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    Dietary Guidelines

    The Glycemic Effect of Carbohydrate Food

    One of the refinements people with diabetes can make to a carbohydrate-controlled diet is to learn about and use strategies to lower the glycemic effect of foods. In this way, blood sugar is less dramatically effected by carbohydrate, making diabetes management a little easier.

    Glycemic effect refers to the speed and degree to which food or combinations of food (meals) raise blood sugar. The more rapidly and higher the blood sugar rises after eating, the higher the glycemic effect. In contrast, foods or food combinations which result in slower, less pronounced blood sugar rises are said to have a low glycemic effect.

    When describing single foods eaten alone, the glycemic effect of the food is compared to glucose. If you eat pure glucose, it will raise your blood sugar quickly and sharply because of two factors:

    1. Glucose requires no digestion so it moves quickly through the gut
    2. 100% of glucose is glucose so it requires no conversion

    No other food (except maltose, formed from two glucose molecules) raises blood sugar to the same degree and with the same speed, but some single foods come close. Most other carbohydrate foods have more modest effects. A few have truly low glycemic effects. Following these simple guidelines can lower the glycemic effect of the foods you eat.

    How to Lower the Glycemic Effect of Foods

    1) Do not over-consume carbohydrate at any one time of the day.


    One of the main principles in carbohydrate management is to space all digestible carbohydrate-containing foods out so that your body is pacing carbohydrate absorption. Both sugar and starch need to be considered. Both digest into sugar and will raise blood sugar upon absorption.

    2) Work to keep blood glucose levels in a normal or near-normal range.


    The glycemic response of food is in large part due to insulin activity and blood sugar control.

    Besides glucose, there are other sugars (e.g., fructose) and sugar alcohols (sorbitol) that are absorbed from foods. These sugars do not immediately contribute to the blood glucose rise after a meal. They must be converted into glucose by the liver before they can.

    For individuals with good insulin activity, conversion of these sugars and sugar alcohols to glucose is less immediate. This is because insulin stimulates the liver to ready these fuels for storage, either as fat or glycogen, so they do not immediately effect blood sugar.

    People with diabetes who have weak insulin activity, however, will not have the same benefit. For them, the conversion of other sugars to glucose will be immediate, and they will definitely contribute to the post-meal blood glucose rise.

    3) Eat carbohydrate-rich foods in combinations with protein and/or fat


    Protein and fat both slow digestive speed. When a meal (or single food) contains protein, fat or both, all components of that meal will digest more slowly. This can be good when you want the carbohydrate of the meal to be absorbed gradually. Mixed meals, as they are called, keep blood sugar from rising quickly and result in more subtle, gradual blood sugar changes.

    On the other hand, this can be a BIG PROBLEM if you are trying to treat a serious low blood sugar reaction (hypoglycemia) by eating a chocolate candy bar. While the sugar is present in the candy, its high fat content will slow its digestion. As a result your recovery (raising blood glucose) will be significantly delayed.

    4) Eat dried beans and peas to lower the glycemic effect of other foods


    Dried beans and peas are a class of vegetable called legumes. When eaten alone, they have an unusually low glycemic effect. When eaten together with other carbohydrate-rich foods, they can actually lower the glycemic effect of the other food. The reason for this is their high soluble fiber content in combination with an enzyme they contain which impairs starch digestion.

    When black beans are eaten together with rice, for example, the glycemic effect of the rice (usually high) is lowered significantly due to the beans. Similarly, adding kidney beans to a pasta dish will lower the glycemic effect of the meal.

    5) Eat fruit, vegetables and grains in whole forms whenever possible.


    Whole foods, or those closer to their natural form, usually have a lower glycemic effect on the blood than do refined, processed and juiced foods. There are several reasons for this.

    One reason is fiber content. Whole fruit, vegetables and whole grains have more fiber than refined foods. Fibers move food through the intestinal tract a little more quickly so there is less time for digestion to be effective. Less carbohydrate digestion and absorption occurs. This is particularly true for foods highest in soluble fiber, such as oatmeal, legumes, apples, peas, and many other fruit and vegetables.

    A second factor is surface. Refined foods, especially ones like dry, ready-to-eat cereals, have relatively little bulk and a large percentage of their surface is exposed and readily available to digestive enzymes. As a result, they are more likely to have a high glycemic effect than less refined food forms.



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