), Acesulfame potassium, L-Leucine, Sodium carboxymethyl cellulose, Lactose (from milk) 1 tablet (0.07g) 2 tsp 1-1½ tsp
    Steviol Glycosides (14%), Flavourings, Croscarmellose Sodium, Silicon Dioxide, Lactose (from milk) 1 tablet (0.085g) 1 tsp ½ - ¾ tsp
    Rebiana (Reb-A), Calcium Silicate, Croscarmellose Sodium L-Leucine, Silicon Dioxide, Magnesium Sterate, Lactose (from milk) 1 tablet (0.07g) 1 tsp ½ - ¾ tsp

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