Dec 1, 2020

Ensure Diabetes Care drink - Review

A blog reader asked me to share my thoughts on Ensure Diabetes Care drink. 

The plethora of drinks available for diabetics these days can be mind boggling. Now why is there a separate category of drinks? Are the nutrition needs different for diabetics as compared to non-diabetics? If so, can the different nutrition needs be fulfilled from real, natural foods such as fruits, vegetables, pulses, grains, nuts and seeds? I'll share my thoughts on these questions in a separate post.

Let's look at the ingredients of Ensure Diabetes Care drink. I searched for it on Amazon but couldn't find it in their product images. Got this image from Flipkart.

First and foremost, if any brand says "Sugar free", make sure to check for any caveat. In this case, the brand has mentioned that Sugar(Sucrose) is 0. But wait, check the ingredients list and you will see "fructose" mentioned. Fructose is another form of sugar and consumers are not made aware of the quantity of fructose used and the source of fructose.

Along with fructose, the product also contains Sucralose, an artificial sweetener.

Artificial sweeteners and their impact on taste preferences
What I have observed is that when diabetics stop sugar and switch over to artificial sweeteners, their taste buds get altered quite a bit. Though artificial sweeteners taste sweeter, they trick the brain into believing that high calorie foods are being consumed. But in reality, there aren't as many calories available as the brain believes it to be. As a result, diabetics tend to crave for more sugary foods.  As their taste buds keep getting altered this way, they are not able to appreciate the real taste of fruits and vegetables and they don't get the required nutrition they need. This results in more fatigue, more tiredness and exhaustion. And they end up searching for "health drinks" in the market to combat the fatigue. Most diabetic focused "health drinks" claim that they are sugar-free but they contain artificial sweeteners. And the vicious cycle continues.

I had written in detail about the harmful effects of artificial sweetener in this post on Brittania Nutrichoice Digestive Zero biscuits. Also refer to this article published on Harvard Health blog on the ill effects of artificial sweeteners.

Artificial sweeteners and their impact on gut health 
Artificial sweeteners change the composition of the gut microbiota. As per this paper,

The consumption of typically used nonnutritive artificial sweetener formulations drives the development of glucose intolerance through the induction of compositional and functional alterations to the intestinal microbiota.

According to this paper
"Continuous exposure to fructose and sugar substitutes may cause dysbiosis with loss of microbial genetic and phylogenic diversity, promoting evolution and maintenance of a Western gut microbiome. In turn adaptive metabolism generates additional energy sources for the host, which may facilitate aberrant host–microbe interactions leading to perturbed energy regulation and altered gut transit times with subsequent enhancement of dietary energy extraction. These differences in microbial composition and metabolic activity may ultimately be sensed by the innate and adaptive immune system leading to intestinal inflammation with later manifestation as endotoxemia. The combination of these processes can undoubtedly contribute to development of many metabolic disorders associated with obesity. "

The other important ingredient to look at is Maltodextrin. It is a cheap, processed white powder derived from corn. It is mainly used as a carrier ingredient for added synthetic vitamins/minerals. It has a high glycemic index and raises blood sugar levels rapidly. Unless the diabetic person who is consuming this drink is involved in active sports or athletics, he/she doesn't need maltodextrin whatsoever.

As I was going through other details in the pack, the brand has mentioned this statement

"It is scientifically formulated to have a low glycemic index to help manage blood glucose response. It is made with a unique combination of fibersol (resistant maltodextrin), FOS and Inositol."

I couldn't find the glycemic index mentioned anywhere on the pack. So there is no way to validate the "Low GI" claim.

Fibersol is a type of digestion resistant maltodextrin (DRM), made from soluble corn fiber.

DRM is indigestible as our body does not produce digestive enzymes to break it down. It goes undigested and ends up being fermented in the colon by the gut bacteria. 

According to this paper,
Resistant maltodextrin helps to maintain blood and lipid profiles as well as promote satiety and reducing food intake. High intake of resistant maltodextrin may cause gastrointestinal discomfort due to the gas production and increased osmotic pressure.

Instead of consuming processed powder with potential side effects, why not consume soluble fiber from real, natural food sources?

One serving (6 scoops) of Ensure Diabetes Care provides 226 kCal.
100gm of this pack provides 435 kCal, which means that one serving is equivalent to around 52 gms.

One serving of this drink provides the following key vitamins and minerals:
Vitamin C = 16.5 mcg
Vitamin A = 55 mcg RE
Potassium = 284 mg
Calcium = 129 mg
Magnesium = 46 mg
Iron = 2.4 mg
Zinc = 1.25 mg

The added vitamins and minerals in this pack are in no way comparable to nutrition provided by real foods. Do check out the values of individual nutrients from plant-based sources linked above. 

It is highly unlikely that such drinks will help manage diabetes. They will only make the condition worser. Let's take the time to understand the ingredients before rushing to buy "diabetic-focused" products.

It is a sad state of affairs that diabetic patients think twice before consuming carrots/beetroots but are voluntarily drinking such artificially sweetened "health" drinks without any hesitation.

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