Agave and Diabetes

Hi Desi,

My name is Nanette and I live in Gladstone, Oregon. My partner, Donna, and I are opening a diabetic bakery creating lovely pies, cakes, pastries, muffins, and more.

I spoke with Barbara today about some concerns we have regarding Agave sweetener and she suggested that I contact you for the answers.

I have been researching Agave. I love the fact that it has a low glycemic index, but my concern is the 16 carbs per tablespoon. How is that going to effect my clients who are carb counting and my insulin dependent customers? I am hypoglycemic and watch my carbs while my husband is a insulin dependent diabetic and watches everything.

BIGGER QUESTION: Can a insulin dependent person eat Agave sweetened food and what effect does it have on them? Do you have more documentation that supports diabetics using Agave. I read that you have the support of the ADA.

Donna and I would love to use this product. Maybe you could pass these questions along to right person. How does using Agave effect the baking properties - browning, height in rising; are cakes light or heavy? I checked some of the baking recipes on your website and they all called for granulated sugar and/or brown sugar, but not Agave. Do you know why that is?

Donna and I would so appreciate a reply from you with the answers to these questions. Barbara asked to be cc: also so she can have the answers when other people call with the same questions.

Thank you for your time and expertise.

Nanette Goin

Hi Nanette,

I've done some searching regarding Agave, and with my Dietetics background, I hope to be able to answer your questions or link you to some good resources.

From my research, Agave is chemically a fructose-based sweetener (http://www.madhavahoney.com/agave.htm).

Fructose raises lipid levels in the blood. While this can be tolerable for some without diabetes, it is not such a good thing for those with diabetes who have an increased risk for heart disease and high blood pressure.

Would it be possible for a person with diabetes to consume enough Agave to make a difference? I hope not, however fructose-based sweeteners are still not recommended by the American Dietetic Association as shown in the following excerpt:(http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/home_3794_ENU_HTML.htm)

Intakes as high as 60 g fructose or sucrose per day may not adversely affect glycemic or lipid response in persons with type 2 diabetes (152). However, because there exists concern for increased blood lipid levels with high intakes of fructose (see hyperlipidemia section), addition of fructose as a sweetening agent is not recommended for people with diabetes (151).

Because it is difficult already to eat "heart-healthy" in our society, I do not recommend adding such sweeteners (high fructose corn syrup or agave) to diabetic-marketed products . . . especially when there is often this mental disconnect between Diabetes and heart health. Many folks I know feel they need only be concerned about "sugar." If not watching the heart-healthy side of food, blood lipid levels could be on the rise, and I think the fructose-based sweeteners will just add to that rise.

Here is an anecdotal review of Agave. I do not know where he/she gets her information, but it is worth looking into.

http://living-with-type-2-diabetes.blogspot.com/2007/10/agave-not-so-sweet.html

If you still wish to use Agave, consumers should count it just like they do other carbohydrates, as recommended by the ADA in the article referenced above: "Given that the primary goal for medical nutrition therapy of diabetes is to maintain near-normal blood glucose levels, the American Diabetes Association suggests that attention be given to the total amount of carbohydrates in meals and snacks rather than to glycemic responses resulting from their consumption (151). Nutritive sweeteners need not necessarily be restricted, but, if consumed, they should be substituted for other carbohydrate sources rather than added. Nonnutritive sweeteners also are appropriate in medical nutrition therapy for people with diabetes and may help control energy intake. Dietetics professionals can help persons with diabetes incorporate nutritive and nonnutritive sweeteners into their individual meal plans."

A tablespoon of table sugar has 12.5 grams carbohydrates (counted as 1 Carbohydrate), while 1 tablespoon Agave, with 16 g carbohydrate is also counted as 1 Carbohydrate. With the carbohydrate count so similar , consumers with diabetes might as well use sugar, as Agave. They, then, would be more cautious and more use more restraint when eating carbohydrate rich foods.

Hope this helps,

Desiri Wightman,
Registered Dietitian

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