Extensive research supports the common-sense notion that a healthy lifestyle can prevent or treat many diseases. A diet high in fruits, vegetables, whole grains, and plant protein which is low in processed carbs, added sugars and saturated fats, combined with regular physical activity and emotional well-being present a potent mix of deterrents that can prevent the need for or even replace many prescription medications. In particular, self-management regimes and dietary plans have been proven effective in diabetes patients.
As per the recent study published by Elsevier on behalf of ‘Diabetes India’ in the Diabetes & Metabolic Syndrome: Clinical Research & Reviews, a high fibre diet is vital for people with diabetes and associated conditions. Increasing fibre intake, preferably through food or through a fibre-rich diabetes nutrition (FDN) supplement has proven to be beneficial.
FDN, a new term coined by experts to create a fibre-specific diabetes nutrition category, is intended to have multi-systemic health benefits such as improvement in blood sugar control, reduction in blood sugar spikes, decrease in hyperinsulinemia, improvement in cholesterol levels, and weight management in diabetes patients.
Studies have also shown that in patients with type 2 diabetes, increasing the intake of high fibre foods or fibre-rich dietary supplements, particularly of the soluble type, helps in managing the disease.
In this context, UK-based ingredients firm Tate & Lyle has launched a fibre calculator to help raise awareness of the population’s ‘fibre gap’. Whilst the health benefits of fibre are becoming more widely known, intake remains low. New consumer research, conducted by Tate & Lyle amongst UK adults, has found that more than a third (36 per cent) of people think they are not consuming enough fibre.
Fibre and protein fortified foods
Dr Kavita Karnik, Global Head, Nutrition & Regulatory Affairs, Tate & Lyle is of the opinion that, “For most people it is difficult to get enough fibre into their diet without exceeding their recommended calorie intake. This is where fibre fortification could play a highly beneficial role to public health. It would allow consumers to continue eating the products they prefer, while potentially lowering rates of cardiovascular disease, type 2 diabetes and help maintain a healthy weight across the population.”
A new diabetic nutritional fibre recognised by the US Food & Drug Administration (FDA) and shown in clinical data to slow the body’s absorption of sugar and improve overall blood sugar levels has found its way into products catering to America’s millions of diabetes patients, and in the process is creating a sizeable market opportunity for top companies like Archer Daniels Midland (ADM), Procter & Gamble, GlaxoSmithKline, Tilray Inc. etc.
Among the first products to reach retailer shelves utilising ADM’s innovative new fibre is GlucoDown, made by Glucose Health Inc. Using a special manufacturing process, the company agglomerates ADM’s fibre together with tea powder. The result is America’s first “healthy” diabetic iced tea.
Likewise, we have recently seen the entry of many fibre-enriched supplements in the Indian market as well. For instance, the Horlicks Plus range, a set of specialised brands formulated by Hindustan Unilever Limited to solve nutritional deficiencies, has forayed into the segment of diabetes by launching a nutritional beverage called Diabetes Plus. It contains high fibre i.e. 22 per cent of dual blend fibre. It is also high in protein.
Talking about the relevance of protein in diabetes management, a study by the Human Nutrition Research Centre and Diabetes Research Group at Newcastle University, UK has shown that drinking a small amount of whey protein before meals helps people with type 2 diabetes control their blood sugar.
The Indian arm of the French firm Danone has recently launched a supplement called Protinex Diabetes Care with high amounts of protein and fibres. Additionally, a recent survey by Danone India has revealed that over 92 per cent of respondents knew that protein and fibre in their diets are essential to manage diabetes. However, daily nutrient intake assessment using Nutri Calculator, a tool developed by Danone with nutrition experts, highlighted that only 14.8 per cent and 21.2 per cent people with diabetes were consuming the requisite amount of protein and fibre on a daily basis.
Lowering carbohydrate intake
Many studies have shown that excess carbohydrate in the diet (polished white rice in the South and East, and refined wheat in the North and West of India) contribute to increased susceptibility to type 2 diabetes. The diet of most Indians consists of about 65 to 70 per cent carbohydrate, with very little protein.
A recent national study funded by the Indian Council of Medical Research (ICMR), based on 18,090 adults has shown, using a linear regression model and quadratic programming, that if the carbohydrate content of the Indian diet can be brought down to 49 to 54 per cent and the protein increased to 19 to 20 per cent and fat maintained around 21 to 26 per cent, diabetes remission or reversal can be achieved. For prevention of progression from pre-diabetes to diabetes, carbohydrate content of 54-57 per cent, protein of 16-20 per cent and fat of 20-24 per cent would suffice.
Commenting on the study, Dr R M Anjana, Vice-President, Madras Diabetes Research Foundation (MDRF), says, “Unlike previous studies which have recommended a very low or near zero carbohydrate intake which is unsustainable in the Indian context, our results show that even a modest reduction in carbohydrate intake with an increase in protein, along with healthy fats, can help both to reverse diabetes as well as prevent its progression.”
This study was carried out in the whole country, and is the largest epidemiological study on diabetes done in India.
In support of this observation, we have seen the entry of many low-carbohydrate versions of foods in the market. For example, Lo! Foods, a Bengaluru-based startup, has stepped into the diabetic food market with the launch of a range of diabetic-friendly low-carbohydrate and sugar-free food products. Their three diabetic-friendly products i.e. atta, snacks, and cookies are affordably priced.
Sudarshan Gangrade, Founder, Lo! Foods, says “The demand for diabetic friendly consumables has seen a sharp increase in the last few years on account of growing awareness about managing diabetes and the rising prevalence of the disease. However, the current diabetic friendly food alternatives available in the market are not the most ideal options for a healthier diabetes diet.”
Besides enriching diets with fibres and proteins while reducing carbohydrates, experts are also backing the benefits offered by plant-based foods for diabetes management. According to a new research published by US researchers, the consumption of healthy plant-based foods, including fruits, vegetables, nuts, coffee, and legumes, is associated with a lower risk of developing type 2 diabetes in generally healthy people, hence aiding diabetes prevention.
Millets- a healthy low GI alternative
Millets are another weapon to fight diabetes. With the United Nations declaring 2023 as the International Year of Millets, it has caught the attention of many scientific minds, making them focus on millets. Minimally processed millets are considered to be 30 per cent more effective in lowering glycaemic index (GI) of a meal compared to milled rice and refined wheat, making them a healthier alternative.
As per the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) study in 2021, eating millets can reduce the risk of developing type 2 diabetes and helps manage blood glucose levels in people with diabetes, indicating the potential to design diets including millets for both diabetic/ pre-diabetic people as well as for non-diabetic populations, as a preventive approach.
“There is no easy solution to diabetes, and it requires a lifestyle change, and diet is a very important part of this. The ICRISAT provides one part of the solution useful for individuals and governments. How we use this and implement it into programmes needs careful planning”, says Dr Hemalatha, Director, National Institute of Nutrition (NIN).
Additionally, studies are pointing towards consumption of quinoa to help prevent type 2 diabetes, since quinoa is a good source of complex carbohydrates, fibre, and contains a high concentration of proteins with all the essential amino acids. According to a recent study in Spain, quinoa-based diets led to lowering of blood sugar in comparison to diets excluding it. This is crucial because post-meal blood sugar spikes are a determining factor in the progression of type 2 diabetes.
Furthermore, National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health in the US has recently awarded a four-year, $2.65 million grant for studying the biomarkers of dietary flavonoids and targeting carbonyl stress to help prevent type 2 diabetes.
But where is the gap?
Although the Indian diabetic food market presents immense opportunities for food companies, a lack of creative thinking in formulating innovative approaches hinders the potential. Various products available in the market are either not specifically diabetic-oriented or lack scientific data, backing the claim.
As mentioned earlier, there are various macro and micronutrients found to be effective for diabetes management, but there is insufficient availability of food products containing those nutrients now in the Indian market. As consumer preferences change over time, the market also needs to cater to the need for variety in its offerings that can compete with the standard fare lining the shelves.
Despite knowing the effectiveness of plant-based foods in managing diabetes, Indian food producers are yet to explore innovations in the plant-based diabetic food segment. Hence, considerable R&D efforts need to be made in this area.
While today’s consumer greatly appreciates the modern-day innovations on offer in the market, the key to unlocking success in the diabetic food market in India probably lies in adding value by providing science-backed products in a range of diverse options to suit their tastes.
Image credit- shutterstock