Low Carb Luxury continues its series of interviews with key players in the low carb and specialty food industry in our ongoing effort to be the liaison between business and consumers. For this issue, we were fortunate to be able to speak with Dr. Francine Kaufman, MD, inventor of ExtendBar, Head of the Center for Endocrinology, Diabetes and Metabolism at Childrens Hospital Los Angeles and Vijay Chauhan on behalf of ExtendBar, distributed by Clinical Products, Ltd. of St. Louis, Missouri.

Low Carb Luxury: As the second woman ever elected President of the American Diabetes Association, and as a children's advocate, you have been relentless in your efforts to make sure every person with diabetes has a fighting chance to stave off grim complications. It's our understanding that you led the effort over the course of 5 years to come up with ExtendBar's patented formula. Can you explain how and why ExtendBar was developed?

Dr. Francine Kaufman: As a pediatric diabetes care provider, we want to continue to come up with treatments that can help improve our patients blood glucose control. We have over 2000 children at our Pediatric Diabetes Center at Children's Hospital in Los Angeles. We know that the more we work to bring blood sugar down to normal levels the greater the risk and incidence of hypoglycemia — a very scary condition. My colleagues and I were trying to determine ways to mitigate hypoglycemia.

We were impressed with the research previously done on the complex carbohydrate, uncooked cornstarch for its slow conversion to glucose. While working with the children (with Type I Diabetes) in clinical studies at our Diabetes Camp, we found that when uncooked cornstarch was combined with specific amounts of fat, protein, and other carbohydrates, it helped stabilize blood glucose levels for long periods of time... up to 7 to 9 hours. (See study abstract at bottom of this interview.)

This would allow these children to get through the night without having hypoglycemic events, allowing for a restful sleep.

The next issue was that there needed to be a way that these children could ingest this formula at home, but the mixture quite frankly tasted pretty bad and was unlikely to be eaten by the children. So we needed to find a way to make it easy to eat and taste good. We came up with a plan to create a snack bar, which worked very well and was well received by the children and youth in my Center and camp.

At this point, we weren't even aware of the hunger abating effects of the formula.

Later, as the study grew to include other children and adults, we were hearing comments about the bars being really filling and that they didn't feel a need for additional food.

At this point, we began doing glucose tests on "normal" people to see what it did to insulin levels. It became obvious that there was a strong appetite suppressant effect with the bars and we saw the applications for those with Type II diabetes, pre-diabetes, those who are overweight with no diabetes, etc.

Vijay Chauhan: Studies were done with people with no diabetes who were mildly obese (BMI of 27 to 31.) We found that when clinically tested as an afternoon snack, ExtendBar helped control appetite and reduced calories consumed at the evening meal by 21%. These tests were done in 2000 with the regular (not the low carb versions) of ExtendBar, but the same results are now seen with the low carb ExtendBars.

LCL: What are your thoughts on carbohydrate reduction for both weight control and treatment of diabetes?

FK: As past President of the American Diabetes Association, I can tell you that our policy always has been that "a carb is a carb is a carb..." However, everybody knows that's not true. Seven year old children with diabetes will tell you, "I can't eat that... it will ruin my blood sugar. But I can eat that." Even if it has the same carbohydrate content — but from vastly different carbohydrate sources. There's no doubt that the quality of the carbohydrate as well as the glycemic index are critical.

LCL: What are your thoughts on the glycemic index?

FK: If we get a bolus of glucose in a liquid form, we get maximum insulin release, but if the same amount of carbohydrates are taken via something with a low glycemic index, you simply don't get the same type of insulin response. So it's obvious that there's a differential response the body has to different types of carbohydrates. To avoid insulin spikes one should look for foods with a low glycemic index and more importantly, a low glycemic load. We think it's important to minimize the amount of carbs with a high glycemic load for controlling diabetes and weight.

VC: All of the ExtendBars have a very low GI/GL:

• Peanut Delight has a glycemic index of 32 with a glycemic load of only 4.
• Apple Cinnamon has a glycemic index 33 with a glycemic load of only 4.
• Chocolate Delight has a glycemic index of 41 with a glycemic load of only 5.

LCL: We already touched on ExtendBar working as an appetite suppressant, but can you expand on that?

VC: One of the key triggers of appetite is when blood sugar goes low. Because ExtendBar prevents low blood sugar for long periods of time, it naturally suppresses appetite. We found that using ExtendBar with those with Type II diabetes and those without diabetes who are overweight really helped to manage hunger. People are able to stay with a healthy eating regimen when they are able to manage their hunger pangs and ExtendBars have done that very successfully. We have people who have been able to shed a lot of weight, reduce their medications, and sometimes get off medication altogether.

While other low carb bars usually won't cause your blood sugar to spike, they also convert to blood sugar much more rapidly than ExtendBar, and can't protect you from episodes of low blood sugar for up to 9 hours like ExtendBar. So they don't work to suppress the appetite, as effectively. Further, ExtendBar is nutritionally balanced to manage hunger and promote heart health. Each bar has only 130 to 160 calories, is high in fiber and protein, low in fat and has no cholesterol and trans-fats.

LCL: You say that ExtendBar stabilizes blood sugar for up to 9 hours. How is this possible?

FK: Unlike the carbohydrates in most foods that convert to glucose quickly causing blood sugar levels to spike, ExtendBar's is designed to break down gradually and release the carbohydrates into your system more evenly and slowly. This provides you with a continuous source of energy for up to 9 hours. Uncooked cornstarch combined with a patented blend of proteins, fats and other carbs provides the blood sugar stabilization.

VC: In fact, an ExtendBar before bed can reduce disturbing nighttime blood sugar lows by up to 75%. This is true of both the low carb versions and the regular versions of ExtendBar because both contain uncooked cornstarch.

LCL: What clinical studies have proven the benefits of ExtendBar?

VC: We have 5 clinical studies that validate ExtendBar's benefits. On the website, you can find abstracts of all the clinical studies done. You can find them by visiting http://www.extendbarworks.com/pages/health_clinical.asp.

LCL: Why did you choose to use sucralose in your lower carb bars?

VC: We needed to replace the fructose (not HFCS!) in our original bars in order to reduce glycemic response. Sucralose had a very good taste profile, and no after-taste compared to other non-coloric sweeteners. Also, sucralose had a very good safety record.

LCL: Why did you choose Chocolate, Peanut and Apple Cinnamon as your flavors, and are there other flavors coming?

VC: We began with market research as you might expect and so we started with the most popular flavors — chocolate and peanut. We also had to look at what flavors work well with the addition of the uncooked cornstarch as an ingredient. When looking for a new flavor to add, we noted that many of our customers were requesting something with a fruit flavor. At the same time, we were interested in the new research coming out about cinnamon and its benefits with blood glucose control. So Apple Cinnamon seemed a natural choice. We are of course looking at new flavors to be added by the end of 2005.

LCL: The Chocolate and Apple Cinnamon are gluten free but the Peanut is not. Why is that?

VC: The peanut bar will be gluten free as well in about three months. The reason it isn't at this point is that the soy crisps in the peanut bar contain very little barley malt extract.

LCL: What are your goals with ExtendBar, and when will they be available in-store on a national level?

VC: We've been very focused on the diabetes market until now because of the blood sugar stabilization benefits of ExtendBar. But as we all know, this is extremely important to the low carb community as well since many of those on low carb diets are doing so for weight reduction and a need to minimize insulin response.

At this time the business is in its early growth stage so the best way to distribute is by direct internet and phone sales. We offer free shipping and volume discounts online. We also wanted to be sure that ExtendBars weren't grouped with other "typical" low carb bars in retail outlets. The freshness factor is also better served when shipped directly to the consumer.

We have a special introductory offer exclusively for Low Carb Luxury Magazine subscribers (click on this link for details.)

LCL: Thank you so much for your time, Vijay and Dr. Kaufman. ExtendBar sounds like a revolution in the diabetes as well as the low carb communities. We encourage our readers to check out our product review of ExtendBar, as well as taking the time to try these amazing bars yourself. It isn't often we are so impressed with a company, a philosophy, and a product.


         

Copyright © January 2005  Lora Ruffner and Neil Beaty for Low Carb Luxury.
ExtendBar™ logo copyright © 2005 Clinical Products, Ltd.; St. Louis, MO


A randomized, blinded trial of uncooked cornstarch to diminish nocturnal hypoglycemia at Diabetes Camp.

Kaufman FR, Halvorson M, Kaufman ND
Department of Pediatrics, Children's Hospital Los Angeles, CA, USA.

OBJECTIVE: To determine if uncooked cornstarch, as part of the evening snack, can avert nocturnal hypoglycemia in type 1 diabetes.

RESEARCH DESIGN AND METHODS: Fifty-one campers and counselors at the American Diabetes Association Camp in San Bernardino, CA were randomly assigned to receive 5 g of uncooked cornstarch as part of the 21:00 evening snack vs. a standard snack of equivalent carbohydrate content. Each snack was given for five nights and the participants and medical personnel were blinded as to assignment. Midnight and 07:00 finger stick blood glucose levels were compared with values <60 mg/dl defined as hypoglycemia and values > 250 mg/dl defined as hyperglycemia.

RESULTS: There were 218 midnight and 222 07:00 values for comparison. There were six episodes of hypoglycemia at midnight and nine episodes of hypoglycemia at 07:00 for the cornstarch snack nights vs. 30 hypoglycemia episodes at midnight and 21 at 07:00 for the standard snack nights (P < 0.001 and <0.05, respectively). There was no difference in the number of hyperglycemic events at midnight or 07:00 for the cornstarch vs. standard snack nights. At midnight, 12% of campers had hypoglycemia after the cornstarch snack vs. 46% after the standard snack (p < 0.001), and at 07:00, 16% had hypoglycemia after cornstarch vs. 26% after the standard snack (p = 0.327).

Conclusions: These data suggest that uncooked cornstarch, as part of the evening snack; can diminish the nighttime and morning hypoglycemia associated with type 1diabetes, without causing hyperglycemia.

Diabetes Research and Clinical Practice 1995 Dec;30(3):205-9