Understand the Glycemic Index and Diabetes
Understand the Glycemic Index and Diabetes
Would you like to understand the Glycemic Index in very simple terms? If you are confused by the Glycemic Index this extensive article will be very helpful as it dives deep to help you understand the Gylcemic Index including the history of the Glycemic Index and how it came to be.
If you would talk about the glycemic index with almost any type of medical professional, nutritional expert, or registered diet professional, you would get a variety of responses. Most of health care professionals simply do not believe in the concept of the glycemic index and its inherent value to the health care of their patients.
Most healthcare professionals believe that a carb is a carb is a carb. In other words, all carbohydrates are the same and that the concept of simple sugar versus complex carbohydrates still dominates in the United States today. This concept is what is still taught to diabetic people in the US.
Complex Carbohydrate and Simple Sugar
Carbohydrates are merely long chains of sugars that are affixed with each other. The rate of digestion, and thus the rise in blood sugar after eating a specific carbohydrate are frequently thought to be established by the length of this sugar chain.
This idea was initially introduced in 1901 and has dominated throughout the whole 20th century and now right into the 21st century. It has been thought that if you eat a simple sugar like glucose or sucrose, your blood sugar would rise quickly because the body does not need to break down the sugar.
However; if you eat a complex carb like a potato or a piece of bread, your blood sugar level would rise slower, and therefore, be better for the diabetic and normal person. Therefore, you’ll notice simple sugars, candy, and sweets at the peak of the USDA food pyramid.
This concept of simple sugar and complex-carbs has been the standard-of-care now for more than 100 years and has been firmly embedded in our thinking and our practice of medicine. It’s difficult to change an idea that has been with us for so long. Nevertheless, as you will discover, it is the primary reason we are facing such a health care dilemma in the United States.
As the concept of low-fat, high-carb diets gained acceptance in the early 1970’s, the basic recommendation was that any carbohydrate other than sugar was acceptable in this newly recommended “healthy” diet.
There was no distinction made between the different characteristics of these complex carbohydrates and the focus was primarily on teaching everyone to reduce the amount of fat that they were consuming in their diet. It was this dependence on a 1901 theory which is the primary reason that we are facing this over-whelming problem with both obesity and diabetes in the Western world today.
Understand the Glycemic Index History
The concept of the glycemic index was introduced in 1981 by Jenkins (et alia) in the American Journal of Clinical Nutrition. They specified glycemic index as the rate blood sugar would rise following the ingestion of a specific test food relative to the ingestion of a standard food (either white bread or sugar).
Therefore, the glycemic index of a specific food or meal is identified mostly by the nature of the carbohydrate or carbs eaten and by additional factors that affect the digestion of that particular meal (including the fat and protein content of that meal).
This notion has totally changed the way we look at carbohydrates. Rather than completely accepting the speculation that the rate of absorption and thus the rate of rise of the blood sugar is simply based on the length and complexity of the sugar being consumed, the actual and true rise of the blood sugar was determined in a clinical setting with standardized techniques.
Most of the complication with the glycemic index in the healthcare community as well as patients is the result of two different standards (white bread and glucose) over the past 20 years. To put it simply, several of our clinical studies dealing with the glycemic index made use of white bread as the standard and some of our other studies used glucose.
When glucose is used as the criterion, white bread has a glycemic index of 70. When white bread is used as a standard it has a glycemic index of 100. Therefore, all the glycemic index numbers for different carbs will be different based on which standard food-either glucose or white bread-was made use of.
It’s believed that the common food that will dominate will be glucose = 100. For that reason, it’s important to refer to all foods according to the standard where glucose equals 100. It is possible to convert the glycemic index from the standard of white bread to glucose by using the factor of 0.7.
The Glycemic Index of Basic Foods
When this concept was first launched the results surprised most diet professionals, nutritionists, as well as medical professionals and physicians. As an example, simple sugars like table sugar (sucrose) had a glycemic index of 61 and the sugar found in fruits (fructose) had a glycemic index of 19.
This contrasted with some complex carbohydrates like white potatoes, which had a glycemic index of 85 or white bread that had a glycemic index of 70.
Even more worrisome was the fact that wheat bread had a glycemic index of 77 and breakfast cereals like corn flakes, bran flakes, and Cheerios had a glycemic index which was very high with some as high as 92.
This literally destroyed the concept that the increase in blood sugar might be figured out solely on whether a carb was a simple sugar or a complex carbohydrate. Clearly, most health-care professionals did not accept this new idea with open arms.
For many years the idea of the glycemic index has been really controversial, many do not fully understand the glycemic index. There have been many heated discussions at conferences where these two ideas have been discussed. Obviously, it takes time for a paradigm-shift; particularly, when it comes to a concept that has been the main-stay of diet counseling and therapy for the past century.
Researches carried out in Australia, Canada, United Kingdom, as well as throughout Europe have actually been proven beyond any doubt, there is tremendous value in the glycemic index. However, the USA remains opposed to this idea and continues to suggest teaching the concept of simple sugar and complex carbohydrates to everyone including our diabetics rather than really help understand the glycemic index.
However, there is no question after reviewing the medical literature regarding the glycemic index that the US will soon follow and accept the concept of the glycemic index. In fact, in the May 8, 2002 issue of the Journal of the American Medical Association an article was presented that reviewed 311 of these studies dealing with the glycemic index.
What Determines the Glycemic Index of Various Foods?
Since we are now realizing that simple sugars and complex carbohydrates no longer give us any indication on how quickly we will absorb these foods, what really determines our body’s ability to absorb a certain food?
In a nutshell, it’s how a specific carbohydrate has been processed and prepared. Since 90% of the carbohydrates we now consume in the USA and many other parts of the world are processed carbs, you are going to begin to understand why high blood pressure, heart disease, obesity, elevated lipids, and diabetes are epidemic in the Western World today.
In fact, you will also begin to realize the main answer in helping solve our current healthcare crisis is by going back to the basics and learning to eat again the “Old Fashioned Way”.
Whole Foods vs Processed Foods
We live in an era of the “instant”. Instant potatoes, instant rice, instant oatmeal, etc. are simply a way of life. We rush to work in the morning grabbing a piece of toast (usually made from white flour or wheat flour), a glass of orange juice, and a 12-oz cup of coffee as we’re on our way out the door.
For lunch, we might stop by our favorite fast-food-joint and become impatient when our hamburger fries, and super-sized coke is not ready within two minutes. After a long-day at the office for both husband and wife a quick call is made on their cell phones to decide who is picking up pizza for dinner that night. Sound a little familiar?
The fast food, instant food, and consumption of many highly-processed foods is the most dramatic change that has taken place in society over the last two generations. The health consequences of this change are not just devastating but lethal!
When you review the following list of the top-20 sources of carbs in our diets today compiled by a Harvard School Public Health Researcher, you begin to understand that the scenario described above is right-on-target.
Top 20 Carbohydrates Consumed in America Today
Potatoes (mashed or baked)
Cold Breakfast Cereal
Dark Bread (made from Wheat Flour)
History of Modern Food Processing
When you understand the glycemic index of these various foods, you quickly realize that most them are very high-glycemic. Much of this is because these foods are highly processed and are made with our modern-day flour. Modern flour comes from high-speed rolling mills, which replaced the traditional millstones of the 18th century.
The new rolling mills were so much more efficient; nevertheless, since they created a lot more heat, the flour would spoil rapidly. This was primarily due to the oxidation of the embryo of the seed which happened much more quickly due to the high heat that was produced.
Well, it certainly didn’t take them very long to figure out that if they were to de-germinate the grain and also remove the covering of the seed (called the bran) whose fiber restrained the new milling process so that the process of oxidation could be avoided.
The results were of high quality, pure white flour, which didn’t spoil. It was an economic stroke of genius! Not only was the bread, bread items, and wonderful pastries made from this flour light and delicious but the flour itself had an extra-long shelf life. It quickly became a delicacy of the rich; while the old, stone-ground flour with its crude texture and taste was delegated to the peasants of the world.
However, as we are beginning to understand our body can absorb these extremely superfine particles of white or wheat flour promptly. This causes a quick increase of our blood sugar and creates a high-glycemic index. As kept in mind previously, white bread and white flour spikes our blood sugar faster than if we were slapping table sugar on our tongue!
Take a minute and consider the amount of processed grains and carbohydrates that are in our diet. White bread, white flour, wheat flour, most rice, cakes, pastries, potato chips, breakfast cereals, fruit juices, sodas, sports drinks, and the checklist goes on and on.
Now have a look at the glycemic index of whole foods. Whole foods are specified as those foods that are consumed in their all-natural state. In other words, they’re not refined and many of these foods are described as live foods. An example of whole foods are apples, oranges, grapes, beans, cauliflower, brussels sprouts, oats, and whole wheat grains.
These foods are completely natural and containing their natural fiber and natural form. When look at these foods on the glycemic index graph, you will find that they are all low-glycemic foods. As a result, a general principle, however not an absolute concept, is that the more highly processed or refined that a food is the higher its glycemic index.
Fiber Content of Foods
As a rule, the higher the fiber content of a particular food the lower the glycemic index. However, according to Thomas Wolever, among the leading authorities in the glycemic index, although it is valuable to understand the type and quantity of fiber in various foods it is not the only element that determines the glycemic index.
As an example, the fiber contained in processed white or wheat flour does nothing to reduce the absorption of these carbohydrates. However, when you consider the viscous fiber found in legumes and whole oats, it absolutely slows down the absorption of the carbs from these foods.
In general, Wolever states that in the purified type of soluble fibers have a greater affect on the glycemic response when compared with insoluble fibers. However, it’s still challenging to determine the glycemic index of a food by merely taking a look at its fiber content.
Amylose / Amylopectin Ratio Affects Glycemic Index
There are two sorts of starches that comprise a lot of our foods. These are called amylose and amylopectin and the proportion with which these two starches occur in our foods has a strong influence on the glycemic index. Amylose is a straight-chain molecule that lines up like a tight set-of-beads.
This configuration makes it tough to gelatinize and therefore much more difficult to digest. On the contrary, amylopectin is made up of linear molecules with many branches. This allows it to be digested quite easily. These two starches are available in many foods at different ratios.
Foods consisting of a high percentage of amylopectin undoubtedly turn out to be high-glycemic. These are typical of many of the rice dishes available. However, those foods that have higher degree of amylose, such as basmati rice, black beans, lentils, and soy beans are extremely low-glycemic.
Type of Sugar Content has a Major Influence on Glycemic Index
One of the most surprising facets of the glycemic index is the vast variation in how various natural sugars are absorbed. For instance, the sugar primarily located in fruits (fructose) has a glycemic index of 19, while glucose has a glycemic index of 100.
The majority of people do not recognize that table sugar (sucrose) is a disaccharide (made up of two molecules), which means that it is a dual sugar made up of one molecule of glucose and a molecule of fructose.
This is the reason that table sugar has a glycemic index of 61, which is essentially in between the two sugars that compose sucrose. Honey has a glycemic index of 55. Lactose (the carbohydrate found in milk) has a glycemic index of 46 while maltose has a glycemic index of 105.
It doesn’t take much to understand the glycemic index of numerous foods will certainly be determined in a huge component by the type and amount of sugar that is present. However, there is still a broad variant in various kinds of fruits.
The exotic fruits like bananas, mango, and pineapple have a medium-glycemic index, while most of the other fruits (aside from watermelon) have a low-glycemic index. Much of the higher processed foods such as most yogurts have a mixture of all-natural and added sugars and therefore, tend to have higher glycemic indexes.
How Food is Prepared has a Significant Influence on Glycemic Index
Generally, the starch in raw foods is saved in hard, compressed granules that make them very difficult to digest. Therefore, you will see that mostly all raw foods have a lower glycemic index than the cooked foods of the same type.
The reason this occurs is because throughout the cooking process these tough, compact starches expand when they are heated and could even rupture. This is a process called gelatinization. These inflamed starches are easy to digest and be absorbed by the starch digesting enzymes of the small bowel. This is precisely why you do not want to overcook any of your food.
When you understand the glycemic index of your foods you will also understand why heat is not your friend! You will discover that heat can turn good-fats into bad-fats and in this situation, turn low-glycemic carbs into higher-glycemic carbs. As an example, you want to generally under-cook majority of your pasta so that it remains firm (al dente).
Trying to determine the actual glycemic index of foods based on their fiber, sugar, and type of carbohydrates is guess work at best. Although it is safe to say that most whole fruits, whole grains, and whole vegetables are going to be significantly lower in their glycemic index than are the more highly processed foods.
The Concept of Glycemic Load
Since the idea of glycemic index is fairly-new to most people, there is constantly some confusion concerning just how to exactly translate its practical use as a guide to healthy and balanced nutrition. One of the significant reasons why you want to become knowledgeable with the glycemic index of most typical foods is because it’s essential to avoid the problem of spiking your blood sugar and subsequently our blood insulin levels after the consumption of a meal. To better comprehend its usage, you need to learn about the concept of glycemic load.
Glycemic load is defined as the weighted average glycemic index of specific foods multiplied by the percentage of dietary energy as carbs (grams of carbohydrates or calories) that the specific food contains.
A straightforward calculation allows you to determine the glycemic load of any food. You can usually locate the grams of carbohydrate of any specific food by looking at the food label or making use of a food composition table and then multiplying it by the glycemic index. Then divide this number by 100.
Glycemic Load Calculation Example
Glycemic Load = (Glycemic Index x Grams of Carbohydrate per serving) divided by 100.
- Rice: 1 cup of cooked instant rice has a Glycemic.
Index (GI ) value of 87 and contains 37 grams of carbohydrate Glycemic Load: (87 X 37) divided by 100 = 32
- Apple: Apples on an average have a GI value of 38 and the contain 16 grams of carbohydrate per serving Glycemic Load of an Apple: (38 X 16) divided by 100 = 6
- Spaghetti: 1 cup of cooked spaghetti has a GI value of 41 (average) and contains 52 grams of carbohydrate.
Glycemic Load: (41×52) divided by 100 = 21
- Carrots: Glycemic index is 49 and the average serving contains an average of 5 carbohydrates per serving.
Glycemic Load: (49 x 5) divided by 100 = 2.4
- Rice: 1 cup of cooked instant rice has a Glycemic.
This concept of glycemic load gives you a far better picture of the glycemic response a that a specific food will have. As an example, cooked-carrots have a medium glycemic index of 49 while its glycemic load is 3.8 (there are merely very few calories in carrots).
This just implies that carrots do not have adequate carbohydrates to spike your blood sugar, even though they have a medium glycemic index (GI). However, potatoes have both a high glycemic index as well as a high glycemic load, which will dramatically raise your blood sugar and boost your insulin reaction.
Determining the Glycemic Index of Mixed Meals
Among the major arguments versus utilizing the glycemic index in clinical medicine stems from the argument that when you combine your carbohydrates, fats, and protein together into a regular meal, all carbohydrates are still absorbed at the same rate.
At first, there were a couple of studies that sustained this perspective. There is no question that fat will decrease gastric emptying, which reduces food digestion and therefore lowers the glycemic index of a combined meal. This has come to be another significant concern with the low-fat, high-carbohydrate diet plan.
As individuals began eating more and more carbohydrates in their diet, they also were eating less and less fat. This caused even greater spikes in their blood sugars following these meals.
Protein takes much longer to digest than most of your carbohydrates. Following a meal or snack that contains a significant amount of protein there will definitely be a slower rise in your blood sugar.
This is the reason that when you eat protein in a meal or snack you are more fulfilled for a longer period of time. However, over the years, more and more studies indicated that when you looked at the glycemic index of various foods in any particular meal, you were able to accurately predict the glycemic and insulin response to that meal.
These studies have shown that in addition of fat and protein to the meal they did not significantly change the overall glycemic response expected by the types of carbohydrates contained in the meals.
Additionally, when two carbohydrates were mixed together in equal proportions in one meal, the blood glucose response was approximately midway between those meals containing each food alone.
Understand the Glycemic Index is Only One Aspect in Determining Healthy Foods
The glycemic index is only one consideration when choosing the types of foods, you are going to eat. For example, sugar, some soft drinks, and some sweets are mid-glycemic. Nonetheless, their poor nutritional value and glycemic load are not suitable for a healthy and balanced diet. It is critical that you learn that our greatest health enemy is processed carbohydrates!
You will likewise discover that there are good fats and bad fats as well as good proteins and bad proteins. However, in this article you hopefully have gained an appreciation for the fact that in this modern, fast paced world, you need to understand the underlying dangers to the instant or fast food craze. It’s a dangerous mentality.
You might be encouraged to spend some time to understand the glycemic index and review the recommended carbohydrates, fats, and proteins. This list of foods has been divided into the most desirable (Low), moderately desirable (Medium), and least desirable carbohydrates (High), fats, and proteins.
The glycemic index, types of fats and protein a particular food contains was taken into consideration before placing them in these various categories. It is important that about 70% of your food choices come from the desirable list, 20 to 25% of your food choices come from the moderately desirable list, and only 5 to 10% of your food choices come from the least desirable list.
Hopefully this article has helped you understand the glycemix index, as you can see it’s really not that complicated and may be life-changing for a diabetic person.
Understand the Glycemix Index Chart for Common Foods in North America