Driving change in blood glucose management

During last year’s virtual Fi Connect event, Dr Kevin Robinson zoomed in to chat with BENEO’s Anke Sentko, Vice President of Regulatory Affairs and Nutrition Communication, to discover why smart nutrition for improved blood sugar management is more important than ever for long-term health and immunity

So many things are new, says Anke, but let me start with a topic that many people have put on the back burner in the past: blood glucose management.

We’ve been talking about this for a long time, but it’s still very relevant for a huge part of the population — from pregnancy through infancy and throughout our whole lives.

Yet, it’s often ignored because it requires long-term preventive thinking in terms of making food choice changes and seeking out low glycaemic alternatives.

It can be challenging to talk about communicable diseases and getting people to understand that the changes you make now will confer advantages in 20 years’ time.

Of course, you’ll be getting benefits straight away, although you might not notice them … and it’s a hard pill to swallow when, 20 years later, you realise that you’ve been doing something wrong for the last 2 decades.

Correcting that is an even bigger challenge. It can be done, of course, but what we’re seeing now is that when people start to get ill, they do want to change, they’re ready to improve their lifestyle and make smarter food choices. The 20-year gap is, though, is still quite a problem.

The COVID-19 pandemic has certainly played a role but, even prior to that, there was a growing awareness of the link between blood glucose levels and things like immune health, better well-being to prevent infection, etc., and people looking more closely at what they put in their bodies.

In 2016, for example, a review paper was published in the American Journal of the Medical Sciences that analysed published studies between 1970 and 2014 on the short-term effects of high blood glucose levels (hyperglycaemia) and the innate immune system.1

It became obvious by going through the literature that hospitalised patients with poor blood glucose control seem to have a compromised innate immune system as they were more seriously affected in emergency room and recovery situations.

So, even then, researchers and the healthcare industry were looking into the context of the immune system and how it’s related to blood glucose control and management. And what they were saying was that we need to pay much closer attention to blood glucose control to avoid those severe reactions.

Anke Sentko

COVID-19 made the reality very clear. Now, researchers worldwide are focusing on people with metabolic syndrome, prediabetes and diabetes and noting their significantly higher mortality rates and faster progression timelines.

All this is related to blood glucose control and its subsequent effects on the immune system. More work needs to be done, but evidence suggests that, in these patients, their ability to kill pathogens is inhibited and their immune system is not functioning properly.

What’s more, this is not just limited to pre/diabetics, the same results have been seen in healthy people who consume a high-glycaemic diet.

Funnily enough, the food people consume in hospital influences their immune system in a very acute way, which prompted a change in tack regarding how we look at blood glucose control.

It’s something that the WHO has monitored for many years. They’ve created maps that show a constant increase in fasting blood glucose within certain populations. What that means is that those people are a lot less well protected against a virus than they think they are.

All of this got me thinking. As you know, we have a “lower rise in blood sugar” claim in Europe which, until now, hasn’t generated a lot of attention in the food industry.

I’m sure this will change because topics such as blood sugar management, etc., are more meaningful to consumers now; they realise that carbohydrates matter … and making the right choice in terms of slow versus fast carbohydrates is very important.

So, the knowledge is already there and we, as a food manufacturer, need to help them to make better decisions. Currently, I think consumers are ahead of the food industry; finding low-glycaemic products is difficult. And when you consider that carbs contribute about 50% of what we eat for energy, they’re a pretty vital group of macronutrients!

KSR: So, Anke, it sounds as if we’ve overcome some of the inertia related to addressing this issue, but how long will it take for industry and consumers to get to where we should be? With better products, improved education and heightened awareness, can we catch up?

AS: Absolutely we can. Industry is very much going into the right direction with sugar reduction, for example, but there is still some confusion regarding blood glucose level management.

If you replace sugar with a high-glycaemic carbohydrate, for instance, which is happening in the market, then you don’t actually improve the final product when it comes to blood sugar. It might even be worse.

Making the right ingredient choice is paramount. BENEO offers Palatinose, for example, and Isomalt, as well as our chicory root fibres that are used to replace high-glycaemic carbohydrates.

We have the products, the knowledge and we’re ready to help our food industry partners and our customers to take a low-glycaemic response approach to their final products (along with the associated on-pack health claim) and target both sugar reduction and the blood glucose response.

As an industry, we need to provide all-day options — including breakfast, in-between snacks, lunch and dinner — that comprise low-glycaemic ingredients.

Research has shown that if you consume low-glycaemic food in the morning, it actually affects what you eat during lunch. It sets up your body to process something such as potatoes, which are high glycaemic per se, and reduce their overall glycaemic impact throughout the day.

What we need, to complement the technology, the support and the changing mindset, is for food manufacturers to realise that it is attractive for consumers and provide the products they want to buy and use.

KSR: When we talk about glycaemic index, sugar replacers, etc., and the often-conflicting information consumers receive, can they be expected to understand what’s good for them and what isn’t? Does industry have a responsibility to address some of those issues?

AS: Orientation is always difficult, which is why on-pack formulation messaging is so important. If you’re interested in low-glycaemic food, you need to be able to find information on the label.

This is what claims are for; they highlight that this product is specifically formulated for that purpose. Of course, believing in the science behind those claims and their validity is key to engendering consumer trust.

As such, I’m hoping for more claims, clearer messaging and a stronger focus on blood glucose or blood sugar management; it can certainly be done and our regulatory department is ready to assist our customers and find attractive ways to promote that communication.

We know that consumers are buying in to this topic: recent BENEO research highlighted that 50% of Germans are interested in slow-release carbohydrates; they want to know where to find more information; they’re looking for available products.

Furthermore, 49% of US consumers, 65% of Indian shoppers and 72% of Chinese purchasers say they are looking for blood sugar reduction products. Given that China has the world’s highest incidence of diabetes, India is number two and the US is number three, it’s somewhat expected.

But, people are becoming more aware and want to do something preventive. They don’t want diabetes! This sea change is possibly heightened because of COVID … but it’s certainly not going away. Even after the pandemic, the drive for change will continue.

KSR: Amongst the perfect storm of global obesity, political uncertainty and the current virus crisis, we may not have previously seen such a convergence of forces that would motivate people to take better care of themselves; in a bizarre way, is this actually a good thing for our long-term health and well-being?

AS: Absolutely yes! Perhaps, as well, this might help to reduce the global incidence of diabetes, metabolic syndrome, overweight and a whole gamut of lifestyle diseases. For better or worse, it’s a much-needed wake-up call for many of us.

KSR: And, for sure, by making inroads into conditions such as diabetes and obesity, we can subsequently focus on associated diseases such as cancer, cardiovascular disease, arthritis, etc?

AS: Very much so. Everything comes back to the immune system. Diabetes and obesity go hand-in-hand with the body’s inflammation responses. These processes damage your cells, disturb your metabolism and cause everything to go wrong.

Inflammation is related to your immune system, which brings us right back to our holistic view of health and metabolism. It’s like a circle. It is possible, however, to control those processes and take ownership, which more and more people are doing.

They’re taking responsibility for their health, staying active, supporting their metabolism and making smarter choices in terms of ingredients, end products and eating better. With help and guidance from companies such as BENEO, we can effect changes now that will deliver real benefits in the future.

Reference

1. N. Jafar, H. Edriss and K. Nugent, “The Effect of Short-Term Hyperglycemia on the Innate Immune System,” Am. J. Med. Sci. 351(2), 201–211 (2016).

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