Orange juice and diabetes

Diabetes Management: 3 Bitter Juices To Manage Diabetes

It is not easy to manage diabetes. For every diabetic, it is very crucial to be mindful of his/her diet. You never know what may surge up the blood sugar levels. Diabetes is a group of diseases that is results in too much sugar in the blood. According to WHO, the global prevalence of diabetes among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014.While it is known that refined grains and sugary goods are not recommended in a diabetes diet plan (these foods tend to get metabolised quickly and cause your blood glucose levels to elevate), there is a lot of confusion about drinks. Did you know fruit juices are also not very advisable to include in your diet, especially the ones you find in markets. These juices are low on fibres and high on added sugar. It is best to consume fruits whole and fresh. However, if you are looking for healthy diabetic juices, always make them at home and be mindful of what you are pickling. There are some bitter fruits and veggies that you can juice, which may prove extremely beneficial in your diabetes diet.

Here are 3 diabetic friendly juices:

1. Karela Juice or bitter melon juice: Karela juice is an excellent beverage for diabetics. Bitter gourd helps regulate the blood sugar level in your body. According to studies, bitter gourd has a few active substances with anti-diabetic properties. One of them is charantin, which is famous for its blood glucose-lowering effect. Bitter gourd contains an insulin-like compound called Polypeptide-p or p-insulin which has been shown to control diabetes naturally. These substances either work individually or together to help reduce blood sugar levels. Here’s how you can make bitter melon juice at home.

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2. Spinach Juice: Spinach is a great source of folate, dietary fibre, vitamins A, B, C, E and K. Fibre delays digestion, which ensures that the sugar is not metabolised quickly and cause a surge in blood sugar levels.

(Also Read: Spinach Nutrition: Amazing Cooking Tips And Health Benefits)

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3. Amla Juice: The Ayurvedic wonder potion may do wonders for your diabetes management. Take two teaspoons of amla juice with a pinch turmeric powder early morning. Amla is the fruit of the Indian gooseberry tree and is a traditional remedy to control high blood sugar levels. It also contains a mineral called chromium which regulates carbohydrate metabolism and helps in making your body more responsive to insulin, says Dr. Shikha Sharma, Wellness Expert and Founder of NutriHealth.

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Before making any drastic changes in your diet, you must consult your expert.

Fruit juice contains a large amount of sugar which raises blood sugar levels very quickly. Therefore, people with diabetes are usually best to avoid drinking fruit juice.

As a general rule, eating whole fruit is healthier than drinking fruit juice or fruit smoothies.

Once regarded as a healthy drink, recent research indicates that that regular consumption of fruit juice may increase the risk of developing type 2 diabetes

What’s in fruit juice?

Aside from vitamin C and calcium, fruit juice contains:

  • Calories – 250ml glass of unsweetened orange juice typically contains around 100 calories, compared to the 60 calories in an actual orange
  • Fructose (a form of sugar) – half a pint of fruit juice contains more sugar than the World Health Organisation recommends ideally having in a day (30g of sugar for men, 24g for women)
  • A lack of fibre – juice always contains less fibre than whole fruit and highly processed juices may not contain any fibre

How does fruit juice affect blood sugar?

Sugar levels in fruit juice can cause a significant spike in blood sugar levels, increasing the risk of hyperglycemia (too high blood sugar levels).

The glycemic index, which is used to reflect the impact on blood sugar levels of individual foods, places orange juice between 66 and 76 on a scale of 100. This makes fruit juice a high GI drink and high GI foods and drinks are best avoided by people with diabetes under most circumstances.

One situation in which fruit juice can be useful is to raise blood sugar quickly in response to hypoglycemia (too low blood sugar).

Fruit juice and fructose

Fruit juice is high in a form of sugar called fructose. Fructose needs to be processed by the liver and research suggests that a diet that is high in fructose may cause the liver to be overwhelmed, leading to problems such as non-alcoholic fatty liver disease and type 2 diabetes.

It is important to note that table sugar is made up of 50% fructose and 50% sucrose. There a diet high in sugar will also be high in fructose.

These points are significant because it means that over-consumption of fruit juice or having fruit juice in addition to a high sugar diet may increase the risk of health problems.

Benefits of fruit juice

Fruit juice has some benefits, however the benefits are generally outweighed by the disadvantage of the sugar content.

Fruit juice is a good source of nutrients such as vitamin C. However, it is better to get vitamin C from eating small portions of whole fruits or eating leafy green vegetables.

Leafy greens have a strong advantage over fruit or fruit juice in that they have much less effect on raising blood sugar levels.

Whole fruit is a better option than fruit juice

It is better to consume whole fruit than fruit juice. Whole fruit has the advantage of having soluble fibre for instance.

Soluble fibre can helps to improve digestion and slows the rate of the rise in blood sugar. It also means that whole fruit represents a less concentrated form of sugar.

It should be noted that people with diabetes should approach whole fruit with some caution too as many whole fruits have a lot of carbohydrate.

The bottom line is that whole fruit is better than fruit juice but should be eaten in moderation. Small portions of fruit are better.

Does drinking fruit juice increase the risk of diabetes?

A study conducted in 2013 suggested that drinking three portions of fruit juice a week was associated with an eight per cent increase in diabetes risk.

Conversely, eating blueberries, grapes, apples and pears was associated with reduced risk. The researchers found that replacing fruit juices with three helpings of certain whole fruits a week would lower the risk by seven per cent.

Some whole fruits reduced the risk more than others. For grapefruits and bananas, there was a five per cent decrease, whereas blueberries reduced the risk by 26 per cent.

What about vegetable juice?

Juiced non-starchy vegetables have a lower glycemic index and contain fewer carbohydrates than juiced fruit. The glycemic index of whole vegetables is lower still.

As with fruit, a proportion of the fibre from whole vegetables is likely be lost during the juicing process. Juiced vegetables can play a part in a healthy diet, particularly if juiced vegetables do not replace having whole vegetables.

Beverage Dos and Don’ts for Diabetes

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To successfully manage type 2 diabetes, plan your beverages as carefully as you plan your food choices. That typically means taking sugary drinks — such as soda, sweet tea, and even juice — off the table.

You might be surprised at how much a single drink can affect you when you have type 2 diabetes. Drinking just one soda a day is associated with developing type 2 diabetes, according to 2013 research in the journal PLoS One. When you are faced with so many new constraints on sugar and other carbs after a diabetes diagnosis, you may be left asking, “What can I still drink?”

Fortunately, there’s a variety of refreshing, flavorful beverages you can enjoy, says Katherine Basbaum, RD, a clinical dietitian in the Cardiology and Cardiac Rehabilitation departments at the University of Virginia Health System in Charlottesville.

Before you take your next sip, here are the top drinking dos and don’ts for those with diabetes.

Do Drink: Water

Water is one of the few beverages you can drink without worry throughout the day and a great way to stay hydrated. If you often forget to drink as much water as you should, Basbaum has a suggestion for increasing your intake: Drink one 8-ounce glass of water for every other beverage you drink that contains sugar substitutes or caffeine. Shake things up with sparkling water or by squeezing lemon or lime juice into your glass.

Do Drink: Skim Milk

“Skim or low-fat milk is also a good beverage option, but it must be counted toward your carb total for a particular meal or snack,” Basbaum says. Cow’s milk also provides protein and calcium. Be aware that non-dairy options, such as almond milk, may have added sweeteners and flavorings.

Don’t Drink: Sugar-Sweetened Soda or Tea

“Sugar-sweetened drinks are absorbed into your bloodstream much too quickly, causing a spike in blood glucose levels,” explains Basbaum. Furthermore, these drinks will affect your carb intake. Twelve ounces of soda, which is a typical serving, contain about 40 grams of carbohydrates. Other sweet drinks, such as fruit punch, have about 30g, according to the American Diabetes Association. Get in the habit of carrying a bottle of water with you in case you get caught somewhere with no sugar-free drink options available.

Do Drink: Artificially Sweetened Drinks

Drinks with artificial sweeteners, such as diet sodas, can be a calorie-reducing alternative to sweetened drinks. “I do endorse artificially sweetened beverages for the purpose of controlling blood sugar and weight,” Basbaum says.

According to a research review in the February 2014 issue of Current Opinions in Lipidology, research hasn’t shown artificial sweeteners to be either beneficial or harmful to your overall health. Because these drinks have zero carbohydrates and low calorie counts, the American Diabetes Association endorses them as a good alternative to regular soda or drink mixes. But dietitians generally prefer patients to train themselves away from sweet flavors. Ultimately, this is an individual decision based on your tastes and preferences.

Do Drink: Tomato Juice

Tomato juice might provide you with some good overall health benefits. Drinking 1½ cups of tomato juice a day for a month cut down on some measures of inflammation in obese women, according to research in the June 2013 issue of the British Journal of Nutrition. Tomato juice has about 10g of carbs per cup, so you’ll need to factor that in.

Do Drink: Coffee and Tea in Moderation

Feel free to drink tea and coffee — either hot or iced — in moderation. “Try them either unsweetened or prepared with a sugar substitute,” Basbaum says. Keep in mind that any milk, cream, or creamer you add to your drink must be counted as part of the carbohydrates in your diet. If you enjoy syrup flavors in coffee drinks, look for sugar-free variations. Rather than adding sugar, tea can be flavored with lemon juice.

Don’t Drink: Sports Drinks

Exercise is great for managing type 2 diabetes, but skip the sports drinks, which may contain up to 25g of carbohydrates. Dietitians only recommend sports drinks for endurance athletes, who may exercise strenuously enough to need salt and nutrient replacement. Water is sufficient to keep you hydrated for moderate exercise. You can also plan on a healthy post-workout snack such as a piece of fruit or a handful of nuts.

Do Drink: 100 Percent Fruit Juice — Occasionally

You can have the occasional 4- to 6-ounce glass of 100 percent fruit juice as a treat, Basbaum says. Remember to count the carbs as part of your overall meal and plan for the blood sugar spike the juice might cause. For example, if you like to have breakfast with fresh-squeezed orange juice, which as 26g of carbohydrates per serving, calculate its nutrient makeup along with your eggs and whole-grain toast for a complete picture of the meal.

Do Drink: Wine in Moderation

For people with type 2 diabetes, moderate alcohol consumption may reduce the risk for heart disease and death, according to research in the May 2014 issue of Diabetes Care. But the key is the word moderate, which means a maximum of one 5-ounce glass a day for women and two for men. More than that amount increases heart disease risk, the study found. Also be careful, because alcohol can weaken your resolve to eat healthfully.

Don’t Drink: Energy Drinks

Energy drinks give you a boost of frenetic energy that comes from sugar, caffeine, and other additives, but all of that can also cause nervousness, shakiness, and irritability. Some energy drinks contain about 29g of sugar in a serving, but even the sugar-free varieties have caffeine and additives. Instead of relying on liquid energy to keep you going, stay hydrated with healthful drinks and fight fatigue in other ways, such as getting more and better sleep or taking a quick, revitalizing walk.

What Juices Can Diabetics Drink?

Diabetes clear liquid diet foods: Nothing is best than water. It is the best perfect drink for everyone. It is said that ‘the best things in the world are free’, but nowadays nothing is free. Water doesn’t count any

  • calories
  • sugar
  • carbohydrates

However, you just can’t survive on water, especially when you have a fatal disease like diabetes. Diabetics are advised to intake liquid or food every two hours to maintain the level of blood sugar. There are several tempting and healthy drinks available in the market, but do you think is it good to have in diabetes? Hence, it is always advised to make things at home, and talking about liquids or juices, they can be easily prepared in a few mins. These healthy drinks can fit into your diabetes meal plan and can satisfy your cravings too.

Along with the juices, diabetics are also recommended to have certain fruits, but in moderation. Health experts also prove that whole fruits are a far better choice than juices.

Juice And Diabetes

Juices, such as grapefruit juice, pineapple juice, and orange juice, if taken in moderation, are considered appropriate for diabetics. All types of citrus fruit juices are a superfood for diabetics as they are nutrient-rich, says the American Diabetes Association (ADA). Apart from citrus juices, diabetics may also drink apple juice for it is rich in fiber, lemon juice as it is low on carbs, tomato juice as it is low on sugar content and carrot juice as it is juiced raw. All fruit juices, however, also contain a significant amount of sugar, which can cause blood sugar levels to spike. Therefore, moderate consumption of fruit juices is advised.

Carbs from juices also add to your total intake of carbohydrates for the day. Having juice along with the meal can surely reduce the effects of the sugar content of the juice. While citrus juices are low on the Glycemic Index table, pineapple and orange juice are rated 46 and grapefruit juice is rated 48.

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Factors Diabetics Should Consider

Consumption of carbs present in the juices results in increased blood sugar levels, though the impact varies from individual to individual. Here are a few points that diabetics should consider if they wish to consume juices or other beverages.

  • The recommended amount of fruit or any other drink is 4 oz. per day.
  • Drinking juices separately can lead to a quicker spike in blood glucose levels.

Also Read: Can Diabetics drink Alcohol?

  • Added sugar in the juices is a major concern for the diabetic’s well-being.
  • Fruit and vegetable juice prepared with the original pulp is a good choice for diabetics. Two of the best juices for diabetics include apple and carrot juice.
  • The recommended amount of juices can be taken if there is a sudden decrease in blood sugar level as it happens during extreme workout sessions or fasting.
  • The carbohydrate content of every juice is different and therefore, the effect of consuming fruit juice on blood sugar level will vary from one fruit to another. Read the label of a container before purchasing to know the nutritional value and sugar content of the juice, suggests ADA.

Also Read: Effects of Whiskey on Diabetics

  • Juices with no sugar are among the best drink choices for diabetics.
  • The number of calories and carbohydrates in sugar-free juices is way less than in the sugary ones, though the latter are also high in vitamins and minerals.
  • No matter what kind of juice you choose, every fruit provides a lot of carbs thus, making them a part of your meal plan would be the best.
  • Low-sodium vegetable juices are an excellent alternative to fruit juices, as one cup of vegetable juice contains only 10 grams of carbohydrates and 50 calories whereas 4 oz. of fruit juice provides 15 grams of carbs and 50 plus calories.

Health Tips

  • It is recommended to consume citrus fruit juice
  • Check the presence of sugar in the juice
  • Avoid drinking canned juices
  • Drink juice along with meal if you are diabetic

Read more articles on Diabetes

Drink This! Diabetes-Friendly Drinks for Any Occasion

You can’t beat these zero- or low-calorie options that have no added sugars.

Why these?

Simply put, they won’t raise your blood sugar levels.

Here’s a closer look:

Water

Your body relies on water to function, and it’s essential for maintaining overall health — whether you have diabetes or not. It’s recommended that men consume about 125 ounces of water per day and women consume about 91 ounces.

A few benefits of drinking water:

Aside from the obvious benefit of keeping you alive, here are some other things water does for you:

  • Helps you maintain a healthy body temperature
  • Lubricates your joints
  • Eliminates excess glucose through your urine
  • Improves your cognitive function

Sugar-free sparkling water

Another great choice is sparkling water that has zero calories and no added sweeteners.

Aside from its short and innocent ingredient list of water and natural fruit essences, sparkling water has been shown to improve swallowing ability, keep you full for longer, and help relieve constipation.

Some popular brands include Waterloo, La Croix, and Bubly. Best flavors? Try lime, peach-pear, mango, or coconut!

Going through the cans too fast and want to make your own? Get a sparkling water maker online.

Coffee

Caffeine affects everyone differently, so you’ll want to check your blood sugar to know if caffeinated coffee is a good choice for you. Otherwise, try decaf.

In any case, the Mayo Clinic recommends limiting coffee intake to four cups per day. Remember to consider the carbohydrate content of dairy or creamers and to choose no-calorie sweeteners.

Tea

Herbal, black, or green; caffeinated or decaf — drink it unsweetened and with a squeeze of lemon for added flavor. (Added cream and nutritive sweeteners like honey will increase calorie and carb content, affecting your blood sugar.)

Try it iced for a refreshing treat or hot to help you relax before bed. Research suggests green tea may help reduce blood pressure and lower LDL (“bad” cholesterol) levels.

New to drinking tea? Find some tasty options online.

Sugar-free sodas

Most sugar-free sodas are 99 percent water and can be counted as part of your water intake for the day. There are many caffeine-free options, too. As with all aspects of living with diabetes, moderation is key.

Low-sugar cranberry juice cocktail

Regular unsweetened fruit juices contain a lot of natural sugars — 15 grams of sugar or more in only 4 ounces.

If you’re craving some fruity refreshment without the extra sugar, try the Diet Ocean Spray flavors like Cran-Mango and Cran-Pineapple. They have only 2 grams of carbs and 10 calories per 8-ounce serving, and they provide 100 percent of your daily requirement for vitamin C.

Other low-sugar juice options

Another great lower-carb juice option is Diet V8 Splash or V8 vegetable juice. The Diet V8 Splash flavors are tasty and have only 10 calories and 2 grams of carbs in an 8-ounce serving. Plus, they contain the antioxidant vitamins A and C.

An 8-ounce glass of regular or low-sodium V8 vegetable juice provides two servings of vegetables and has only 45 calories and 9 grams of carbs and no added sugars.

Fruit juice and type 2 diabetes

“Fruit juice ‘is diabetes risk’” is the headline in The Sun . “A daily glass of ‘healthy’ orange juice could actually increase the risk of diabetes,” the newspaper says. Women who drink a daily glass of fruit juice are 18% more likely to develop type 2 diabetes, but those who eat three pieces of fruit instead actually reduce their risk by the same amount, the newspaper adds.

This study – a large and, on balance, a well-conducted one – suggests a link between fruit juice and risk of type 2 diabetes. Diabetes is a complex condition, unlikely to be caused by a single factor. In light of this fact and some limitations with the study it is difficult to quantify the contribution that fruit juices make to risk, or the mechanisms by which this might happen, and the findings warrant further study.

Where did the story come from?

Dr Lydia Bazzano and colleagues from Tulane University School of Public Health and Tropical Medicine in Louisiana and other medical and academic centres across the USA carried out this study. The research was supported by the National Institutes of Health. One of the researchers received a grant from the Office of Research on Women’s Health and Office of Dietary Supplements. It was published in the peer-reviewed medical journal: Diabetes Care .

What kind of scientific study was this?

This was a cohort study of over 70,000 female nurses followed for 18 years to determine the links between diet and risk of various outcomes. The study has published many parts of its results over time, and in this particular paper the researchers report on the association between all fruit and vegetables, particular types of fruit or vegetable, and fruit juice with the onset of type 2 diabetes during the 18 years of follow-up.

The study included 121,700 nurses aged between 30 and 55 years old, living across 11 different states in the USA. They were sent an initial questionnaire to collect data about their medical history, lifestyle, diet and other health practices. A follow-up questionnaire was sent every two years after that, and detailed dietary information has been collected since 1980. The questionnaires also asked whether the women had a diagnosis of diabetes. Those who responded yes were sent a further questionnaire to ask more about their symptoms so that an independent diagnosis could be made according to accepted criteria (on the basis of the responses). Women were included in this analysis if they completed the 1984 questionnaire, provided a sufficient amount of information (less than 12 questions blank), ate between 600 and 1500kcal and did not have cardiovascular disease, cancer or diabetes in 1984.

In total, 71,346 women were available for analysis and they were followed up with more questionnaires, including detailed food frequency questionnaires, at various time points until 2002. Since 1984, the food questionnaires included 16 questions on fruit consumption, 28 on vegetable consumption and three on potato consumption. Frequency of intake (ranging from never up to six times a day) and the size of portions were reported. The responses were used to calculate average daily intake and total intakes. Intake of other beverages, including cola or sweetened drinks, was also recorded.

The researchers assessed the risk of type 2 diabetes being reported during follow-up, and the intake of fruit and vegetables (not including fruit juice). They then looked at any associations with specific food groups, e.g. green leafy vegetables, legumes, fruit juices. In the end, they did not include potatoes in any of their analyses, suggesting that they have a different energy and nutrient density and are more likely to be found in fast foods. Women were followed up until death, diagnosis of diabetes or June 1 2002 – whichever came sooner.

What were the results of the study?

Overall, women who consumed more fruit and vegetables were older, less likely to be smokers, did more exercise and were more likely to use hormone replacement treatment than those who did not eat fruit and vegetables as frequently.

During the 18 years of follow-up, there were 4,529 new cases of type 2 diabetes. There was no link between total fruit and vegetable intake and risk of developing the disease, or with total vegetables on their own. Intake of total fruit and green leafy vegetables appeared to reduce the risk of type 2 diabetes.

When exploring the link with fruit juice, having more than three cups per month of apple or grapefruit juice increased the risk of type 2 diabetes compared with having less than one cup a month. Similarly, drinking one or more cups of orange juice per day increased the risk of diabetes by about 24% compared with drinking less than one cup a month. They also found that drinking carbonated beverages, colas (sugar sweetened and low-calorie) and fruit punch increased the risk of diabetes between 4 and 11% per increase in daily single servings.

What interpretations did the researchers draw from these results?

The researchers conclude that the study has shown a positive association between fruit juice consumption and diabetes risk. They say that this may be related to the lack of fibre and high sugar load, among other factors.

What does the NHS Knowledge Service make of this study?

This large and long-term cohort study is well-conducted and provides evidence of a link between intake of fruit juice and incidence of type 2 diabetes. The greatest limitations of the study – which the researchers discuss – are problems with measurement (e.g. misreporting of food intake) and potentially failing to account for other factors that may be responsible for the association. Over time, food consumption has changed, and the use of the same food frequency questionnaire throughout the study may not have captured this. As the study sample was nurses, the researchers suggest that the likelihood of them misreporting their diabetes diagnosis is limited.

These findings warrant further investigation. The link between fruit juice consumption and risk of type 2 diabetes may, in part, be related to the high sugar load that is delivered through the juice (in the absence of other fruit components that would be eaten with solid fruits). Some juices also have added sugar, and it is known that a high sugar intake is linked to an increased risk of diabetes. As the researchers state, the results have implications for recommendations that 100% fruit juice can be considered to be a serving of fruit.

Analysis by Bazian
Edited by NHS Website

Links to the science

Bazzano LA, Li TY, Joshipura KJ, Hu FB.

Intake of Fruit, Vegetables, and Fruit Juices and Risk of Diabetes in Women.

Diabetes Care 2008; 31:1311-1317

Further reading Nield L, Summerbell CD, Hooper L, et al.

Dietary advice for the prevention of type 2 diabetes mellitus in adults.

Cochrane Database Syst Rev 2008, Issue 3

Family links

You’re also at increased risk if people in your family have it.

It says: “You’re two to six times more likely to get type 2 diabetes if you have a parent, brother, sister or child with diabetes.

Heritage

Type 2 diabetes is to to four times more likely in people of South Asian decent and African-Caribbean or Black African descent.

High blood pressure

You’re more at risk if you’ve ever had high blood pressure.

Overweight

You’re more at risk of type 2 diabetes if you’re overweight, especially if you’re large around the middle.

One of the best ways to prevent the condition developing is making simple lifestyle changes to your diet. For those who are diagnosed with diabetes type 2 this can also help control your blood sugar levels.

Alcohol isn’t a risk factor for this type of diabetes, but it can contain a lot of calories which can lead to putting on weight – this can increase the risk of the condition developing.

Certain types of alcoholic drink can cause blood sugar to spike more than others.

If your wee smells more concentrated than normal, it could be an early warning sign that you have diabetes, revealed Now Patient’s Chief Medical Officer, Dr Andrew Thornber to Express.co.uk.

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