Rubbing a dose of sugar gel into the inside of the cheek of premature babies is a cheap and effective way to protect them against brain damage, say experts.
Dangerously low blood sugar affects about one in 10 babies born too early. Untreated, it can cause permanent harm.
Researchers from New Zealand tested the gel therapy in 242 babies under their care and, based on the results, say it should now be a first-line treatment.
Rubbing a dose of sugar gel into the inside of the cheek of premature babies is a cheap and effective way to protect them against brain damage
The researcher’s work is published in The Lancet.
Dextrose gel treatment costs just over $1.5 per baby and is simpler to administer than glucose via a drip, say Prof. Jane Harding and her team at the University of Auckland.
Current treatment typically involves extra feeding and repeated blood tests to measure blood sugar levels.
But many babies are admitted to intensive care and given intravenous glucose because their blood sugar remains low – a condition doctors call hypoglycaemia.
The study assessed whether treatment with dextrose gel was more effective than feeding alone at reversing hypoglycaemia.
Stevia – a naturally-sourced sugar substitute – apparently has no calories, no carbohydrates, and does not raise blood sugar levels.
Mention “stevia” to someone and you may well get a quizzical look, as if you’re failing to grasp some unknown language.
But stevia – a plant used as a sweetener for centuries in Paraguay and Brazil – can now be found in many British supermarkets. In the US, it’s even more common.
It has been heralded as a “miracle sweetener” and the “holy grail for the food industry”, because of its natural origins and claimed health benefits.
Although stevia has been sold in Japan for about 40 years, stevia-based products have only been approved as a food additive since 2008 in the US, and 2011 in the EU.
Companies have been quick to capitalize. There was a 400% increase globally in new stevia-based products between 2008 and 2012, with a 158 per cent rise from 2011-2012, according to Mintel.
British vitamin retail chain Holland & Barrett says it has witnessed a 50% sales rise for stevia products in the last four weeks, compared with the same period last year.
Coca-Cola dared to alter the recipe for Sprite in the UK, re-launching a new stevia-inspired version in March and claiming a 30% calorie reduction.
Even sugar giant Tate & Lyle has responded with a sugar-stevia hybrid. You can now find stevia-based sweeteners in products as varied as yoghurts, chocolates, and even beer, says Mintel’s global food and drinks analyst David Turner.
Refined sugar is now regularly linked to obesity in the media. And obesity is now widely described as an epidemic.
Stevia has the potential to help with weight management, dental health, and diabetes, says Dr. Laura Wyness, senior nutrition scientist at the British Nutrition Foundation.
Except that these possible medical benefits are also true of the artificial low-calorie sweeteners that have been around for years, such as aspartame or saccharin.
“The big deal about stevia is that it has a natural source,” says food writer and TV presenter Stefan Gates.
“That doesn’t mean it isn’t incredibly highly processed by the time it gets into your drink or food… but that’s what everyone is craving.”
Stevia is extracted from the stevia plant in a similar process to sugar, says Dr. Margaret Ashwell, who is on the scientific advisory board of the Global Stevia Institute.
“The extraction process involves steeping the dried leaves of the plant, like you would tea, and then separating or purifying the best tasting sweet compounds, which are known as steviol glycosides.”
Stevia is a naturally-sourced sugar substitute and apparently has no calories, no carbohydrates, and does not raise blood sugar levels
The concentrated extracts are about 300 times as sweet as sugar.
The steviol glycosides remain intact and chemically unchanged throughout the whole process, she says.
In contrast, artificial synthetic sweeteners such as aspartame – used in soft drinks like Diet Coke – have long been the subject of controversy.
Aspartame has been linked to cancer, and even though there’s never been any substantiating proof, people remain wary of the word “artificial” when it comes to food, says Stefan Gates.
“There’s a desperation in the food industry to be able to list things as having <<no added x>>,” says Stefan Gates.
“If you can label your product <<free from>> something, you have a massive advantage in the marketplace because people are swayed by news stories that whip up paranoia about food.”
The British Dietetic Association and Diabetes UK make no distinction between their advice for artificial sweeteners and stevia.
“As a dietician, I support and promote the use of sweeteners in cooking and diet,” says Sioned Quirke, a spokesperson for the British Dietetic Association.
“There is no evidence to suggest that low-calorie sweeteners, such as saccharin, aspartame and sucralose, are harmful or bad for you,” although she advises stevia use only as a sweetener and believes that the evidence for the claimed health benefits is insufficient for an endorsement.
“We have a dearth of data,” says anti-sugar advocate Dr. Robert Lustig, author of Fat Chance: The Bitter Truth About Sugar, who refuses to endorse alternative sweeteners for this reason.
The Food and Drug Administration (FDA), in the US, and the European Food Standards Authority (EFSA) only require acute toxicity studies, which test whether something will poison you in the short-term, explains Robert Lustig.
What we don’t know are the long-term effects of sweeteners like stevia, he says, such as whether these compounds affect hormones that alter brain function.
We don’t know how the body responds to being primed for an influx of sugar that it never receives, he adds.
“It may be that it fools your brain into thinking that it needs to release more insulin,” Robert Lustig suggests, potentially negating any supposed weight-loss benefits.
And since the FDA and the EFSA do not demand these studies, then there is no incentive for the food industry to do them, says Robert Lustig.
“We’re at an impasse.”
In the meantime, David Turner expects the stevia market to continue growing strongly, both in pre-prepared food and as a table top sweetener.
But there remain two obstacles if stevia is ever to replace sugar as the nation’s sweetener – taste and price.
“As with artificial sweeteners such as sucralose or aspartame, when they first appeared there was a distinct aftertaste,” says Turner.
“In stevia’s case this is often described as a little aniseed-like.”
“The food buying public is naturally very conservative,” says Stefan Gates.
“There are lots of people who hate the idea of change.
“I can’t see it ever replacing sugar in the kitchen.”
The stability of stevia under high temperatures could also give it a potential edge over artificial sweeteners such as saccharin when it comes to cooking, its advocates say.
But cost is a downside, explaining why hybrid products are popular at the moment.
At high prices, it’s unlikely that too many people will switch to stevia unless it’s either a medical requirement or they can afford to be so health conscious.
What is stevia – and how is it used?
- Natural sweetener that is 250-300 times sweeter than sugar
- Made from leaves of stevia plant (Stevia rebaudiana Bertoni)
- No calories, no sugar or carbohydrates and its glycemic index is zero
- Mainly added to non-alcoholic beverages
- Increasingly used in combination with sugar
The stevia plant:
- Genus of about 240 plants, native to tropical and sub-tropical areas of South and Latin America
- Named after 16th Century botanist Pedro Jaime Esteve
- Traditionally used for medicinal purposes by the Guarani people of south America, and first developed commercially as sweetener in Japan in 1970s
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People of South Asian, African or African Caribbean descent living in UK are significantly more likely to develop Type 2 diabetes than their European counterparts, British researchers have warned.
Half had developed the disease by the age of 80 in a study of 4,200 people living in London – approximately twice the figure for Europeans.
The researchers said the rates were “astonishingly high”.
The findings were published in the journal Diabetes Care.
People of South Asian, African or African Caribbean descent living in UK are significantly more likely to develop Type 2 diabetes than their European counterparts
Losing control of blood sugar levels increases the risk of heart disease, stroke, kidney failure, blindness and amputations. Type 2 diabetes is often linked to lifestyle and diet.
Some ethnic groups are already known to have a higher risk of Type 2 diabetes. However, one of the researchers at Imperial College London, Dr. Therese Tillin, said it may be down to them simply getting the disease earlier in their lives and the figures would even out over time.
But the study showed: “The rates don’t slow down as you get older. The astonishing difference continues,” Dr. Therese Tillin said.
She warned this could be a sign of things to come with the potential for soaring levels of diabetes around the world as more people lived in cities and enjoyed a calorie-rich diet.
The scientists involved said that fat, particularly around the waist, could explain some, but not all of the difference, between the ethnicities.
Fellow researcher, Dr. Nish Chaturvedi, said genetics could not explain the difference either as there were similar levels of “risky genes” across all groups.
She said: “There is something else that puts them at higher risk and we’re not sure what that is.”
Dr. Mike Knapton, from the British Heart Foundation and a GP, said: “Awareness is really low considering the magnitude of the problem, even I’m surprised by the figures.”
He also warned that failing to deal with diabetes would have huge financial consequences for the NHS.
The director of research at Diabetes UK, Dr. Iain Frame, said it was “even more important” for people at high risk to manage their weight.
He said: “People from these communities should be screened earlier than the general population – from the age of 25 rather than 40.
“People need to know their risk of developing Type 2 diabetes and get diagnosed as early as possible. We know that people from South Asian backgrounds can often be living with the condition for around 10 years before they are diagnosed, which increases the risk of complications such as heart disease, stroke, kidney failure, blindness and amputation.”
