Diabesity: where satiety, the glycaemic index and heart health merge

Obesity and diabetes are on a parallel trajectory in the United States, linked in many minds like peanut butter and jelly. The two are conjoined into a single word — diabesity.

The word — coined earlier this decade and popularised in 2005 by Dr Francine R Kaufman's book, Diabesity (Bantam Books, 2005) — describes the tendency for obesity to be accompanied by the adult form of diabetes, a condition marked by high levels of blood glucose due to problems in insulin production or resistance to its effects. More than 23 million children and adults in the US live with diabetes, according to the American Diabetes Association. That number is expected to rise, with about a third of the country now obese.

While a number of companies have offered diabetes-specific supplements and ingredients for years, 2009 may prove to be the breakout year for those positioned to address the diabesity epidemic.

"Indeed, this trend has been in our focus for a very long time," says Jan Kritzer, with Beneo-Palatinit in Europe. "What is daunting about the development in the last two years is the pace it has picked up within the US, and the fact that the trend is spilling over to countries like China or India."

Beneo-Palatinit has two ingredients tailored for the diabesity market. Isomalt is a sugar replacement that provides only half the calories of sucrose, a very low glycaemic index, and an alternative for sugar-free candies that can also reduce calories in baked goods and chocolate. The company also produces a functional, slowly digesting carbohydrate (part of a class of ingredients called 'slow carbs') called Palatinose.

The use of the glycaemic index is gaining increased attention from formulators, nutritionists, manufacturers and retailers, according to Joe O'Neill, executive vice president of sales and marketing for Beneo-Orafti in North America. The index rates how quickly a food containing 50g of carbohydrates is digested and absorbed in the blood. The lower the GI, the slower the glucose is released.

"Rather than removing carbs from the diet, research indicates that the correct selection and type of carbohydrates is important," O'Neill says. His company produces two prebiotic ingredients, inulin and oligofructose, that are zero glycaemic and do not trigger an insulin response. "Inulin and oligofructose have attracted a significant amount of attention as nondigestible carbohydrates with prebiotic properties through their ability to modify colonic microflora," he adds.

Many companies see fibre, the indigestible part of plants, as another ideal ingredient for attacking diabesity, thanks to its slow absorption rate, which helps reduce blood-sugar levels. Rhonda Witwer, nutrition-business manager for National Starch Food Innovation, says her company's Hi-maize 5-in-1 fibre, a natural resistant fibre, can serve as a replacement for flour in a wide range of products, including baked goods, cereal and snacks. A number of studies, she adds, show Hi-maize helping weight management and blood-sugar control.

She predicted as early as 2006 that blood-sugar management would be one of the next big health concerns for consumers, a projection that appears ready to play out this year. "HealthFocus International reports that 42 per cent of American primary grocery shoppers think that 'helps maintain healthy blood sugar levels' is an extremely or very important claim on food labels," Witwer notes.

Many supplements also have diabesity applications. Chromium and B vitamins have received the most attention and research dollars for addressing the diabetic condition. Cinnamon extract, the herb fenugreek and alpha-lipoic acid also top the list of diabetic-specific supplements.

From 1997 to 2007, diabetes-specific supplement sales doubled, from $309 million to $666 million.

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