Tom Nuckels asked:


Is the glycemic index (GI) the wrong way to assess the insulin-related effects of food?

The glycemic index measures blood sugar response per gram of carbohydrate contained in a food, not per gram of the food, and leads to some odd numbers. For example, a parsnip has a glycemic index of 98, almost as high as pure sugar. If taken at face value, this figure suggests that dieters should avoid parsnips like the plague. In fact, parsnips are mostly indigestible fiber, and you would have to eat a few bushels to trigger a major glucose and insulin response.

This high number results because the glycemic index rates the effects per gram of carbohydrate rather than rating the effects per gram of total parsnip. The sugar present in minute amounts in a parsnip itself is highly absorbable. The high glycemic index rating of parsnips is thus extremely misleading. Books such as The Glucose Revolution take care of issues like this on a case-by-case basis by saying, for example, that you can consider most vegetables free foods regardless of their glycemic index. But in fact the same considerations apply to all foods and distort the meaningfulness of the scale as a whole.

This is taken into account by a different measurement, the glycemic load (GL). The GL is derived by multiplying the glycemic index by the percent carbohydrate content of a food. Therefore, it measures the glucose/insulin response per gram of food rather than per gram of carbohydrate in that food. The glycemic load of a parsnip is 10, while glucose has a relative load of 100. And remember our potato problem, that terrible goblin of GI diets? The glycemic load of a typical serving of potato is only 27, not such a goblin at all. These kind of numbers make a lot more sense.

So is there direct evidence suggesting low GI diets support weight loss? It is certainly possible that focusing on low glycemic-index or low glycemic-load foods will help you lose weight, even if the theoretical justification for the idea is weak. However, there is only preliminary evidence to support this possibility. The studies commonly cited, although promising, are too preliminary to prove much.

In one of these studies, 107 overweight adolescents were divided into two groups: a low-GI group and a low-fat group. The low-GI group was counseled to follow a diet consisting of 45% to 50% carbohydrates (preferably low-GI carbohydrates), 20% to 25% protein, and 30% to 35% fat. Calorie restriction was not emphasized. The low-fat group received instructions for a standard low-fat, low-calorie diet divided up into 55% to 60% carbohydrates, 15% to 20% protein, and 25% to 30% fat. Over a period of about 4 months, participants on the low-GI diet lost about 4.5 pounds, while those on the standard diet lost just less than 3 pounds.

However, this study does not say as much about the low-GI approach as one might think. The most obvious problem is that the low-GI diet used here was also a high-protein diet. It could be that high-protein diets help weight loss regardless of the glycemic index of the foods consumed as claimed by the proponents of high-protein diets.

The study was also flawed in that participants were not assigned to the two groups randomly. Instead, researchers consciously picked which group each participant would join. This major flaw introduces the possibility of intentional or unintentional bias. It is quite possible the researchers placed adolescents with greater self-motivation into the low-GI group, based on an unconscious desire to see results from the study. Modern medical studies always use randomization to prevent this kind of bias.

Finally, researchers made no effort to determine if participants followed their diets. It might be that those in the low-fat diet group simply didn’t stick to the rules as well as those in the low-GI diet group because they found the rules were more challenging.

In another study, 30 overweight women with excessively high insulin levels were put on either a normal low-calorie diet or a diet that supplied the same amount of calories but used low-GI foods. The results over 12 weeks showed that women following the low-GI diet lost several pounds more than those following the normal diet.

Another small study involved overweight adolescents in which a conventional reduced calorie diet was compared against a low-glycemic load diet that with no calorie restrictions. The results showed that simply by sticking to low GI foods, without regard for calories, the participants on the low GI diet were able to lose as much or more weight as those on the low calorie diet.

However, conclusions based on observational studies are notoriously unreliable due to the possible presence of unidentified confusing factors. For example, because there is an approximate correlation between fiber in the diet and glycemic load, it is possible that benefits, when seen, are really due to fiber intake instead. Factors such as this one may easily obscure the effects of the factor under study, leading to contradictory or misleading results.

Intervention trials (studies in which researchers actually intervene in participants’ lives) are more reliable, and some have been conducted to evaluate the low-GI diet. One such study followed 30 people with high lipid levels for three months. Low-GI foods were substituted for higher-GI foods during the 2nd month, while other nutrients were kept similar. Improvements were seen in total cholesterol, LDL cholesterol, and triglycerides, but not in HDL. A close analysis of the results showed that only patients who had high triglycerides at the beginning of the study showed benefit. Another controlled trial found that a high carbohydrate, low glycemic load diet optimized lipid profile as compared to several other diets.

Another approach to the issue involves analysis of effects on insulin resistance. Evidence suggests that increased resistance of the body to its own insulin raises the risk of heart disease. One study found that use of a low-GI diet versus a high-GI diet improved the body’s sensitivity to insulin in women at risk for heart disease. Similar results were seen in a group of people with severe heart disease and a group of healthy people.

The evidence that a low-GI diet will help you lose weight is not yet very impressive. Its theoretical foundation is weak, and it appears to be using the wrong method of ranking foods regarding their effects on insulin. However, there’s no evidence showing a low-GI diet causes harm. If you find that you lose weight with a low-GI diet, stick with it.

However, while the most popular low-GI diet books (The Glucose Revolution, Sugar Busters) recommend a diet that is generally reasonable and should be safe, it is easy to design some fairly extreme low-GI diets. For example, a diet consisting of nothing but lard would be a very, very low-GI diet, since the glycemic index of lard is 0. While it no longer seems that saturated fat is as harmful as once thought, a pure lard diet is probably not a good idea. If you run across a diet book that recommends achieving a low glycemic index by consuming an extreme diet, approach it with caution.



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Patrick Beaufay asked:


 

The concept of glycemic index became very popular near the public, particularly in the deal of the weight loss, even if finally the use of glycemic index (G.I.) should in general aim at the maintenance of health. But for recall, what is the concept of glycemic index or G.I.?

More one food causes a secretion of insulin quickly after its ingestion, more its glycemic index is known as “high or tall “. There exist now tables providing the G.I. (glycemic index) of the majority of food. It is considered that the food having an index higher than 70 should be consumed with parsimony and that the food lower than 50 is favorable to health.

But you have to take care; the glucose index in blood is influenced by the value of the glycemic index of a particular food but also by the quantity of glucids contained in the consumed portion of this food. To eat a minor amount of a very hyperglycemic food will have less effect on the glucose index in the blood, than to consume a great quantity of a food lower in glucids.

It is here that the concept of glycemic charge is, which takes account at the same time of the glycemic index of a food, but also of the consumed quantity (standard weight of a portion) and the proportion of glucids contained in the eating portion.

 

The glycemic charge is thus the product of the glycemic index and of the quantity of glucids contained in a portion of food, divided by 100.

 

For example:

- White bread (a portion of 30 gr.): G.I. = 70

Glycemic charge = 10

 

- Whole wheat bread (a portion of 30 gr.): G.I = 72

Glycemic charge = 8

 

- Water melon (a portion of 120 gr.): G.I. = 72

Glycemic index= 5

- Dry grapes (a portion of 60 gr.): G.I. =64

Glycemic index = 28

- Brown rice (a portion of 150 gr.): G.I. = 76

Glycemic index = 29

The glycemic charge allows to predict the repercussion of the consumption of certain food will have on the glycemia and consequently on the insulin answer during a meal. It is possible to calculate the glycemic load of a meal by using certain tables and while devoting themselves to certain calculations, you will agree with me that this is not the easiest manner to compose a meal!

 

Also it is good to put in perspective the importance of the glycemic charge. Important studies carried out by the researchers of the University of Harvard showed that the health risk presented a correlation between the glycemic index and the glycemic charge. These studies confirm that the food with high glycemic index is less beneficial for health than food with weak glycemic index. But attention, while seeking to consume absolutely a food which brings a weak glycemic charge, there is a risk to result reducing exaggeratedly glucids in general and in substituting them by food too rich in fat, which would be an error.

 

What really counts in a meal, this is not that it has a low glycemic charge because it is low in glucids, but that it is rich in glucidic food with weak glycemic index.

 

In practice it is enough simply to ensure to preferably consume food having a G.I. that is lower than 50 and moderately food located between 50 and 70.

 

As regards food having a glycemic index higher than 70 they should be consumed by exception or in infinitesimal quantities!

 

Use the glycemic index to compare food of comparable nature, use the glycemic charge if you realize that for a portion of food, the G.I. is high whereas its content of glucids is weak.

 

You will find on my blog the glycemic index table’s in a previous article.

 



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NoSkinnyChick asked:

www.debbrittlive.com http What constitutes a low-glycemic diet, and what is the significance of the Glycemic Index? A brief overview of the science and why it works so effectively for weight loss. Deb Britt 610-926-7749 Skype: deb.britt AIM: djbritt911

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Caroline J. Cederquist, M.D. asked:


If you’re one of those people who can’t stand all the counting and tracking and adding and charting that some diets require, you could find a refuge in one simple numerical scale: the glycemic index. On the other hand, you might find it another maddening way to complicate the simple act of eating.

The glycemic index is a measure of the quality of carbohydrate foods. It’s kind of a good carbs/bad carbs thing, based on how they affect your blood sugar. Though it’s not new, it did start getting a lot of press when the anti-carb movement took hold.

It works like this: in the glycemic index , pure glucose is arbitrarily assigned the score of 100; it doesn’t mean anything in particular; it’s just a set reference point for how it has affected the blood sugar by about two hours after eating. Then all other foods in the index are given a number relative to glucose and its affect on the blood sugar.

Foods with a low index typically break down slowly and don’t cause drastic fluctuations in blood sugar. Foods with a high index typically do. For instance, green peas have an index of 39, while corn flakes have an index of 92.

Originally developed to help folks—particularly diabetics—control their blood sugar, the index includes mainly carbohydrate foods, because protein and fat don’t have much immediate effect on blood sugar.

But assigning numbers to different foods based on their glycemic effect just happens to create a scaled list of foods that ends up being a very useful tool for people dealing with obesity and other health issues, as well. That’s because simply maintaining a low-glycemic index diet tends to guide people toward healthier eating and weight loss, even when that is not their specific goal.

Consider: Type II diabetes, as well as various cancers and cardiovascular disease, are all highly correlated with high index diets. There’s abundant research that shows that reducing the overall glycemic index also reduces the risks of those problems.

That’s because almost by default, a low-index diet will include more fresh fruits and vegetables, more fiber, more dairy, all foods that offer essential nutrients, that are more likely to be lower in calories and which tend to keep the body sated longer, holding off the next hunger spell. All that usually adds up to weight loss, no matter what the program.

Proponents of the index say it’s more helpful than counting calories or grams of fats or carbs, and actually offers a simplified approach to learning to eat better, but some experts caution that people shouldn’t get too wrapped up in worrying about the precise numbers. Instead, they urge that people pay attention to whether the foods they’re eating have a low, medium or high index.

That’s because, as with any rule, there are exceptions to the fairly consistent physiological rules that underlie the index. For instance, watermelon has a pretty high glycemic index, about 75, which is even higher than table sugar. Does that make it bad for you? No. Because in spite of its high index, watermelon actually has a pretty low glycemic load. That’s a measure based on the amount of food you’d actually consume, not just an arbitrary quantity used in testing, as with the index.

The glycemic load of a food can be determined using the glycemic index number for a food, divided by 100 and multiplied times the available carbohydrate you’d eat. With most foods, low index is consistent with low load, but there are the quirky exceptions. Of course, to find them, you’d be back to doing a bunch of math again, and that’s just not the way people normally eat.

That’s why doctors and nutritional experts encourage people who are trying to develop a healthy diet to avoid getting caught up in the numbers game and look more generally at the foods in the index, leaning toward those at the low end. Anything over 70 is considered high index, 55 through 69 is medium and below 55 are foods with a low glycemic index.

And look what’s in those groups: high index foods include most breakfast cereals, white breads and other processed baked goods, most potatoes, ice cream, candies and table sugar, your veritable Atkins nightmare.

Lower index foods include cherries, grapefruit, broccoli, legumes like lentils and beans, most whole grain baked goods and most dairy foods. So even without counting calories or keeping track of specific index numbers, you can see that steering your diet toward the low end of the index is bound to do you good.

We like to encourage patients to think of glycemic index and glycemic load as just two more tools that can be helpful in developing healthier thinking and planning about dietary habits.

A final thing to remember: there’s not one standardized

glycemic index list and most indexes include brand-name items that people buy on a typical shopping trip, as well as the more generic items like vegetables and fruits. This is one of the more helpful aspects of the lists, but only if you get one that relates to where you live.

If your average Southwest Florida resident looked at an index created in Australia, it wouldn’t be much help, because really, when’s the last time you had a couple Golden Pikelets with a nice glass of Milo?

THROUGH THICK & THIN

Fruits tend to have a high glycemic index, so I recommend that people take their fruits with a meal, or with some protein like cottage cheese or regular cheese. These protein sources help mitigate the fruits glycemic effect. Don’t let a high index number keep you away from your apple a day.

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Caroline J. Cederquist, M.D. is a board certified Family Physician and a board certified Bariatric Physicians (the medical specialty of weight management). Dr. Cederquist is the founder of Bistro MD formerly Diet To Your Door, a home diet delivery program that specializes in low calorie gourmet food that is delivered to your home or office. Bistro MD serves as culmination of Dr. Cederquist’s expertise and experience in the world of medical weight loss.



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