Sunday, April 1, 2018

Type 2 Nutrition #426: Extend Bars, for diabetes management

The other day, while standing in the checkout line at my local supermarket, I saw a slightly overweight, middle aged man put some real food on the conveyor belt, and then a passel of Extend Bars. The previous day I had seen a TV ad for Extend Bars that made some bold claims.  So, since we are all influenced by marketing efforts for manufactured “foods,” and as a long-time type 2 and unofficial diabetes educator, I decided to take a look.
Extend Bars come in 8 delicious sounding varieties, all 150 calories. The first four have from 5 to 6 grams of fat, half of it saturated. These bars also have from 9 to 10 grams of protein. The balance of the calories (22 to 24 grams) is from carbs. Translating the grams to calorie percentages, fat percentages range from 30 to 36%, protein percentages from 24 to 27%, and carb percentages 59 to 64%, except…wait a minute, that >100%.
Keeping the fat and protein calories as fully metabolized, and subtracting from 100%, the carbohydrate percentages in the energy calculation for these 4 bars are reduced to from 59/64% to between 40/46%. How?
Extend explains: “How to Count the Carbs: Fiber, Maltitol, and *Non-Factor Other Carbs (5 grams uncooked cornstarch and 4 grams glycerin) convert slowly, thus have a minimal impact on blood sugar.” So, in their large print calculation on the Extend Bar, they subtract all but 1 gram of carbs (e.g.: 22g - 4g - 8g - 9g = 1 net gram).
However, in their energy calculation of 150 calories per bar, Extend subtracts only some of the carbs, leaving the uncooked corn starch and the glycerin, plus a little soluble fiber and some sugar alcohol (Maltitol) -- from 15g (40%) to 17.25g (46%) of carbs total -- to “convert slowly, thus have a minimal impact on blood sugar.” Nota bene: carbs that “convert slowly” are still AUC, i.e., Area Under the Curve, i.e., still fully-metabolized.
So, ignoring that they taste like candy bars, what’s the “virtuous rationale” of eating Extend Bars for diabetes management? The Extend website provides 4: 1) Minimize Spikes and Avoid Blood Sugar Swings, 2) Avoid Low Blood Sugar (Hypoglycemia), even Overnight, 3) Reduce Hyperglycemia in the Morning, and 4) Comfortably Bridge Gaps between Meals. Do you see anything in common in these 4 mechanisms? How do they do that?
You eat one bar in mid-morning, then one in mid-afternoon, then one before going to bed… and behold, you will “minimize spikes and avoid blood sugar spikes, avoid low blood sugar, even overnight, reduce hyperglycemia in the morning, and comfortably bridge gaps between meals” (because you ate a slowly converting, carb-loaded, candy bar between meals). By eating 3 “balanced” meals, and 3 carb-loaded “snacks” a day, 6 high carb "meals" a day, you will remain a carb-addicted, type 2 diabetic…even as you thought you were eating just 1 net gram. 
The mechanism, then, is to “juice” your body with CARBS, even with the Extend bar's reduced 40% - 46% carb content, perhaps because it is slowly converting to glucose in your blood. Uncooked corn starch and glycerin, from 3 Extend bars a day as recommended, is giving you a continuous infusion of carbs, sort of like being on a glucose drip.
Extend Nutrition describes their bars as “sweet,” with “rich (sugar-free) chocolate” and “creamy peanut butter.” I’m sure they taste good, if you have a sweet tooth (and who doesn’t). But just to be clear: when you double down from eating 3 “balanced” (carb-filled) meals a day to eating 6 times a day, supplementing the carb-laden meals with “snacks” that intentionally mislead you into thinking you are eating just 1 gram of carbs when they are, in fact, from 40% to 46% carbs with 15 to 17.25 grams of carbs that “convert slowly,” you are not really managing your diabetes wisely. But that’s up to you.
I put my food on the conveyor belt and checked out: eggs, heavy cream, grated cheese, green olives, fresh cod, beef short ribs, celery, yellow onions and garlic. I was tempted to buy crackers and some Macadamia nuts, but I know that if I have them in the house, I will eat them, and my diabetes management plan doesn’t allow for snacks between meals. When I avoid eating carbohydrates, I don’t need snacks. I’m not hungry.

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