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HOW TO TREAT DIABETES FROM A NUTRITIONAL PERSPECTIVE
IDENTIFYING THE PROBLEM:
Diabetes, also known as hyperglycemia, has become virtually epidemic in America and other industrialized nations of the world. More than 135 million people worldwide have diabetes. The World Health Organization estimates that by the year 2025, 300 million people worldwide will have diabetes. Currently, some 16 million Americans have diabetes. From 1990 to 2000, the incidence of adult-onset diabetes increased 33 percent in the United States and by an incredible 70 percent among people in their 30's. The American Diabetic Association shows diabetes to be the forth leading cause of death in America, resulting in 160 thousand deaths annually. Hundreds of thousands more suffer from multiple complications of diabetes such as heart disease, stroke, blindness and amputations. Between 1993 and 1995, 67,000 diabetes related amputations were performed and 28,000 cases of end-stage kidney disease were identified in 1995. Clearly, we have a major health problem relative to blood sugar metabolism.
DEFINING THE PROBLEM:
What is diabetes and how does it develop. Simply put, a person is defined as diabetic if, when waking up in the morning, their blood glucose level is above120 milligrams per deciliter (mg/dl) of blood. Some health care professionals feel that any fasting blood sugar above 100 mg/dl is diabetic. After you eat a meal, glucose levels will initially raise and then slowly fall as carbohydrates are digested and turned into glucose. Doctors call this your postprandial (post-meal) curve. The normal peak in this curve should be around 139 mg/dl. Higher postprandial glucose levels can be indicative of diabetes.
There are two types of diabetes. Juvenile-onset diabetes occurs at a very early age, when the pancreas stops making the hormone insulin. Insulin must then be injected to facilitate the processing of glucose from the blood into the cells. Adult-onset diabetes, which is the most common type of diabetes, occurs when cells of the body gradually become resistant to insulin, resulting in elevated glucose levels. With adult-onset diabetes, the pancreas is often producing adequate amounts of insulin but the cells are not accepting that insulin. Eventually, the pancreas can become weakened and no longer produce adequate amounts of insulin. This can lead to the need for oral or injectable insulin and other pharmaceuticals to control blood sugar levels. Is there an alternative to pharmaceutical intervention? Making significant dietary changes and using nutritional supplements to regulate blood sugar will be my focus
Adult-onset diabetes can largely be traced to the over consumption of refined carbohydrates. Such carbohydrates are broken down quickly into glucose in the digestive process and require large amounts of insulin from the pancreas. After a while, the cells become insensitive to insulin and even more insulin is required from the pancreas to facilitate the transfer of glucose to the cells. Elevated insulin and elevated glucose can lead to a host of health problems. Elevated glucose levels generate large numbers of free radicals which damage tissues and lead to accelerated aging.
Excess glucose can also react with, and damage the body’s proteins. The bi-products of these reactions include advanced glycation end-products abbreviated as AGEs AGEs involves glucose fusing with protein. This fusing damages body tissues in much the same way as over-cooking toughens a steak. AGEs contribute to heart disease by increasing the oxidation of LDL cholesterol and creating cross-links in the proteins forming blood vessel walls. This causes aging of the blood vessels, making them less flexible.
Because excess glucose creates excessive free radicals and damaged protein, this condition can have devastating effects on the entire body. Excess glucose leads to increased levels of both cholesterol and triglycerides. It leads to blood platelets becoming more sticky, increasing the risk for greater blood clotting. Excess glucose interferes with blood circulation which leads to poor wound healing and deterioration of organ systems such as the kidneys. Because of its damaging effect on the circulatory system, high glucose levels can lead to diabetic retinopathy which is damage to the retina of the eyes. This can lead to loss of eyesight and blindness. Restriction of blood flow can cause diabetic neuropathy which is nerve damage. Diabetic neuropathy can produce numbness, pain and even lead to amputations due to the dying of tissue.
Insulin resistence results in the pancreas producing excessive insulin to deal with the excessive glucose levels in the blood. This excessive insulin has its own damaging effects. It can negatively affect the behavior of endothelial cells which line the walls of the arteries and therefore affect the health of the heart. There is substantial evidence that elevated levels of insulin increase the risk of colon, liver, pancreatic, breast and endometrial cancer. High insulin causes retention of sodium which causes retention of fluids. This fluid retention can lead to high blood pressure which can lead to heart problems. Insulin mediates blood fats and high insulin can result in elevated triglyceride levels.
SOLVING THE PROBLEM:
Since high glucose levels in the blood is such a serious threat to the health of the body, it is imperative that this condition be addressed. There are several areas that must be considered. The most important area is diet. The standard American diet is largely responsible for adult-onset diabetes. Simple and refined carbohydrates make up a large segment of the typical American diet. It is these types of carbohydrate that are broken down quickly into the simple sugar glucose by the digestive process. This results in the need for large amounts of insulin being released by the pancreas to facilitate the transfer of glucose from the blood into the cells.
White sugar, also known as sucrose, is a primary example of a simple carbohydrate. White sugar is made of a chain of the two sugar molecules glucose and fructose. This is called a disaccharide (di meaning two and saccharide meaning sweet). This is a very simple carbohydrate which breaks down very quickly in the digestive process. Many foods will naturally contain disaccharides such as sucrose. The problem comes in when sucrose, fructose and other simple sugars are added to foods. The addition of these sugars to foods greatly increases the amount of these simple sugars that we ingest. Up to 25% of the standard American diet is simple sugar. For teenagers, it’s much higher.
White bread is a good example of a refined carbohydrate. The making of white bread begins with whole wheat grain. This grain has complex carbohydrate called starch. This starch is composed of long chains of sugar molecules called polysaccharides (poly meaning many). After removing the bran (the fiber part of the wheat), and the germ (the part that contains most of the vitamins and minerals), this grain is then ground into a very fine flour. Because of the very small particle size of this flour, it is easy for water to be absorbed. This adsorption of water greatly expands the surface area of each particle. This expansion makes it easy for enzymes to break down this flour in the digestive tract. The removal of the fiber from the grain contributes further to its gelatinization. Gelatinizaton is where water and heat expand the starch granules to where there is created much larger surface areas to which digestive enzymes can attach and, therefore, speed up the process of breaking down the polysaccharides into disaccharides and finally into the monosaccharides of glucose, fructose and galactose (mono meaning one).
Even though the grain from which the white bread is made is a starch, and therefore, a more complex carbohydrate, because of the manner in which it is processed into a fine flour, this carbohydrate breaks down quickly in the digestive process. This leads to an abundance of glucose which requires insulin to transfer it from the blood into the cells. Many of the foods Americans eat are made from refined flours, including many bakery products, pastas, breakfast cereals and snack foods. When you combine these refined flour products with the large amount of the simple sugar sucrose that is added to many of these products, you can easily see why diabetes has become the health problem that it is.
THE FRUCTOSE QUESTION:
Since sucrose has become such a recognized contributor to high blood glucose levels, many food manufactures have begun to substitute the monosaccharide fructose in their products. It’s believed that this sugar is safer, as it is not immediately turned into glucose, but travels to the liver where it is largely converted to glycogen. Glycogen, which is a stored starch made up of glucose, is released by the liver as needed by the body. Upon its release, glycogen is broken down into glucose. It is at this point that insulin gets involved in having to remove this glucose from the blood into the cells. In 1980, the average person ate 39 pounds of fructose and 84 pounds of sucrose. In 1994, the average person ate 83 pounds of fructose and 66 pounds of sucrose. You can see how fructose consumption has accelerated. You can also see how total simple sugar consumption has increased.
Fructose is naturally found in fruit, therefore its name. The fructose being used by the food industry is not derived from fruit as that would be much too expensive. Commercially used fructose is instead derived from corn syrup and in reality is a blend of 55 percent fructose and 45 percent glucose. While the fructose does not immediately convert to glucose, the glucose in this blend will raise blood sugar quickly and therefore must be processed out of the blood by insulin. Substituting fructose for sucrose is not improving things very much.
In addition to being converted to glycogen, fructose also stimulates the liver to produce triglycerides. In research done with feeding men a high glucose or a high fructose diet, it was the high fructose diet that led to significantly higher triglyceride levels in the blood. Fructose converts to fat more readily than any other sugar. Other research has shown that fructose caused an increase in serum cholesterol and low density lipoproteins (LDL). Fructose ingestion increases uric acid levels which can lead to inflammatory problems.
It should be apparent that fructose from corn syrup is not the answer to improving blood sugar control. When fructose is analyzed relative to its fat generating effect, we have even more reason to avoid it. Fructose found in fruit and vegetables is present in small amounts and is combined with fiber and a variety of nutrients. This is the way you should eat your fructose.
THE ROLE OF DIET IN SOLVING THE PROBLEM:
Diet plays the major role in regulating blood sugar levels. As a general rule, the more processed and refined a food is, the faster it will breakdown into its component nutrients in the digestive tract and be absorbed into the blood. These nutrients then travel to the liver and get rerouted from there or are carried by the blood directly to body tissues. As noted above, processed starches and simple sugars become absorbed quickly and the glucose derived from this breakdown must be removed from the blood into the cell. This process is largely facilitated by the hormone insulin. Insulin is secreted by the beta cells of the pancreas.
Eating carbohydrates that have been minimally processed will, as a general rule, result in a slower release of glucose into the blood and subsequently result in a slower release of insulin. Many foods have been categorized as to their glycemic (G.I.) response in the body. Glycemic response has to do with the rate at which a carbohydrate will breakdown into glucose. The standard is set as pure glucose having a rating of 100. The glycemic range is as follows: A low G.I. food is below 55, a intermediate G.I. food is between 55 and 70 and a high G.I. food is more than 70. For example, Kellogg’s Corn Flakes have a G.I. of 84. This means that this food has a high G.I. and its carbohydrates will rapidly turn into glucose.
Old Fashioned Oatmeal has a G.I. rating of 49 which means that this carbohydrate food will break down into glucose much slower. The Kellogg’s Corn Flakes are much more processed and have sugar added, whereas the Oatmeal is much less processed.
While, as a general rule, the more a food is processed the lower will be its glycemic rating, this is not always the case. A baked potato has a rating of 93 where as french fries are rated at 75. Why would the less processed baked potato have a faster blood sugar response than the more processed french fries. The starch in the baked potato has a highly gelatinized (swollen) surface making it more accessible to digestive enzymes and therefore rapid breakdown into glucose. The french fries have more fat because of being fried in oil. The fat actually slows down the digestive process and therefore increases the time it takes the carbohydrate to break down into glucose. It must be remembered, however, that both the baked potato and the french fries have high glycemic ratings which should be a consideration in developing a sugar control diet. In addition, the french fries have more fat, including the dangerous trans fats, and therefore are overall less healthy than the baked potato.
There are two basic types of starch in foods. One is called amylose and the other amyolpectin. The ratio of one to the other in a food has a direct effect on the glycemic index of that food. Amylose is a straight chain of glucose molecules tightly bound together and therefore hard to gelatinize and therefore slow to digest. Amylopectin is a string of glucose molecules with lots of branching chains which results in a starch that is easier to gelatinize and therefore, more easy to digest.
Foods that have little amylose but lots of amylopectin have higher glycemic ratings. Wheat flour is an example of a high amylopectin carbohydrate. Basmati rice and most legumes have a lot of amylose and therefore are examples of foods having lower glycemic ratings. Pasta that is made from durum wheat (semolina flour) will generally have a low glycemic rating because durum wheat is very hard when milled. This results in larger particles with less gelatinization and therefore slower digestion.
A good book to read on the subject of glycemic index is The Glucose Revolution. This book will explain the glycemic index in detail and provide glycemic ratings for hundreds of foods, including combinations of foods that make up meals. As a general rule, you will greatly improve your blood sugar control by avoiding white flour bakery products, processed breakfast cereals, candies, soda waters and most snack foods. You will experience improvement in your blood sugar metabolism by eating more whole grains such as brown rice (G.I. of 55), legumes such as kidney beans (G.I. of 27), and lentils (G.I. of 30). Unprocessed fruit is almost always a good choice. An apple (G.I. of 38), a plum (G.I. of 39), and a grapefruit (G.I. of 25) are low glycemic foods that also provide good overall nutrition.
Pastas, by and large, have a low glycemic index. Try to eat pasta made from whole grain flours.To obtain the glycemic index on a variety of food, you can visit www.glycemicindex.com.
SUGAR SUBSTITUTES:
Many diabetics, wishing to continue consuming their favorite products, will switch to using sugar substitutes in their attempt to regulate blood sugar levels. Some sugar substitutes have been shown to be safe and effective. Others have not. Here is a review of sugar substitutes and what the research shows.
ASPARTAME: Aspartame (NutraSweet or Equal) is found in many beverages and a variety of food products. Both NutraSweet and Equal contain sugar disguised as dextrose and/or maltodextrin. Of greater concern is the fact that 75% of all non-drug complaints registered with the FDA concern aspartame and at least 70 different symptoms and five deaths have been associated with its use. Some research has indicated that aspartame destroys neurons and contributes to the development of brain and nervous system disorders. Aspartame has also been associated with reduction of sight, including blindness. This sweetener is made from the amino acids phenylalanine, aspartic acid and the wood alcohol, methanol. There are serious concerns as to how well these elements, as combined in aspartame, are metabolized by the body. Methanol, in particular, is known to be toxic in even modest amounts. I would strongly recommend staying away from aspartame.
ACESULFAME K ( A-SCH-SUHL-FAYM-K ): This non caloric sweetener, also known as acesulfame potassium, was approved by the FDA in 1988. It is sold commercially as Sunette or Sweet One. It is 200 times sweeter than sugar and retains its sweetness when heated. It is synthesized from a combination of carbon, nitrogen, oxygen, hydrogen, sulphur and potassium atoms. This sweetener has undergone numerous studies over 15 years and has been found to be relatively safe. However, concerns have been raised by the Center for Science in the Public Interest (CSPI) as to acesulfame K being a potential carcinogen. The CAPI has charged that previous tests done on asesulfame K did not follow adequate protocols. I urge caution relative to this sweetener.
SUCRALOSE: This sweetener, sold under the brand name Splenda, is a recent entry into the artificial sweetener market. It is made by changing the chemical structure of sucrose by using chlorine. Sucralose is non-caloric and about 600 times sweeter than sucrose. Few human studies have been done with this sweetener. Research with animals has identified a variety of problems, including shrinking of the thymus gland, enlarged liver and kidneys, and decreased red blood cell count. Many European countries have yet to approve sucralose until more research is done. I personally will avoid products containing sucralose until I see some positive human trials.
SACCHARIN: This is the oldest of the artificial sweeteners. It was introduced over a hundreds years ago and is synthesized from coal-tar derivatives and is therefore completely artificial. It has no calories and requires no insulin. Sold under the brand name Sweet-n-Low, this sweetener came under fire in 1977 when studies revealed that male rats given large amounts of saccharin developed bladder cancer. This led the FDA to require a warning label on saccharin and it was also included in the FDA’s list of known carcinogens. The 1977 rat study has since been shown not to apply to humans and the FDA has removed saccharin from its list of carcinogens and no longer requires a warning on labels of products containing this substance. Saccharin appears to be completely eliminated from the body unchanged and therefore is not metabolized. No current evidence suggests this sweetener is a threat to human health.
STEVIA: I can recommend the herb stevia as a sugar substitute.. This herb is non-caloric, has 200 to 300 times the sweetness of sugar and will not raise blood glucose levels. Stevia can be purchased as a powder or liquid and can be used to sweeten drinks and foods. There are recipe books available that show how to use stevia in a variety of ways. This sweetener has been used all over the world for decades and proven to be very safe.
Diabetes, also known as hyperglycemia, has become virtually epidemic in America and other industrialized nations of the world. More than 135 million people worldwide have diabetes. The World Health Organization estimates that by the year 2025, 300 million people worldwide will have diabetes. Currently, some 16 million Americans have diabetes. From 1990 to 2000, the incidence of adult-onset diabetes increased 33 percent in the United States and by an incredible 70 percent among people in their 30's. The American Diabetic Association shows diabetes to be the forth leading cause of death in America, resulting in 160 thousand deaths annually. Hundreds of thousands more suffer from multiple complications of diabetes such as heart disease, stroke, blindness and amputations. Between 1993 and 1995, 67,000 diabetes related amputations were performed and 28,000 cases of end-stage kidney disease were identified in 1995. Clearly, we have a major health problem relative to blood sugar metabolism.
DEFINING THE PROBLEM:
What is diabetes and how does it develop. Simply put, a person is defined as diabetic if, when waking up in the morning, their blood glucose level is above120 milligrams per deciliter (mg/dl) of blood. Some health care professionals feel that any fasting blood sugar above 100 mg/dl is diabetic. After you eat a meal, glucose levels will initially raise and then slowly fall as carbohydrates are digested and turned into glucose. Doctors call this your postprandial (post-meal) curve. The normal peak in this curve should be around 139 mg/dl. Higher postprandial glucose levels can be indicative of diabetes.
There are two types of diabetes. Juvenile-onset diabetes occurs at a very early age, when the pancreas stops making the hormone insulin. Insulin must then be injected to facilitate the processing of glucose from the blood into the cells. Adult-onset diabetes, which is the most common type of diabetes, occurs when cells of the body gradually become resistant to insulin, resulting in elevated glucose levels. With adult-onset diabetes, the pancreas is often producing adequate amounts of insulin but the cells are not accepting that insulin. Eventually, the pancreas can become weakened and no longer produce adequate amounts of insulin. This can lead to the need for oral or injectable insulin and other pharmaceuticals to control blood sugar levels. Is there an alternative to pharmaceutical intervention? Making significant dietary changes and using nutritional supplements to regulate blood sugar will be my focus
Adult-onset diabetes can largely be traced to the over consumption of refined carbohydrates. Such carbohydrates are broken down quickly into glucose in the digestive process and require large amounts of insulin from the pancreas. After a while, the cells become insensitive to insulin and even more insulin is required from the pancreas to facilitate the transfer of glucose to the cells. Elevated insulin and elevated glucose can lead to a host of health problems. Elevated glucose levels generate large numbers of free radicals which damage tissues and lead to accelerated aging.
Excess glucose can also react with, and damage the body’s proteins. The bi-products of these reactions include advanced glycation end-products abbreviated as AGEs AGEs involves glucose fusing with protein. This fusing damages body tissues in much the same way as over-cooking toughens a steak. AGEs contribute to heart disease by increasing the oxidation of LDL cholesterol and creating cross-links in the proteins forming blood vessel walls. This causes aging of the blood vessels, making them less flexible.
Because excess glucose creates excessive free radicals and damaged protein, this condition can have devastating effects on the entire body. Excess glucose leads to increased levels of both cholesterol and triglycerides. It leads to blood platelets becoming more sticky, increasing the risk for greater blood clotting. Excess glucose interferes with blood circulation which leads to poor wound healing and deterioration of organ systems such as the kidneys. Because of its damaging effect on the circulatory system, high glucose levels can lead to diabetic retinopathy which is damage to the retina of the eyes. This can lead to loss of eyesight and blindness. Restriction of blood flow can cause diabetic neuropathy which is nerve damage. Diabetic neuropathy can produce numbness, pain and even lead to amputations due to the dying of tissue.
Insulin resistence results in the pancreas producing excessive insulin to deal with the excessive glucose levels in the blood. This excessive insulin has its own damaging effects. It can negatively affect the behavior of endothelial cells which line the walls of the arteries and therefore affect the health of the heart. There is substantial evidence that elevated levels of insulin increase the risk of colon, liver, pancreatic, breast and endometrial cancer. High insulin causes retention of sodium which causes retention of fluids. This fluid retention can lead to high blood pressure which can lead to heart problems. Insulin mediates blood fats and high insulin can result in elevated triglyceride levels.
SOLVING THE PROBLEM:
Since high glucose levels in the blood is such a serious threat to the health of the body, it is imperative that this condition be addressed. There are several areas that must be considered. The most important area is diet. The standard American diet is largely responsible for adult-onset diabetes. Simple and refined carbohydrates make up a large segment of the typical American diet. It is these types of carbohydrate that are broken down quickly into the simple sugar glucose by the digestive process. This results in the need for large amounts of insulin being released by the pancreas to facilitate the transfer of glucose from the blood into the cells.
White sugar, also known as sucrose, is a primary example of a simple carbohydrate. White sugar is made of a chain of the two sugar molecules glucose and fructose. This is called a disaccharide (di meaning two and saccharide meaning sweet). This is a very simple carbohydrate which breaks down very quickly in the digestive process. Many foods will naturally contain disaccharides such as sucrose. The problem comes in when sucrose, fructose and other simple sugars are added to foods. The addition of these sugars to foods greatly increases the amount of these simple sugars that we ingest. Up to 25% of the standard American diet is simple sugar. For teenagers, it’s much higher.
White bread is a good example of a refined carbohydrate. The making of white bread begins with whole wheat grain. This grain has complex carbohydrate called starch. This starch is composed of long chains of sugar molecules called polysaccharides (poly meaning many). After removing the bran (the fiber part of the wheat), and the germ (the part that contains most of the vitamins and minerals), this grain is then ground into a very fine flour. Because of the very small particle size of this flour, it is easy for water to be absorbed. This adsorption of water greatly expands the surface area of each particle. This expansion makes it easy for enzymes to break down this flour in the digestive tract. The removal of the fiber from the grain contributes further to its gelatinization. Gelatinizaton is where water and heat expand the starch granules to where there is created much larger surface areas to which digestive enzymes can attach and, therefore, speed up the process of breaking down the polysaccharides into disaccharides and finally into the monosaccharides of glucose, fructose and galactose (mono meaning one).
Even though the grain from which the white bread is made is a starch, and therefore, a more complex carbohydrate, because of the manner in which it is processed into a fine flour, this carbohydrate breaks down quickly in the digestive process. This leads to an abundance of glucose which requires insulin to transfer it from the blood into the cells. Many of the foods Americans eat are made from refined flours, including many bakery products, pastas, breakfast cereals and snack foods. When you combine these refined flour products with the large amount of the simple sugar sucrose that is added to many of these products, you can easily see why diabetes has become the health problem that it is.
THE FRUCTOSE QUESTION:
Since sucrose has become such a recognized contributor to high blood glucose levels, many food manufactures have begun to substitute the monosaccharide fructose in their products. It’s believed that this sugar is safer, as it is not immediately turned into glucose, but travels to the liver where it is largely converted to glycogen. Glycogen, which is a stored starch made up of glucose, is released by the liver as needed by the body. Upon its release, glycogen is broken down into glucose. It is at this point that insulin gets involved in having to remove this glucose from the blood into the cells. In 1980, the average person ate 39 pounds of fructose and 84 pounds of sucrose. In 1994, the average person ate 83 pounds of fructose and 66 pounds of sucrose. You can see how fructose consumption has accelerated. You can also see how total simple sugar consumption has increased.
Fructose is naturally found in fruit, therefore its name. The fructose being used by the food industry is not derived from fruit as that would be much too expensive. Commercially used fructose is instead derived from corn syrup and in reality is a blend of 55 percent fructose and 45 percent glucose. While the fructose does not immediately convert to glucose, the glucose in this blend will raise blood sugar quickly and therefore must be processed out of the blood by insulin. Substituting fructose for sucrose is not improving things very much.
In addition to being converted to glycogen, fructose also stimulates the liver to produce triglycerides. In research done with feeding men a high glucose or a high fructose diet, it was the high fructose diet that led to significantly higher triglyceride levels in the blood. Fructose converts to fat more readily than any other sugar. Other research has shown that fructose caused an increase in serum cholesterol and low density lipoproteins (LDL). Fructose ingestion increases uric acid levels which can lead to inflammatory problems.
It should be apparent that fructose from corn syrup is not the answer to improving blood sugar control. When fructose is analyzed relative to its fat generating effect, we have even more reason to avoid it. Fructose found in fruit and vegetables is present in small amounts and is combined with fiber and a variety of nutrients. This is the way you should eat your fructose.
THE ROLE OF DIET IN SOLVING THE PROBLEM:
Diet plays the major role in regulating blood sugar levels. As a general rule, the more processed and refined a food is, the faster it will breakdown into its component nutrients in the digestive tract and be absorbed into the blood. These nutrients then travel to the liver and get rerouted from there or are carried by the blood directly to body tissues. As noted above, processed starches and simple sugars become absorbed quickly and the glucose derived from this breakdown must be removed from the blood into the cell. This process is largely facilitated by the hormone insulin. Insulin is secreted by the beta cells of the pancreas.
Eating carbohydrates that have been minimally processed will, as a general rule, result in a slower release of glucose into the blood and subsequently result in a slower release of insulin. Many foods have been categorized as to their glycemic (G.I.) response in the body. Glycemic response has to do with the rate at which a carbohydrate will breakdown into glucose. The standard is set as pure glucose having a rating of 100. The glycemic range is as follows: A low G.I. food is below 55, a intermediate G.I. food is between 55 and 70 and a high G.I. food is more than 70. For example, Kellogg’s Corn Flakes have a G.I. of 84. This means that this food has a high G.I. and its carbohydrates will rapidly turn into glucose.
Old Fashioned Oatmeal has a G.I. rating of 49 which means that this carbohydrate food will break down into glucose much slower. The Kellogg’s Corn Flakes are much more processed and have sugar added, whereas the Oatmeal is much less processed.
While, as a general rule, the more a food is processed the lower will be its glycemic rating, this is not always the case. A baked potato has a rating of 93 where as french fries are rated at 75. Why would the less processed baked potato have a faster blood sugar response than the more processed french fries. The starch in the baked potato has a highly gelatinized (swollen) surface making it more accessible to digestive enzymes and therefore rapid breakdown into glucose. The french fries have more fat because of being fried in oil. The fat actually slows down the digestive process and therefore increases the time it takes the carbohydrate to break down into glucose. It must be remembered, however, that both the baked potato and the french fries have high glycemic ratings which should be a consideration in developing a sugar control diet. In addition, the french fries have more fat, including the dangerous trans fats, and therefore are overall less healthy than the baked potato.
There are two basic types of starch in foods. One is called amylose and the other amyolpectin. The ratio of one to the other in a food has a direct effect on the glycemic index of that food. Amylose is a straight chain of glucose molecules tightly bound together and therefore hard to gelatinize and therefore slow to digest. Amylopectin is a string of glucose molecules with lots of branching chains which results in a starch that is easier to gelatinize and therefore, more easy to digest.
Foods that have little amylose but lots of amylopectin have higher glycemic ratings. Wheat flour is an example of a high amylopectin carbohydrate. Basmati rice and most legumes have a lot of amylose and therefore are examples of foods having lower glycemic ratings. Pasta that is made from durum wheat (semolina flour) will generally have a low glycemic rating because durum wheat is very hard when milled. This results in larger particles with less gelatinization and therefore slower digestion.
A good book to read on the subject of glycemic index is The Glucose Revolution. This book will explain the glycemic index in detail and provide glycemic ratings for hundreds of foods, including combinations of foods that make up meals. As a general rule, you will greatly improve your blood sugar control by avoiding white flour bakery products, processed breakfast cereals, candies, soda waters and most snack foods. You will experience improvement in your blood sugar metabolism by eating more whole grains such as brown rice (G.I. of 55), legumes such as kidney beans (G.I. of 27), and lentils (G.I. of 30). Unprocessed fruit is almost always a good choice. An apple (G.I. of 38), a plum (G.I. of 39), and a grapefruit (G.I. of 25) are low glycemic foods that also provide good overall nutrition.
Pastas, by and large, have a low glycemic index. Try to eat pasta made from whole grain flours.To obtain the glycemic index on a variety of food, you can visit www.glycemicindex.com.
SUGAR SUBSTITUTES:
Many diabetics, wishing to continue consuming their favorite products, will switch to using sugar substitutes in their attempt to regulate blood sugar levels. Some sugar substitutes have been shown to be safe and effective. Others have not. Here is a review of sugar substitutes and what the research shows.
ASPARTAME: Aspartame (NutraSweet or Equal) is found in many beverages and a variety of food products. Both NutraSweet and Equal contain sugar disguised as dextrose and/or maltodextrin. Of greater concern is the fact that 75% of all non-drug complaints registered with the FDA concern aspartame and at least 70 different symptoms and five deaths have been associated with its use. Some research has indicated that aspartame destroys neurons and contributes to the development of brain and nervous system disorders. Aspartame has also been associated with reduction of sight, including blindness. This sweetener is made from the amino acids phenylalanine, aspartic acid and the wood alcohol, methanol. There are serious concerns as to how well these elements, as combined in aspartame, are metabolized by the body. Methanol, in particular, is known to be toxic in even modest amounts. I would strongly recommend staying away from aspartame.
ACESULFAME K ( A-SCH-SUHL-FAYM-K ): This non caloric sweetener, also known as acesulfame potassium, was approved by the FDA in 1988. It is sold commercially as Sunette or Sweet One. It is 200 times sweeter than sugar and retains its sweetness when heated. It is synthesized from a combination of carbon, nitrogen, oxygen, hydrogen, sulphur and potassium atoms. This sweetener has undergone numerous studies over 15 years and has been found to be relatively safe. However, concerns have been raised by the Center for Science in the Public Interest (CSPI) as to acesulfame K being a potential carcinogen. The CAPI has charged that previous tests done on asesulfame K did not follow adequate protocols. I urge caution relative to this sweetener.
SUCRALOSE: This sweetener, sold under the brand name Splenda, is a recent entry into the artificial sweetener market. It is made by changing the chemical structure of sucrose by using chlorine. Sucralose is non-caloric and about 600 times sweeter than sucrose. Few human studies have been done with this sweetener. Research with animals has identified a variety of problems, including shrinking of the thymus gland, enlarged liver and kidneys, and decreased red blood cell count. Many European countries have yet to approve sucralose until more research is done. I personally will avoid products containing sucralose until I see some positive human trials.
SACCHARIN: This is the oldest of the artificial sweeteners. It was introduced over a hundreds years ago and is synthesized from coal-tar derivatives and is therefore completely artificial. It has no calories and requires no insulin. Sold under the brand name Sweet-n-Low, this sweetener came under fire in 1977 when studies revealed that male rats given large amounts of saccharin developed bladder cancer. This led the FDA to require a warning label on saccharin and it was also included in the FDA’s list of known carcinogens. The 1977 rat study has since been shown not to apply to humans and the FDA has removed saccharin from its list of carcinogens and no longer requires a warning on labels of products containing this substance. Saccharin appears to be completely eliminated from the body unchanged and therefore is not metabolized. No current evidence suggests this sweetener is a threat to human health.
STEVIA: I can recommend the herb stevia as a sugar substitute.. This herb is non-caloric, has 200 to 300 times the sweetness of sugar and will not raise blood glucose levels. Stevia can be purchased as a powder or liquid and can be used to sweeten drinks and foods. There are recipe books available that show how to use stevia in a variety of ways. This sweetener has been used all over the world for decades and proven to be very safe.