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Glycemic Index Helps Manage Blood Sugar

doctor offering a donut or an apple
August 26, 2014 (Updated: August 16, 2018)
Lily Moran

If you or someone you know is diabetic or has problems with weight or blood sugar management, you’ve probably heard of the glycemic index (GI).

The glycemic index is an objective way to measure the impact of various carbohydrates on your blood sugar (glucose) levels.

It does not focus on carbs because they are necessarily “bad.” It’s just that fat and protein don’t elevate blood sugar as much as carbs do. So the glycemic index helps you avoid or cut back on foods that raise your blood sugar the most, something that’s very important to anyone with diabetes or pre-diabetes, or who’s trying to lose weight.

Eating a steady diet of high glycemic foods leads to a blood sugar rollercoaster. Elevated blood glucose levels signal your pancreas to produce too much insulin, the hormone that enables glucose to enter your cells, to create energy.

Repeat this day in and day out, and soon your cells lose their sensitivity to insulin. As a result, blood glucose levels soar to dangerous levels.

Reduced insulin sensitivity, or insulin resistance, has strong connections to high blood pressure, weight problems – especially around the waist – elevated blood fats, and a greater risk of developing type 2 diabetes.

This combination of symptoms is sometimes called metabolic syndrome or pre-diabetes. About 70 million Americans are pre-diabetic, and another 30 million have the more advanced disease, type 2 diabetes.

That’s about one-third of the population. No wonder many medical experts believe diabetes is at epidemic levels!

Individuals with diabetes or pre-diabetes have an increased risk of heart attack and heart disease, stroke, certain types of cancer, vision disorders, and even amputations.

When I say “increased risk,” I don’t just mean a slight elevation. People with diabetes, for example, have as much as four times the risk of a stroke as people without the disease. And they’re two to four times more likely to have heart disease than those without diabetes.

Obviously, anything you can do to avoid diabetes or to keep blood glucose at reasonable levels is smart. And that’s where the glycemic index (GI) comes in handy.

The GI is not a diet. But it’s very helpful for separating the healthy carbs from unhealthy, so that your blood glucose levels don’t go off the charts.

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The GI uses a scale that goes from 100 to 1. Pure glucose is at the top with a score of 100. Foods with a GI above 70 fall into the high GI category. These include potatoes, bread (white, wheat, and made from gluten-free alternatives like rice), corn chips and corn flakes, rice cakes, candy, honey, and watermelon.

At the low end of the GI scale (0 to 55), you’ll find most fruit and non-starchy vegetables, long grain rice, low-fat yogurt, and 100% whole grain pasta.

In the middle (56 to 69), there’s brown rice, macaroni and cheese, kidney beans, potato chips, sweet corn, and even oatmeal cookies!

The best way to use the GI is by combining it with a second, related measure, one that helps you maintain healthy blood glucose levels without sacrificing all the foods you love.

The second part of the healthy blood glucose picture is the glycemic load (GL). GL looks at grams of carbohydrates in a typical serving.

So, for example, while watermelon has a high glycemic index (72), most of what you eat in a serving is water, not carbohydrates. Based on a typical serving size of four ounces (which has 5.5 grams of carbohydrates), the glycemic load of watermelon is a mere 4.

That information may seem contradictory, but not if you know how to use it correctly. One method is to establish a glycemic index limit, and not eat anything with a GI above 55.

Another option is to set a daily target glycemic load, say, for example, between 60 and 80 grams of carbs daily. With this method, you can include small portions of foods that would be forbidden if you went with the low to moderate GI plan.

With either method, you do need to watch portion sizes carefully, but that’s an excellent habit to develop. You can establish your glycemic index or glycemic load targets with one of the many on-line tools or with the help of your physician or a nutrition counselor.

Please don’t avoid the glycemic index because it seems complicated. There are a number of excellent books and websites on the subject. And once you’re familiar with the system, it works very well. I’ve had patients who struggled for years to lose weight or get a grip on blood glucose tell me that the glycemic index is the only thing that works.

And whatever you do, don’t make the mistake of avoiding all carbs. Learning to tell the healthy ones from the unhealthy is the way to go, because it puts you on track to better weight and blood glucose management.

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