February 4, 2012

Type 1 Diabetes and the GI Diet

Among my friends growing up was a girl with Type I diabetes.  She stood out because even the most miniscule amount of sugar wasn’t allowed anywhere near her mouth . . . not cake at birthday parties . . . not a small candy bar after a softball game . . . and certainly not a drop of soda at anytime.  While such strictness undoubtedly helped control her condition, I have to wonder how the rigidity played on her quality of life.

All people with diabetes should “eat healthy,”  yet those with Type 1 diabetes also must measure the quantity, type and timing of their food choices – simply ensuring they eat their daily quota of fruits and vegetables won’t cut it.  Focus on blood glucose and insulin levels is key.

You see, most foods are broken down into glucose by digestive enzymes. The glucose is then absorbed from the intestine into the bloodstream. The hormone, insulin, then takes the glucose from the bloodstream to either use or store for later.  People who do not have diabetes will produce just the right amount of insulin to cope with the rise in blood glucose that occurs after a meal.

People with Type 1 diabetes, however, are unable to produce insulin; instead they must inject it into their bodies.  To keep their blood glucose level close to normal after eating, they must inject just the right amount of insulin to deal with the food they’ve eaten. The injection should be timed right, so that the insulin arrives in the bloodstream at the same time that the glucose is absorbed into their blood-streams.

Too little insulin (for the amount of glucose coming from the digested food) results in very high blood glucose levels or hyperglycemia. Too much insulin (or not enough glucose coming from the digested food) spurs low blood glucose levels or hypoglycemia.  Every food morsel must be balanced, weighed and measured.

Since my grade school days, there have been many advances in blood sugar monitoring and insulin delivery. Knowledge of proper diets have, unfortunately, lagged behind.

Most doctors and dietitians agree that careful monitoring of glucose levels is key to minimizing complications from the disease. The standard diet given to both children and adults is based on a diabetic carbohydrate exchange list which has been shown to be ineffective as many children and their parents struggle to understand or follow the guidelines.

The Glycemic Index diet has proven to be far more effective.  Simply, the Glycemic Index (GI) is a ranking of foods on a scale from 0 to 100 based on the extent to which they raise blood sugar levels after eating.

The group of foods primarily responsible for the rise and fall in blood glucose levels after a meal are carbohydrates. The Glycemic Index provides a ranking of how quickly carbohydrates in food are digested by the body, compared to pure glucose which has a ranking of 100 percent. When carbohydrates are quickly broken down, high levels of glucose are released into the bloodstream very soon after a meal. Some examples of these foods (which have rankings of 70 percent or more) are white breads, potatoes, cornflakes and white rice.

Conversely, foods that contain carbohydrates that break down slowly, and release glucose gradually into the bloodstream, have a low GI (a ranking of 55 percent or less). Examples of low GI foods are most fruits, rolled oats, whole-wheat pastas, basmati rice and legumes. Medium GI foods have a ranking of between 56 and 69 percent.

Studies have shown that the GI diet is an effective user-friendly way of controlling diabetes.   For example, a study published in the American Journal of Clinical Nutrition found that children who followed the low GI diet enjoyed more stable blood sugar levels, fewer episodes of hyperglycemia and generally better quality of life than their counterparts following the CHOx diet.

In addition, a small study published in the issue of Diabetes Care shows that a low Glycemic diet leads to better blood glucose control in children and adolescents with Type 1 diabetes.  Researchers found that the youngsters’ blood glucose levels were in their target range 66% of the time when they were eating low-GI meals but only 47% of the time when eating high-GI meals—a notable difference. The children also required less insulin.

Moreover, a new study has found that eating a high glycemic index (GI) diet may cause faster progression to type 1 diabetes in those people with a genetic predisposition.

Researchers at the Barbara Davis Center for Childhood Diabetes in Colorado studied whether dietary glycemic index are associated with the progression of islet autoimmunity to type 1 diabetes. Islet autoimmunity occurs when the body develops antibodies to the insulin-producing cells in the pancreas — it is just one step away from Type 1 diabetes.

Investigators studied eating habits of 89 children seen as genetically predisposed to diabetes.  The results published online in the Journal of Endocrinology and Metabolism, found that 89 children developed islet autoimmunity and 17 subsequently developed type 1 diabetes.

While GI levels were not related the development of islet cell autoimmunity, eating a high GI diet did result in a faster progression to type 1 diabetes in children who already had islet autoimmunity.

For these reasons, the GI diet can help prevent the onset of type I diabetes, and definitely make afflicted children healthier with excellent quality of lives so they can even enjoy some occasional birthday cake.  For more information, consult glycemic index chart to better understand food interactions and hidden glucose values.

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Putting my Family on the GI Diet

Putting My Family on the Glycemic Index Diet…  And Living to Tell About It.

When it came to taking care of myself and my family, I thought I was on task.  We were all relatively healthy and my two young girls were growing like the overactive weeds in my neglected garden.  There were, however, a few hitches in our suburban paradise that I chalked up to simply living “life in the fast lane.”

The first hiccup would occur in mid afternoon when I would become overwhelmed with a kind of fatigue that no amount of coffee or diet soda could overcome. When my fog finally cleared and it was time to make dinner, another snag appeared – my kids turned into tattling, slapping, hair-pulling, screaming and crying monsters.   Many evenings I would dive headlong into a glass of wine while the meth amphetamine-driven romper-room ensued. After dinner, all was calm on the suburban front until the evening news when my husband would help himself to a huge midnight snack that rivaled dinner. These nightly meals disturbed his sleep, digestion, and at times his disposition.

Relief came the day I learned about the Glycemic Index (GI) Diet from my fitness trainer.   At first glance, it seemed to benefit diabetics more than typical folks like us.  Yet, as I studied the diet more, I realized it was the key to a bliss-filled home. Simply, the Glycemic Index (GI) is a ranking of carbohydrates on a scale from 0 to 100 based on the extent to which they raise blood sugar levels after eating. High GI foods break down quickly during digestion, causing blood glucose levels to increase quickly, and then drop suddenly. Examples include most breakfast cereals, white bread, short-grain rice, potatoes and most crackers. Low GI foods consist of carbohydrates that slowly break down during digestion, gradually unleashing glucose in the bloodstream. Examples are whole-grain breads, most fresh fruits and vegetables. 

For a more comprehensive list of both high and low GI foods, you may check out the glycemic index food list. Eating high GI foods pushes your body to extremes making you feel either very full and highly energetic, or, decidedly tired and hungry.  Low GI carbs slowly release glucose into your blood stream maintaining balanced energy levels and longer feelings of satiety.  The GI diet can also:

  • Help you lose and control weight
  • Lower your risk of heart disease
  • Reduce cholesterol levels
  • Prolong your physical and mental endurance

As matter of fact, an Australian study published in the March edition of the American Journal of Clinical Nutrition, examined the diets of almost two million (1,950,198) healthy men and women worldwide.  The findings were astounding: high blood glucose led to heightened risks of type-2 diabetes and heart disease, and certain cancers. Other studies indicate that a high-GI diet may increase infertility, risks of stroke and Premenstrual Syndrome in women. Yet the thought of radically switching the diets of my already finicky family made me wan to stick my head in the sand. Instead, I began making small, gradual changes. I didn’t count grams; as matter of fact, I didn’t really count anything at all.  Instead, I followed these simple guidelines:

  • Bought breakfast cereals with barley, bran, and oats
  • Used breads with whole-grains, stone-ground flour or sour dough
  • Reduced the amount of potatoes we ate
  • Added a fruit or vegetable to every meal and snack we ate
  • Cooked with basmati rice
  • Mixed whole-wheat pasta with regular noodles
  • Ate plenty of salad vegetables with a vinaigrette dressing.

Some other tips and tricks I followed were: Mixing – When you combine high-GI foods with low-GI foods in one sitting the final GI value will be medium.  Therefore, it’s acceptable to combine rice and lentils or even apple slices with potato chips. Al Dente – When foods are cooked for a long time, their structures change causing the particles to swell into soft, gelatinized blobs that are easy to digest.  The faster a food is digested the higher the GI-value will be which is why al dente pasta has a lower GI than the overcooked variety. Acids – Acidic foods reduces the rate at which food is broken down and lowering its GI value.  Vinegar, lemon juice, lime juice citrus fruits, and sour dough bread are great examples of acidic low-GI foods. Fibers – Such fibers as oats, beans and apples slows digestions and lowers foods GI levels. On the home-front, I first replaced all potato chips and other processed starches with peanut butter on apple slices, orange slices and small chunks of cheese for my kids’ after school snacks.  

Within a few weeks, I noticed that the early evening fights and tantrums had decreased to a few manageable squabbles as their blood sugar levels remained relatively. In addition, complex carbohydrates found in many low-GI foods boost levels of serotonin, a neurotransmitter that produces calm and happy feelings. High-GI foods create quick mood boosts followed by quick crashes that leaves you sad and agitated. According to recent studies, low GI diets benefit kids in other areas as well. Research at Massachusetts Institute of Technology found that children raised on diets high in refined sugars had lower-IQs than those raised on low-GI diets. I quit my early morning bagel habit for a whole-wheat English muffin.  By lunch time, I wasn’t so ravenous for high-GI carbs like French fries and white pasta. 

Soon after, my mid afternoon fatigue disappeared.  High-GI foods I was eating caused sudden peaks and valleys in my blood sugar making me crash.  With this new eating plan, my gradual insulin rises give me more even amounts of energy. As an added benefit, I even lost a few pounds since low-GI foods keep you satiated more and hungry less. Gradually I started making low GI dinners using salads, whole-wheat pasta, and lean meat, fish, and chicken. For wonderful low-GI recipes, visit Glycemic Index and read about the South Beach Diet Phase 1 plan too.  As a result, my husband is no longer ravenous and his late-night forages into the refrigerator have markedly decreased. Low GI foods benefit every member of a family.  They enable you to feel satiated longer so you can maintain a healthy weight, and provide your body and brain with more consistent energy throughout the day. They can also help prevent major health problems endemic to the United States.  Suburban bliss has never felt so good.

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