Fruits
Levulose is a naturally occurring sugar in fruits, and is not isolated but bound to other naturally occurring sugars. Unlike man-made fructose which robs the body of many nutrients, levulose contains enzymes, vitamins, minerals, fibers, and fruit pectin. That is why levulose should not be interchanged with fructose because doing so would be like saying that margarine is butter. According to Dr. Balaji, Consultant Diabetologist at the Chennai based Apollo Hospitals, "Levulose is insulin independent as it does not require insulin's assistance to enter a cell. So it has a negligible effect on insulin secretion and hence has very little effect on blood glucose. … we saw [even] an improvement in the fasting blood glucose level." This really holds true because even in the 1930s up to the present, several studies have proven this and especially levulose effects on those with diabetes. The following are some of studies done on levulose or fruit sugar occurring naturally:
• Levulose is less effective in preventing the symptoms of hypoglycaemia.
Bollman and Mann (1931) observed that levulose is less effective in preventing the symptoms of hypoglycaemia than dextrose and this was further proven by Burget & associates (Burget, Moore & Robert Am J Physiol 101: 570-572, 1932) when they removed the gastro-intestinal tract together with the liver, they found that levulose was without effect in preventing the symptoms of hypoglycaemia.
• Levulose Ingestion results in markedly lower Serum Glucose and Insulin Responses than either Dextrose or Sucrose.
Levulose/fructose ingestion results in markedly lower serum glucose and insulin responses and less glycosuria than either dextrose or sucrose, both when given alone or as a constituent in a test meal. However as glucose tolerance worsens an increasingly greater response to Levulose is seen (PA Crapo, OG Kolterman and JM Oiefsky: Effects of oral Levulose in Normal, Diabetic, and Imparied Glucose Tolerance subjects: Diabetes Care, Vol 3, Issue 5 575-582, Copyright by American Diabetes Association).
It was observed that there was a reduced postprandial hyperglycemia to an oral glucose challenge after 14 days without a significant difference in insulin response. There was no change in the markedly blunted glucose response to a Levulose challenge but significantly lower insulin response (area under the 3-h curve) was observed after 14 days of Levulose feeding. There was reduced postprandial hyperglycemia after 14 days of Levulose feeding with test meals as compared with baseline, without significant differences in insulin response (PA Crapo, OG Kolterman and RR Henry: Metabolic consequence of two-week Fructose feeding in Diabetic subject: Diabetes Care, Vol 9, Issue 2 111-119, Copyright by American Diabetes Association).
• Crystalline Levulose combined with a High Carbohydrate High-fiber Low Fat diet appears to be Safe and Acceptable for diabetic individuals when total calorie intake is controlled - A LONG TERM STUDY.
The long-term safety of Levulose consumption was studied and evaluated in 14 middle-aged men with diabetes. Subjects followed an ambulatory high-fiber high-carbohydrate control diet at home for 8 wk, entered the hospital for 5 days on this diet, and spent the next 7 days on a similar diet supplemented with 50-60 g Levulose. They continued the fructose diet at home for 23 wk, then resumed a postcontrol diet for an additional 16 wk.
In the hospital, glycemic control improved significantly on the Levulose-supplemented diet compared with the hospital control diet. In the ambulatory setting, no significant differences in plasma glucose, glycohemoglobin, serum cholesterol, triglycerides, lactate, or urate occurred between precontrol, Levulose, or postcontrol period. Fasting serum lactate was higher by 0.5 meq/L during the ambulatory Levulose period than during the precontrol period. Body weight also increased during the ambulatory fructose period due to higher calorie intake. Adherence to Levulose consumption was excellent and improved adherence to carbohydrate and fat recommendations.
Therefore, if the total calorie intake is controlled to promote desirable body weight, crystalline Levulose used with a high-carbohydrate high-fiber low-fat diet appears to be safe and acceptable for diabetic individuals.
(JW Anderson, LJ Story, Nc Zettwoch, NJ Gustafson and Bs Jefferson, Metabolic Research Group, Veterans Administration Medical Center: Metabolic Effects of Levulose Supplementation in Diabetics Individuals: Diabetes Care, Vol 13, Issue 5337-334 Copyright 1989 by American Diabetes Association).
• Levulose given as a part of a meal results in Lower Glucose Levels in Diabetic and Normal Subjects
Sucorse, sorbital, and Levulose (35 g) were fed to normal and diabetic subjects as a component of a 400- calorie breakfast.
In both normal and diabetic subjects, the mean peak increment in plasma glucose was highest after the sucrose meals (44.0 mg/ dl for normal subjects; 78.0 mg/dl for diabetic subjects): lowest after sorbitol meals (9.3 mg/dl for normal subjects; 48.0 mg/dl for diabetic intermediate after the Levulose meals (29.0 mg/dl for normal subjects; 48.0 mg/dl for diabetic subjects). In normal subjects, the mean peak increment of plasma immunoreactive Insulin followed a similar pattern, but in diabetic subjects there was no significant difference between the three groups.
Therefore , it is concluded that Levulose or sorbital, given as part of a meal, results in lower glucose levels in both normal and diabetic subjects, but that the latter is not related to a difference in insulin release.
(S Akgun and NH Ertel: A comparison of Carbohydrate Metabolism after Sucrose, Sorbitol, and Levulose meals in Normal and Diabetic subjects: Diabetes Care, Vol 3, Issue 5 582-585, Copyright by American Diabetes Association).
The following are the health benefits of fruits.
• Fruits contain essential nutrients needed for proper growth and functioning of the body.
• They provide the necessary antioxidants that help strengthen the immune system, thereby protecting from various illnesses.
• Fruits also aid in the digestion and metabolic process.
• Fruits which are excellent sources of vitamins, minerals and proteins , help in proper functioning of the brain and also safeguard from many diseases associated with the same.
• Fruits relieve day-to-day minor health disorders.
Fruits for Diabetic Patients
The above-cited benefits are not only applicable to non-diabetic people, but also to those suffering from diabetes. Many people think that, fruits are not good for diabetics! How could this be when fruits are the powerhouse of important nutrient necessary to prevent diabetes and its complications?
• In this large prospective cohort of middle-aged American women, overall fruit and vegetable intake was not associated with the development of type 2 diabetes. Intake of fruit juices was positively associated with incidence of type 2 diabetes, whereas intake of whole fruits and green leafy vegetables was inversely associated. Higher intakes of fruit and vegetables are associated with a lower risk of the metabolic syndrome; the lower risk may be the result of lower CRP concentrations. These findings support current dietary recommendations to increase daily intakes of fruit and vegetables as a primary preventive measure against cardiovascular disease. (A. Esmaillzadeh, M. Kimiagar, Y. Mehrabi, L. Azadbakht, F. B Hu, and W. C Willett. Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome. Am. J. Clinical Nutrition, December 1, 2006; 84(6): 1489 – 1497)
• A lower lung cancer risk was also seen for all fruit (adjusted OR = 0.75 for high consumption), high vitamin C vegetables and fruit (OR = 0.75), carrots (OR = 0.71), and broccoli (OR = 0.72) and for the nutrients ß-carotene (OR = 0.81) and vitamin C (OR = 0.81) (all 95% confidence intervals included 1.0). Lung cancer risk was unrelated to consumption of the three food groups defined as "high-carotenoid" (ß-carotene, lutein, and lycopene) and tomatoes. In an analysis stratified by histological type of lung cancer, the strongest inverse associations for vegetables and fruit were seen for large cell carcinoma. (Kristi A. Steinmetz, John D. Potter2 and Aaron R. Folsom, Cancer Research 53, 536-543, February 1, 1993)
• Data from the European Prospective Investigation into Cancer and Nutrition (EPIC) showed that for every 200 grams (about two servings) of total fruits and vegetables eaten per day, the incidence of cancer was reduced by 4 per cent. This is according to a new study, published in the Journal of the National Cancer Institute. It is the largest study on diet and cancer to date, and included 142,605 men and 335,873 women. The participants were followed for an average of about nine years, during which time over 30,000 cases of cancer were diagnosed. ( Boffetta et al. Fruit and Vegetable Intake and Overall Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC). Journal of the National Cancer Institute, 2010; DOI: 10.1093/jnci/djq072).
• In an accompanying editorial, Prof Walter Willett from the Harvard School of Public Health noted that one study reported no link between cancer and fruit and vegetable intake, but a 30 per cent lower risk of coronary heart disease or stroke. This is what he wrote:
“[Also,] data from a large randomized trial showing that increasing intake of fruits and vegetables reduces blood pressure, a major determinant of cardiovascular disease, make the case for causality compelling, although benefits through additional pathways are also possible. Thus, recommendations and actions to increase intake of fruits and vegetables have a sound basis,” he added.
(Journal of the National Cancer Institute. Published online ahead of print, doi:10.1093/jnci/djq072)
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