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.

My current desk

My current desk setup. I have been playing "musical chair" the whole of 2020, shifting my workplace across different rooms and desks. For the past couple of months, there wasn't a desk available either. I tried to focus, working out of the sofa in the living room and moving around with my laptop whenever someone switches on the TV. I could hardly focus and the main topic of my "complaints" was that I don't have any space or time to do deep work. This reflects in the less number of blog posts written in the past 2 months.

No, I don't work for any employer presently but I love to invest time in projects that are of self-interest (food and nutrition research, blogposts, courses, reading etc). 

My bandwidth became limited because of family related responsibilities in the past 2 months. And it is going to become even more limited in the next 4-5 months.

Before other family commitments take up my time and attention, I decided to secure a corner for myself, where I can do deep work, even if it is just for an hour or two in a day. Along with playing multiple roles (wife, mother, daughter, daughter-in-law, sister etc) in a day, it is also important to allocate time when I'm "Anu" the individual, and where I have the physical and mental space to just be me.

Do you complain?

 Over the past few months, I have observed that I complain quite a bit about various issues. I haven't outpoured many of these complaints in public forums (blog, social media). Mostly, husband bore the brunt of my complaints sessions🙂

I'm glad at least I had the awareness that the rate of my complaining has increased. Being the analytical person I am, I initially thought I should keep count of the number of complaints in a day and then gradually decrease the count. But it was just too overwhelming to keep track and I discontinued it.

One conscious practice I'm trying to follow these days is to be aware whenever I get into complaining mode either with myself or with someone else. While I'm aware, I observe my thoughts and words. Just the fact that I'm being aware makes me more conscious and helps me pause and reflect.

I wouldn't say that I have put an end to this addictive habit, but the rate of complaining/cribbing has come down. 

Lack of gratitude is usually suggested as the reason why many of us complain about certain people/situations. Though it might be true, we have inherent biases that prevent us from focusing on the positives about certain people/situations from the past. Through the conscious practice of daily gratitude, we can overcome the effects of these default biases. But it is also worthwhile to understand the triggers behind such complaints. 

When I asked myself on many occasions, "Why am I complaining about this issue?", I realized that there were three common triggers that push me into this mode.

1. I want to be in control of a situation. I want certain things to go as planned. If it goes haywire, I tend to complain about it.
2. I want to be heard. Maybe, that's why I'm vocal about my thoughts and feelings. There is no point bottling up our feelings and then bursting out one fine day.
3. I'm clear about my priorities, sometimes even fixated on them without giving any leeway for change. This has both pros and cons. If a person/situation comes in the way of executing my priorities, I get into complaining mode.

The point is not to JUDGE these triggers and classify them as right/wrong. All we need to do is to become aware of them.

Mark Manson in his article titled "Life is a video game. Here are the cheat codes" says,

Complaining takes a problem and then prolongs it.

How true! 

I understand this year has been tough for all of us. I'm sure some of us would have gotten into the complaining mode knowingly or unknowingly. There is no need to feel guilty about it. The main intention is not to put to an end to complaining altogether, which is a far-fetched goal. Let's try to understand what do we complain about and why we complain. This will give us insights into our deep-seated beliefs, wants and desires. Self-awareness is the key.

Benefits of eating an early dinner

 One major positive change that I made in 2020 is to have an early dinner before 7PM. I have mentioned this in a few posts but I believe this one needs a separate post in itself. 

Until last year, I used to finish my dinner by 8PM on most days. I slowly shifted the timings to 7:30, 7:15 and now 7PM. This shift by just an hour has made a huge difference in my life in multiple ways.

(1) I automatically feel sleepy by 9:30-10PM 

(2) Since there is a good 3-hour gap between the time I finish my dinner and the time I go to bed, the food I eat gets digested easily

(3) My stomach feels light when I wake up the next morning

(4) Bowel movements are regular 

(4) Sleep quality is much better

(5) I start to feel hungry by 8:30-9AM and my stomach is ready to eat a proper breakfast

(6) I have lost a few inches around my tummy. These were quite stubborn inches, by the way :-) And people with PCOD would know how hard it is to lose weight around the tummy

(7) My mind feels fresh and active the next morning. No sluggishness or lethargy

My dinner menu is quite simple. Usually, it is either dal rice, kichdi, dosa+chutney/sambhar, sambhar rice, rasam rice etc. Yes, I prefer to eat rice for dinner, as it suits my body and it digests easily. No soup, salad or rotis. Figure out what foods work for your body and choose accordingly. There are no universal guidelines applicable for all. 

Whenever I talk about early dinner, I get atleast a couple of DMs asking whether I would feel hungry around 9-10PM. I don't feel hungry after dinner and I don't eat or drink anything else. I usually chew 1/2 tsp of fennel seeds (sombu/saunf) after dinner. This helps to ease the digestion. At the same time, this habit acts as a signal to my brain (and tummy) that no more food would follow from hereon.

Having an early dinner helps our body and mind in so many ways. Do give it a try. Take it slow, shift it back by 15-20 minutes at a time, continue it for a few weeks and then shift it further. 

P.S. If you sleep late by midnight or post that, then you might end up feeling hungry if you have an early dinner. Try to fix your sleep routine first, before changing your dinner timings.

Dealing with unexpected situations

A few days back, I stumbled upon a speech by Tamil Actor Satyaraj. It was just a small clip, a few seconds from his speech. Wish I could get hold of the entire speech.

I'm translating what he spoke in Tamil

"In life, if we want to be happy, we have to stop doing two things

(1) Stop worrying about what other people think of you

(2) Stop trying to change how other people should behave"

This was such a powerful statement. As I pondered over it, I realized that I have reduced the first thought pattern to a large extent over the years, which has brought in a lot of peace.

But I also realized that I get caught in the second thought pattern more often. Not just that, but I try to take it even further - Trying to change not just how people should behave but also change the different situations I encounter. Yeah, wishful thinking!

Life throws unexpected situations at us. They can neither be predicted nor be molded in a way we want them to unfold. Complete acceptance is the solution I hear from many. But I find it hard to reach that level of complete acceptance and surrender to the situation. I see myself resisting a lot when the situation is unfavorable to me.

Ever since I became aware of this nature of mine, instead of pushing myself hard to accept the situation, I have started to follow this 3-step process.

(1) I ask myself this question - "Can I do anything to change the situation?"

More often than not, the response is NO.

(2) I pick up my journal or open Evernote and journal about the situation on the following lines:

• Why am I feeling uncomfortable about this situation?
• How would this situation affect me?
• Are there any positives that this situation can bring in?
• What are the possible negative outcomes I'm foreseeing?
• How can I address these? Are there any workarounds I can figure out?

(3) I reflect on my priorities and realign my schedule to accommodate the new situation but at the same time, not give up on what I needed to do for my happiness and peace.

From my experience, the key learning in the past few months is this - Acceptance and surrender might be the destination - a state of utmost peace, but for people in the journey, trying to practice complete acceptance without clear thinking and planning will only lead to more frustrations and helplessness.

The situation we encounter might be out of our control, but how we deal with it in an empowered way requires a good deal of planning and reflection.