Positive Health Online

Forty years ago diabetics were told to avoid carbohydrate and sugar like the plague. The advice given by health care professionals in the 1960s is now regarded as a myth, and diabetics are told that there is nothing they are forbidden to eat. The understanding of diabetes has developed dramatically over the last four decades, largely due to scientific research and technological developments. The official policy from Diabetes UK at present is "everything in moderation, as part of a healthy diet".

So why is it that some companies continue to label their sweets and chocolate as 'diabetic'? Not only is this confusing for diabetics, but it is also exploiting a medical condition to make extra profit. The notion of 'diabetic' produce was born in the 1960s, when the advice to diabetics was to avoid sugar completely. Many manufacturers jumped on the bandwagon of 'no added sugar' and created treats which would be, in theory, suitable for diabetics. Of course diabetics had to pay extra for these special treats of chocolate, sweets, jam and soft drinks, causing many food companies to abuse diabetes as a market to exploit. With currently over 2.6 million diabetics in the UK and half a million undiagnosed, the temptation to utilize the disease is proving difficult for some companies to resist.

Libby Dowling, Care Advisor at leading health charity Diabetes UK, said: "Diabetic foods tend to be 'treat' foods such as chocolates and biscuits. These foods do not contain sugar so some people may think that they're fine to eat in large quantities. However, diabetic foods offer no benefit to people with diabetes. They are expensive, contain just as much fat and calories as the ordinary versions, can have a laxative effect and will still affect blood glucose levels."

Despite the change in dietary advice and warning statements from healthcare professionals, a handful of leading UK chains continue to insist on producing 'diabetic' ranges. In the summer of 2007 Diabetes UK joined forces with the Food Standards Agency in an attempt to stop this false advertising. Almost three years ago the two organisations issued this statement; "Many people with diabetes and their families believe that 'diabetic' foods are beneficial or even essential. This is simply not the case. People with diabetes should eat a normal healthy balanced diet, the same as everybody else."

Unfortunately, nothing has changed. Boots and Thorntons persist in advertising 'diabetic' produce. Boots shelves host an entire range of over twenty cakes, biscuits, chocolate bars, gift chocolates and sweets, all 'suitable for diabetics.' Boots' biggest rival is Thorntons, which offer diabetics a similar selection of treats. But there is nothing innocent about these indulgences.

Hiding amongst the nutritional information on these packets lies a controversial ingredient – Polyol. This sugar replacement is a nutritive sweetener found in most sweets, chocolate, biscuits and chewing gum labelled as 'sugar free'. The warning is on the label however, as most products establish "Excessive consumption may produce laxative effects". One of the major disadvantages of using Polyol is its effects on the digestive system, potentially causing diarrhoea and flatulence. This is especially dangerous for children whose bodies are not yet fully developed. The term 'excessive consumption' is also extremely misleading. Guidelines recommend that no more than 20g of Polyols should be eaten per day. In a 75g bar of Thorntons "no added sugar, diabetic milk chocolate' (RRP £1.39) there are 7.1g of polyols in four squares. Any consumer, diabetic or not, would only be able to eat less than 12 squares in a day, hardly 'excessive consumption'.

One of Diabetes UK and the FSA's biggest concern to diabetic labelling was the mixed messages it was sending diabetics. By branding a bar of chocolate as 'suitable for diabetics', it implies that no insulin needs to be taken to counterbalance the food intake. For diabetics who inject insulin and carbohydrate count, extra care is needed. The Polyol replacement means that less insulin is needed as not all carbohydrates in this sweetener are absorbed.

The FSA and Diabetes UK agree that in no way is the production of diabetic alternatives beneficial to those who suffer from the condition. Advertising such products is misleading not only to diabetics themselves, but also friends and family who are unaware of the differences between ordinary food, and those labelled as 'suitable for diabetics'.

As a type 1 diabetic myself I have decided to compare diabetic branded produce against ordinary treats to see which is really more suitable for the occasional indulgence. I am basing this judgement on sugar content, fat content, sweeteners, cost and taste.

Diabetic Treats

Boots diabetic plain Swiss chocolate currently retails at a price of £0.69 for a 42g bar. Each bar contains 179 kcal, 17g of carbohydrate (0.5g of which sugars), 12g of Polyol sweetener and 14f of fat (9.6g of which saturates). The taste of the chocolate is very rich and bitter, much like dark cocoa.

Thorntons no added sugar diabetic milk chocolate sells at £1.39 for 75g. Per 15g (4 squares) contains 69 kcal, 8.4g of carbohydrate (1.1g of which sugars), 7.1g of Polyol sweetener and 4.8g of fat (3.0g of which saturates). This, in my opinion, tastes most like ordinary chocolate – creamy and sweet.

Thorntons no added sugar diabetic vanilla flavour toffee costs £1.29 for a 100g packet. Each bag contains 447 kcal, 61.1g of carbohydrate (3.0g of which sugars), 58.1g of Polyol and 31.9g of fat (22.7g of which saturates). I could not fault the taste of this toffee, it was delicious and I would have not been able to tell the difference between this and ordinary toffee. Worryingly about this product is the amount of Polyol. In 25g there is 14.5g of the sweetener, almost 3/4 of the recommended daily allowance. The toffee however, was not individually wrapped and in chunks of various sizes. This made it extremely difficult to judge how many grams of toffee I was consuming. Unless you have a pair of scales handy, working out how much of this product I could safely eat was a challenge.

Celtic no added sugar fine milk chocolate can be purchased in Holland & Barrett at £0.65 for 35g. The packaging on this particular product is very helpful and explains that the 3.05g of sugar in this bar of chocolate is due to the lactose which occurs naturally in milk. It also highlights for carbohydrate counters (particularly valuable for diabetics using insulin) that the Net Carbs, 3.47g in this instance, is calculated by deducting carbohydrate from Polyols from the total carbohydrate count. This is because not all carbohydrate from polyols is absorbed. Each bar contains 15.09g of Polyol and 11.97g of fat (7.56g of which saturates). The texture of this chocolate is very similar to ordinary brands, but leaves a strange after-taste.

I found that all the diabetic ranges I tasted didn't satisfy the craving for real chocolate that would encourage me to indulge in the occasional treat. Personal taste preferences aside, the nutritional information for each product were a concern. The amount of fat in the sweets were exceptionally high, in some cases nearly half of the recommended daily allowance. This is exceptionally risky for diabetics, who are five times more likely to develop cardiovascular disease (CVD) and must closely monitor their fat intake as a result.

Ordinary Treats

A chocolate Freddo bar usually retails at 17p. Each bar contains 95 kcal, 5.7g of carbohydrate and 5.4g of fat. The creamy texture satisfies the craving for chocolate, perhaps limiting the amount you would eat in comparison to a diabetic bar of chocolate which didn't give you the same pleasure.

Fairtrade Divine dark chocolate retails at £0.75 For 45g. Each bar contains 249 kcal, 12.4g of carbohydrate and 20.8g of fat. The taste is extremely rich and bitter, with a moist texture. Again the strong flavour would perhaps lead you to consume a lesser amount.

Cadbury Dairy Milk chocolate sells at £0.50 For 49g. Each bar contains 260 calories, 27.9g of carbohydrate (27.8g of which sugars) and 14.6g of fat (9.1g of which saturates). The milky creamy taste is mouth-watering.

Cereal Bars

Nakd cocoa loco is a raw fruit, nut and oat bar which contains no added sugar. Each 30g bar retails at £0.65 And contains 332 kcal, 55g of carbohydrate and 10g of fat. For me, taste is compromised here and the bar was brittle, bitter and dry.

Nakd cherry raisins contain only naturally occurring fruit sugars for £0.65 Per 25g. Each pack contains 299 kcal, 79g of carbohydrate and no fat. One of your five a day, the raisin are a tasty snack, although one bag would probably suffice as the taste is quite sickly.

Kelloggs Nutri-Grain Strawberry bar can be purchased for £0.47 For 37g. Each pack contains 130 kcal, 26g of carbohydrate (12g of which sugars) and 3g of fat (1.0g of which saturates). The soft golden crust provides a fruity snack.

Kelloggs Special K original can be bought for £0.40 Per 23g. Each bar contains 88 calories, 18g of carbohydrate (9g of which sugars) and 1g of fat (0.8g of which saturates). This cereal is extremely fruity and sweet, with a yoghurt topping.

For me personally, the best alternative to chocolate and tasty treat is the Cadbury Raisin BrunchBar sold at £1.71 for a pack of 6. Each 35g bar contains 150 kcal, 23.3g of carbohydrate (14.8g of which sugars) and 5.4g of fat (2.8g of which saturates. This cereal and raisin bar is half covered with real chocolate, making the tiniest portion completely satisfying. This chewy mixture lulls you into believing you're eating a chocolate bar, not oats and wheat.

Living with diabetes is not easy, and eating a healthy balanced diet is the key to avoiding long term complications. It has been made clear by healthcare professionals that eating the occasional chocolate bar won't hurt, and the most suitable indulgence is what everybody else eats – ordinary chocolate and cereal bars. The illusion of diabetic chocolate is tempting, as the packaging suggests its 'better for you' by marketing those specifically with the condition. Dietary advice has always recommended to read the label, but in this case, the label isn't always in customer best interests.

A Boots UK spokesperson commented: (March 19th 2010)
"Boots UK takes the opinion of customers very seriously. In 2002, on the advice of Diabetes UK we removed our Diabetic Food Range. However, we received significant, sustained customer complaints about the lack of a specifically labelled Diabetic Food range at Boots UK and we always listen to their feedback carefully.

"Our customers told us that they liked the peace of mind of being able to buy 'treat' foods clearly labelled as suitable for those living with diabetes. In light of this customer reaction, we took the decision to reinstate the Diabetic Food Range in 2005. The range is designed to offer occasional 'treat' food that those with diabetes often miss, such as no added sugar chocolate. These occasional foods are not designed to be a main part of a balanced diet. Boots UK recommends that people with diabetes follow a healthy, balanced diet with a wide variety of foods, and we offer advice and information in store and online and our pharmacists are available to help and offer lifestyle advice. We listen to our customers and care about their opinion – we are aware of the issues surrounding this type of range and carry out regular reviews."