Meal planning is often called a cornerstone of diabetes management, but there are many ways to plan a meal, and not all of them will help to keep blood glucose levels in target range. Among those that will is carbohydrate counting, and when the GI of carbohydrate-containing foods is also taken into account, the results may be even better. But how wise it is to rely upon GI? Read on….
Carbohydrate counting involves identifying which foods contain carbohydrate, then assessing how much carbohydrate a serving of food contains. Accurately counting the amount of carbohydrate in your meals can help with blood glucose management, because carbohydrates (with the exception of fiber) raise blood glucose levels. However, some forms of carbohydrate raise blood glucose levels more and faster than others. This is where the glycemic index comes in.
The glycemic index of a food is a ranking (from 0 to 100) of how much it raises blood glucose level after it is eaten. A number of things affect a food’s glycemic index, including the type of starch it contains, the type of fiber it contains, and how finely milled or broken down the grain kernels, beans, or seeds are. Luckily for consumers, lists of commonly consumed foods and their glycemic index values are readily available.
The glycemic load of a serving of food puts together its carbohydrate content and its glycemic index to give a more accurate estimate of how much it will affect blood glucose level. Once you know a food’s glycemic index and the carbohydrate content of the amount you plan to eat, it’s fairly easy to calculate your portion’s glycemic load. So is it all black or white OR are there grey areas? Read on….
Foods and beverages that contain carbohydrate include bread, cereal, pasta, grains, dried beans and lentils, potatoes, corn, peas, milk, yogurt, fruit, juices, sweets, sugary beverages, and desserts. Packaged foods list the total grams of carbohydrate per serving. The carbohydrate content of non-packaged foods (such as fresh fruits and vegetables) can be found on numerous Web sites.
The total carbohydrate listed on food packages is the sum of starches, natural and added sugars and fiber. Since fiber is not absorbed by the body and is therefore not broken down to glucose, the grams of dietary fiber can be subtracted from the total carbohydrate for a more accurate estimate of how the portion of food will affect blood glucose level
Foods given below are sorted by Net Carbs, from lowest to highest, by percentage. The fiber content of carbohydrate does not affect blood sugar so it is subtracted from total carb counts to create net carbs, i.e. usable carbs. This is the carb count people use for lowcarb or diabetic diets. For a more detailed list refer immuneweb.org
Food (per 100 grams)ProteinFat Total Carbs FiberNet Carbs
Rice flour, brown 7.23/2.78 / 76.48/ 4.6/71.88
Wheat flour, white,
Rice, brown, long-grain7.94/2.92/77.24/3.5/73.74
unenriched, yellow 7.25/1.79/79.15/4.0/75.15
Rice, white, short-grain6.50/0.52/79.15/2.8/76.35
Potato flour 6.90/0.34/83.10/5.9/77.20
Rice flour, white 5.95/1.42/80.13/2.4/77.73
It is obvious that the difference in Net carbs is marginal in the list above.
Foods with little effect on blood glucose:
Non-starchy vegetables contain small amounts of carbohydrate (5 grams or less in half a cup cooked or 1 cup raw) and generally have no effect on blood glucose levels when eaten in typical amounts. Some examples of nonstarchy vegetables include asparagus, green beans, Brussels sprouts, broccoli, celery, onions, mushrooms, greens, lettuce, peppers, okra, tomatoes, cucumber and cabbage.
Protein alone does not raise blood glucose, but few, if any foods contain ONLY protein. Most foods that are high in protein also contain fat, such as meat, poultry, fish, dairy products, and nuts, and some contain carbohydrate, including dairy products, nuts, and beans. Those that contain carbohydrate will have a glycemic index value; those that don’t will not.
Fat alone or in combination with protein does not raise blood glucose, so foods such as butter, margarine, oil, and meat do not have a glycemic index value. When fat is combined with carbohydrate, it tends to lower the glycemic index value of the food, since fat slows digestion. This is why potato chips have a lower glycemic index than boiled white potatoes — and this in turn is an illustration of why a food’s glycemic index value is not the only the only thing to consider when deciding what to eat. Choosing foods that are lower in saturated fat and higher in monounsaturated and polyunsaturated fatty acids is important for heart health, regardless of glycemic index. Examples of healthier fats and fatty foods include olive oil, canola oil, liquid margarine, nuts, and avocado.
A typical nutritive table available on NET looks like this. With the help of such tables it is easy to plan your food intake keeping your dietary requirements ( No of calories needed) in focus. The amount of carbohydrate, protein and fat per meal and per day depends on a person’s age, activity level, sex, health status, and weight. Remember: 1gram of - Fat: = 9 calories, Protein: = 4 calories, Carbohydrates: = 4 calories, Alcohol: = 7 calories.
Food (100g)Calories (kcal)/Carbohydrate (gms)/Protein (gms)/Fat(gms)
Egg White 52/0.73/10.90/0.17
Olive Oil 884/0/0/100
It is easy to arrive at a proper diet after looking at such data in the NET.
Eat moderate portions of lean meat, poultry, fish, eggs, low-fat milk, yogurt and cheese, plus beans, peanut butter and nuts.
There are three types of carbohydrates: sugars, starches and fiber. Avoid white, Avoid grains;
Simple sugars occur naturally in foods such as fruit juice (fructose) or come from refined sources such as table sugar (sucrose=glucose+fructose) or corn syrup. Added refined sugars like sucrose, fructose and glucose are essentially devoid of nutrients other than calories.
As mentioned earlier, the glycemic index of a carbohydrate-containing food is a ranking of how much it raises blood glucose level compared to pure glucose, which is assigned a glycemic index value of 100. Consuming a food along with protein, fat, or other carbohydrates that have a lower glycemic index effectively lowers its glycemic index value.
Scarcity of GI data & Wide variation in GI measurements:
Although methods for determining Glycemic Index have been in existence for more than 20 years, GI values have so far only been determined for about 5% of the foods in the database.
The reported Glycemic Index table shows a single value of GI for each food but in reality, though, the reported values are generally averages of several tests. There's nothing wrong with that methodology, but individual measurements can vary a significant amount. For example, baked potatoes have been tested with a GI as low as 56 and as high as 111! The GI for the same fruit has even been shown to increase as the fruit ripens. This amount of variation adds a great deal of uncertainty to GI calculations.
GI values affected by preparation methods and combination with other foods:
The Glycemic Index gets even trickier when you take into account the changes in value that occur in response to differences in food preparation grinding, cooking, baking etc. The process will elevate GI values for certain foods, because it makes those food quicker and easier to digest. We often consume those foods in combination with other foods. The addition of other foods that contain fiber, protein, or fat will generally reduce the Glycemic Index of the meal.
The glycemic load takes into consideration both the glycemic index of a food and the amount of carbohydrate in the portion of food eaten. The glycemic load is calculated by multiplying the glycemic index value by the number of grams of carbohydrate, then dividing by 100. Using cooked carrots as an example, 1 cup of cooked carrots provides about 10 grams of carbohydrate, and the glycemic index of cooked carrots is 49. That makes the glycemic load of a cup of cooked carrots 4.9;
A site devoted to GI and GL, glycemicindex.com has a tool to come out with a list of foods with GI and GL as the criterion. A whole range of foods include bakery products, breakfast cereals, dairy products, grains, fruits, vegetables, legumes, nuts and traditional foods of any country.
Individual differences in glycemic response:
The rate at which different people digest carbohydrates also varies, so there are some individual differences in glycemic response from person to person. And finally, different people have different insulin responses (i.e. produce different levels of insulin), even with an identical glycemic response. This fact alone means that a diabetic can not rely completely on the Glycemic Index without monitoring his own blood sugar response. This, of course, is a limitation of any food index, and not a specific limitation of GI
How Glycemic Load Improves the Glycemic Index:
Although most candy has a relatively high Glycemic Index, eating a single piece of candy will result in a relatively small glycemic response. Why? Well, simply because your body's glycemic response is dependent on both the type AND the amount of carbohydrate consumed
Glycemic Load is calculated this way:
GL = GI/100 x Net Carbs
(Net Carbs are equal to the Total Carbohydrates minus Dietary Fiber) Therefore, you can control your glycemic response by consuming low-GI foods and/or by restricting your intake of carbohydrates.
GI's below 55 are considered low, and above 70 are considered high. GL's below 10 are considered low, and above 20 are considered high. If you use GI and GL values as the sole factor for determining your diet, you can easily end up over-consuming fat and total calories. See example below...
Apples have a GI of 38, and a medium-size apple, weighing 138 grams, contains 16 grams of net carbs and provides a GL of 6. This is a low GL, and most would consider the apple to be a very appropriate snack.
Peanuts have a GI of14, and a 114 gm serving has 24 gms of carbs, and provides an even lower GL of 2 because of higher content of fibre .
Based on Glycemic Load alone, you would have to believe that the peanuts were a better dietary choice than the apple. But if you take a look at the Calories contained in these two foods, you'll see that the apple contains approximately 72 Calories, while the peanuts contain more than 500! THOSE Calories are NOT going to help you lose weight. (OR you have to eat ONLY 16gms of peanuts.) It's important to remember that the Glycemic Index is only a rating of a food's carbohydrate content.
Another Way to Control Blood Sugar
As you consider the strengths and weaknesses of the Glycemic Index, it's important that you don't lose sight of the original goal. What we are really trying to do is control blood sugar levels. Is the consumption of low-GI foods the only way to do this? No, it is not. As we mentioned before, your blood sugar can also be controlled simply by limiting the total number of carbohydrates that you consume in any given meal.
One alternative to the low-GI diet is the low-carbohydrate diet, which also centers on the concept of controlling blood sugar levels, but does so by limiting total carbohydrate consumption. Low-carb diets have become popular, partially because they are very successful at doing this. As opposed to low-GI diets, they are also very easy to plan and monitor, since carbohydrate counts are known for all foods as against lack of data of GI,GL on all foods.
Your low-carb diet should not restrict the amount of fruits and vegetables that you eat, because of theneed for vitamins, nutrients and dietary fiber, which are much more abundant in plant-based foods. There are also many phytochemicals present in plant-based foods that we will be avoiding if we do not take plant based foods.
Putting it all together:
The American Dietetics Association (Now, the Academy of Nutrition and Dietetics) (not ADA of diabetes fame) notes that choosing carbohydrate foods with a medium or low glycemic index in place of foods with a high glycemic index is one way to lower the overall glycemic load of your meal plan. Another way is to consume less carbohydrate overall. A general rule of thumb for remembering which carbohydrate-containing foods have a lower glycemic index is the less processed a food is, the lower its glycemic index is likely to be.
All nutrients in any of the forms like protein, carbohydrates, fat are essential to the body. Choosing the right kind of food/diet helps you maintain balanced blood sugar levels.
1) Eat food only when you are hungry. Try intermittent small meals instead of a few large meals. This will help better with your metabolism and will help in reducing blood sugar levels. When you sit down to eat get up as soon as your hunger is satisfied.
2) If you are a compulsive carbohydrates eater, focus on choosing foods that are high fiber carbohydrates. They provide you with energy that lasts for hours and don’t make you feel hungry as fast. Whole foods (carbohydrates) including whole wheat, brown rice, fruits, vegetables, grains, beans, and soy products in their natural form are rich in fiber which slows their absorption. Since they are absorbed slowly, your blood sugar does not need to spike, and so your body does not need to produce elevated levels of insulin. You now become more sensitive to insulin rather than resistant to it-These are metabolized more slowly so the insulin demand is reduced. However, keep an eye on carbs content of whole grains. Avoid simple carbs such as sugar, cereals and white rice, wheat flour or white bread.
3) Include foods in your diet that have a lower glycemic index. You should include foods that have a low glycemic index and are high in fiber in your diet. Such foods may be nuts, seafood, and beans.
4) Reduce the amount of soft drinks and soda you drink. They are high calories and also high in sugar which will cause spikes in your blood sugar levels.
5)Limit salt intake. High levels of sodium can add up to high blood pressure. Salt is 40% Sodium. A teaspoon of common salt has 2.4gms of Sodium. Low sodium salts have less.
6) Avoid fatty foods. Choose only unsaturated fats. These are considered good fats. These come in the form of vegetable oils such as olive oil; Even nuts are considered a healthy fat.
7)You can also include foods which contain omega 3 fatty acids. Omega-3’s contain anti-inflammatory properties as well as many other health benefits, including improving heart health. Foods high in omega-3 include cold water oily fish such as salmon, and macker, krill fish extracts, walnut, freshly ground flax seed.
There is NO "one size fits ALL" here when it comes to food/diet for diabetes people since the what everybody leaves out a PRIMARY parameter.
That is YOU, YOUR METABOLISM ..............
BUT, NOW, MAKE YOUR DIET PRIMARY...YOUR METABOLISM will bring back good health to YOU....
Jacquie Craig, MS, RD