FW: diabetes & glycemic index (diet!!)
From: ping ong [mailto:pingong77@yahoo.com]
Sent: Saturday, December 03, 2005 00:37
To: jopieong@pacific.net.sg
Cc: pocoates@gmail.com; wsh@metro.com.sg; lingo@pacific.net.sg; Jenn Nong Ong; xiangyi lau
Subject: diabetes & glycemic index (diet!!)
NUTRITION
How the gylcaemic index can help
Dr Bridget Farham
Taking care with what you eat is essential if you have diabetes, and is considered to be the backbone for the control and management of diabetes. For some people, this is all they have to do to keep their blood sugar levels in the normal range. Others also need to take tablets or injections of insulin.
But no matter what the treatment, everyone with diabetes must take care with their food in order to keep their blood sugar levels under control. If blood sugar levels are not properly controlled, diabetes can cause damage to the blood vessels in the heart, legs, brain and kidneys. For this reason, heart attacks, strokes, kidney failure and blindness are more common in people with diabetes.
The only part of food that directly affects our blood sugar levels is CHO. When we eat carbohydrate foods, they are broken down into sugar and cause the blood sugar levels to rise. The body responds by releasing insulin into the blood. The insulin clears the sugar from the blood, moving it into the muscles where it is used for energy and the blood sugar level returns to normal. If there is not enough insulin or if the insulin does not do its job properly, that is when diabetes or high blood sugar levels develop.
Some people think that because carbohydrates raise the blood sugar level, they should not be eaten at all by people who have diabetes. This is not correct. Carbohydrates are a normal part of the diet and at least half of our total calories should come from CHO's. In fact, the more CHO's you eat ,the better, because this automatically reduces the proportion of fat in your diet.
Renewed interest during the last few decades toward a more liberal use of CHO in the dietary management of diabetes mellitus has spawned a new area of research. In the past, dietary advice for diabetes focused on the avoidance of simple CHO's and inclusion of large amounts of complex CHO's into the daily diet.
It was thought that our bodies absorbed and digested simple sugars quickly, producing rapid increases in our blood sugar levels and thus a swift release of insulin. Traditionally sugar was excluded from diabetic diets because it was thought to be the worst type of carbohydrate. This assumption was simply not correct. We now know that simple CHO's do not make our blood sugar rise any more rapidly than some complex CHO's do.
Carbohydrates are now classified according to their blood glucose response or "glycaemic index", which is a ranking of foods based on their ability to increase blood glucose levels over a two to three hour period after ingestion. The glycaemic index (GI) measures how fast the CHO of a particular food is converted to glucose and enters the bloodstream. The lower the number, the slower the action and the better it is for the diabetic.
Whilst the GI factor research has not negated the significance of the quantity of carbohydrate in the diet, it has shown us the importance of considering the type of carbohydrate food that we include.
The GI factor shows us that the way to increase the quantity of carbohydrate in the diabetic diet, without increasing sugar levels in the blood, is to choose foods with a low GI factor. Lowering the GI factor of your diet is not as hard as it seems, because just about every carbohydrate food that you eat has an equivalent food with a low GI factor.
Research has shown that blood sugar levels in people with diabetes are greatly improved if foods with a low GI factor are substituted for high GI factor foods. The diabetic should therefore concentrate on low glycaemic index foods and avoid high glycaemic index foods in the context of a balanced diet and regular exercise. This is the mainstay of dietary therapy. Of course, simple sugars are simply empty calories and should still be minimised for that reason.
If you are having trouble controlling your blood sugar level after a meal, look up the GI factor for the carbohydrate it contains. See if you can find substitutes with a lower GI factor. Eating a meal with a lower GI factor can lower blood sugar rise after a meal. The GI factor is especially important when carbohydrate is eaten by itself and not as part of a mixed meal. Carbohydrate tends to have a stronger effect on our blood sugar levels when eaten alone.
This is the case with between-meal snacks that most people with diabetes have to have. When choosing a between-meal snack, pick one with a low GI factor. For example, an apple with a GI factor of 36 is better than a slice of soft white bread with a GI factor of around 70, and will result in less of a jump in the blood sugar level.
Although we have not mentioned them yet, don't think that fatty foods are not important to limit. They are, especially in people who are overweight. But fatty foods do not increase the blood sugar levels — only CHO foods do. However, being overweight and eating fatty foods prevents the body's insulin from doing its job and indirectly causes the blood sugar levels to rise.
Some foods such as ice cream, peanuts and potato chips have been found to have relatively low GI's, but their increased use would lead to an increased fat intake (which contributes to many lifestyle diseases including diabetes). Therefore, these kinds of foods cannot be recommended on the basis of their low GI. As an occasional snack they are fine, but not every day. Some low-fat and low-GI snack foods to start eating are:
Raisin toast
Low-fat milkshakes or smoothies
Apples and oranges
Low-fat fruit yoghurts
Dried apricots
Peaches and plums
Baked beans
Hypoglycaemia — the exception to the low GI rule
In people with diabetes who are treated with insulin or tablets, the blood sugar may sometimes drop too low. When this happens, they might feel hungry, shaky, sweaty and be unable to think clearly. This is called hypoglycaemia. A hypo is a potentially dangerous situation and must be treated straight away by eating some carbohydrate food. In this case you should pick a carbohydrate with a high GI factor because you need to increase blood sugar quickly. Jelly beans (with a GI factor of 80) are a good choice.
It should be pointed out, that there are many factors that affect your blood sugar levels. If you have diabetes and you are struggling to control your blood sugar level, it is important to seek medical help. The amount of exercise you do, your weight, stress levels, total dietary intake and need for medication have to be assessed, so see your doctor!
As a general rule of thumb, foods with a GI value of:
75 - 100 are best avoided
60 - 75 should be used sparingly
45 - 60 are safer choices
30 - 45 are good choices
Under 30 are very good choices
posted by travel_lingo at 11:41 AM
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