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The Glycemic Index of Foods For many years people with diabetes have been advised to count kilojoules, measure food exchanges and keep to a strictly controlled low fat, high fibre, sugar-free diet. Although this remains important in ensuring optimal blood glucose control, the Glycemic Index is a more user-friendly and revolutionary way of looking at diabetic meal planning. What is the Glycemic Index? The Glycemic Index (GI) of foods is simply a rating of carbohydratecontaining foods according to their actual effect on blood glucose levels. In the past it was assumed that complex carbohydrates or starches such as rice, bread, mealie meal and potato were digested and absorbed slowly, resulting in a slight rise in the blood glucose level. Simple sugars, on the other hand, were believed to be digested and absorbed quickly producing a large and rapid rise in the blood sugar level. We now know that these assumptions were incorrect, and the general public as well as those with diabetes no longer need to avoid sugar completely, provided it is used correctly, i.e. no more than 2 level teaspoons in a mixed low GI meal. By using the GI concept in combination with a low-fat eating plan, people with diabetes, low blood-sugar (hypoglycemia) sufferers, people at risk of heart disease or any form of chronic disease, and sportsmen can all benefit from more optimal blood glucose control. For those wanting to lose weight, the increased satiety - – and the fact that less insulin (a hormone that encourages fat storage) is secreted when consuming a low GI diet - – results in more efficient fat loss. Some of the factors affecting the GI of a food: Particle size Intact grains such as whole wheat have much lower GI values than the flours made from the same grains. This is because once the wholewheat kernel is ground to a fine powder, such as cake flour or bread flour, the carbohydrate is absorbed far more rapidly. Fibre type and content Foods containing soluble fibre, (found in foods such as oats and legumes), will delay the digestive process and thereby have a GI lowering effect. Protein and fat 1 A mixed meal containing small amounts of protein and fat tends to lower the blood sugar response of a meal. All meals should therefore contain some protein, such as meat, chicken, fish, eggs, dairy products, beans and nuts to ensure an optimal blood glucose response. How to use the Glycemic Index The table below provides details of the Glycemic Index of some carbohydrate-rich, low fat foods. All foods that have a low GI are slow release carbohydrates and are the best choices for people with diabetes and hypoglycemia, as they do not result in a sudden and high rise in blood glucose levels. However, many of your favourite foods may be high GI and this does not mean that you may never eat them. By combining a high GI food such as Weet-Bix with a low GI food such as oat bran, milk or yoghurt, the blood sugar response of the combined meal will be markedly lower than eating the Weet-Bix dry or with water. For baking purposes, add low GI ingredients such as oat-bran, grated apple, milk or yoghurt together with less of the high GI ingredients such as flour, to effectively lower the recipe’s final GI. Foods with an intermediate GI should be eaten in moderation, and are also suitable for diabetics after high intensity exercise. Foods with a high GI need to be limited by people with diabetes as they result in a sudden increase in blood sugar levels. However, it is for this reason that small portions of these foods can be useful during a low blood glucose ‘attack’ to quickly correct a low blood sugar level. They are also useful, in the correct quantities for Sportsmen during/ just after high intensity, long duration exercise. A table providing detail of low, medium and high GI foods 2 Slow release foods – RECOMMENDED Fast release foods -AVOID Low GI Foods Intermediate GI High GI Starches All lentils – canned / dried All beans & peas – canned / dried Pea dhal Baked beans in tomato sauce Soya beans / soya mince Mealies / sweetcorn, fresh Pearled Barley Pearled Whole Wheat / Weetrice/ Stampkoring Rice:Brown(Old Mill Stream), White (Tastic), Wild Sweet potato Pasta (durum wheat only) Cold mealiemeal Cold samp Starches Sweetcorn, creamed Basmati rice Baby/new potatoes with skin Mealiemeal porridge- reheated Samp & beans Couscous, bulgur/ durum wheat, cooked Starches Mealie rice Rice – Arborio (sticky types) Jasmine rice Potatoes – boiled, mashed, baked and fried Minute noodles Samp Fruit All deciduous fruit e.g. apricots, cherries, peaches, plums, apples, pears, kiwi, nectarines, etc Grapes- watch portions All citrus fruit e.g. lemon, lime, grapefruit, naartjies & oranges Canned fruit: all of the above in fruit juice Pie Apples Safari Just Bars Fruit juice: pure apple juice Fruit Tropical fruits – mango, banana, pawpaw, litchis, pineapple Dried fruit – raisins, dates, sultanas Canned fruit: pineapples, peaches, apricots Most fruit juices Fruit Dried fruit rolls Melons including watermelon Fruit juice: Litchi, Medley of fruits Vegetables Most vegetables except those listed intermediate/ high GI Vegetables Beetroot Marogo &Spinach Cereals Kellogg’s Hi-Fibre Bran Wholewheat Pronutro – original and apple bake only Bokomo Fibre Plus cereal Bokomo Bran Flakes Oat-bran, raw Oat-so-easy, natural Nature’s Source mixed berry/ orange & spices/ apple & Cereals Rolled oats (Pouyoukas) Bokomo/ Pick n Pay/ Wooloworths cooked oats Nature’s Source oats, cooked Jungle Oats, cooked Shredded wheat Mealiemeal – reheated or with added corn Kellogg’s All Bran flakes Vegetables Pumpkins, turnips & parsnips (still acceptable as part of a balanced meal) Cereals Puffed wheat Rice crispies Fruit loops, Coco pops Corn flakes Special K Toasted muesli Pronutro (most flavours) Mealiemeal – refined / coarse Maltabella porridge 3 cinnamon muesli Bokomo Morning Harvest muesli Vital muesli Fineform Muesli Pronutro Flakes Breads Low GI Seed loaf e.g. Sasko Nature’s Harvest/ Fine Form / Duens country collection/ Olde Cape Low GI bread e.g. Albany, Blue Ribbon Pumpernickel Astoria Volkorn Rye Bread Provita, original & multigrain Rye and soy flour Breads Pita Rye (wheat free) Ryvita crackers Provita, oats & brown sugar Ouma Nutri rusks Chapatti, maize/ corn Dairy Low fat/ fat free milk (plain/ flavoured) Low fat/ fat free yoghurt (plain and sweetened) Low fat/ fat free custard (sweetened & unsweetened) Low fat ice cream (sweetened & unsweetened) Dairy Ice cream: Megalite Tiger Oats, cooked Instant oats, flavoured Oat bran, cooked Weetbix (regular & sugar-free) Nutrific Breads White bread & rolls Brown bread & rolls Wholewheat bread & rolls Flour (cake, rice, potato, corn) Gluten free bread Bagels Snackbread (white/wholewheat) Rice cakes & corn thins Matzo crackers Cream crackers Rusks, muffins, scones, cakes Meal Replacements Ensure, Sustagen Snacks/ Sugars Fine Form and Sugar free jams Home made popcorn, low-fat Fructose- not more than 20g per day (4 level tsp) Sugar-free sweets Lactitol, maltitol, sorbitol, xylitol, polydextrose Snacks/ Sugars Regular colddrinks and cordials Table sugar (sucrose), brown or white Raw honey All homemade jams (50% fruit at least) Digestive biscuits, plain Home made bran muffins/ pancakes (containing oat bran) Snacks/ Sugars Glucose, maltose, maltodextrin, dextrose Honey Marie & Boudoir biscuits Boiled and jelly sweets e.g wine gums Energy bars Cakes Packet soups & instant soups Gravy powder Most sports/ energy drinks 4 The Glycemic Load It is important to realize that portion size is as important as the GI and eating lower GI foods does not give one the liberty to eat as much as one likes. The larger the portion size of the food, the more carbohydrate it will contain and the more work it is for the body to keep blood glucose levels well controlled. The Glycemic Load of a meal or food takes into account the portion size and the rate of absorption of the carbohydrate in the food. It is thus an indication of the carbohydrate ‘load’ the body has to deal with to maintain normal blood glucose levels. Menu-planning ideas *Suggested portion sizes are for women to help with optimal blood sugar control 5 Breakfast 25g (4Tbs) wholewheat Pronutro or 35g (4 TBS) high fibre bran + 1 cup fat-free or low fat milk or unsweetened yoghurt + + a small piece of fresh fruit HINT: Add flaked almonds for a bit more crunch OR 1 slice of wheat-free rye bread or seed loaf + + 3 Tbs. baked beans in tomato sauce + 1 poached or boiled egg + a small piece of fruit HINT: Add 2 grilled tomato halves to bulk your meal Snack ideas 4 Provita with 2 Tbs. hummus or peanut butter OR 100ml tub of unsweetened yoghurt with a pear OR 4 dried peach or pear halves OR 1 large apple or pear or peach HINT: Add in a handful of nuts for a more substantial snack Light meals 1 slice of seed loaf or wheat-free rye bread + tuna / chicken / cottage cheese / 3 Tbs. baked beans + + salad vegetables + avocado or low oil dressing + a small piece of fruit HINT: Add chopped peppadews for more flavour OR 1 cup home-made bean and vegetable soup + 1 slice of wheat-free rye bread or seed loaf + a small piece of fruit HINT: Use some grated mozzarella cheese with the soup Main meal 3 baby potatoes or 1/3 c sweet potato or ½ c rice or pasta + fish or chicken or lean meat + Plenty of vegetables or a large salad + a low oil dressing or avocado + a small piece of fruit HINT: Add 50ml of unsweetened yoghurt to the fruit 6