Glycemic Index vs Glycemic Load vs Insulin Index
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How To Actually Use Those Indices
Carbohydrates are essential for our life, and/but often bring about our early demise. It would be a very conveniently simple world if it were simply a matter of “enjoy in moderation”, but the truth is, it’s not that simple.
To take an extreme example, for the sake of clearest illustration: The person who eats an 80% whole fruit diet (and makes up the necessary protein and fats etc in the other 20%) will probably be healthier than the person who eats a “standard American diet”, despite not practising moderation in their fruit-eating activities. The “standard American diet” has many faults, and one of those faults is how it promotes sporadic insulin spikes leading to metabolic disease.
If your breakfast is a glass of orange juice, this is a supremely “moderate” consumption, but an insulin spike is an insulin spike.
Quick sidenote: if you’re wondering why eating immoderate amounts of fruit is unlikely to cause such spikes, but a single glass of orange juice is, check out:
Which Sugars Are Healthier, And Which Are Just The Same?
Glycemic Index
The first tool in our toolbox here is glycemic index, or GI.
GI measures how much a carb-containing food raises blood glucose levels, also called blood sugar levels, but it’s just glucose that’s actually measured, bearing in mind that more complex carbs will generally get broken down to glucose.
Pure glucose has a GI of 100, and other foods are ranked from 0 to 100 based on how they compare.
Sometimes, what we do to foods changes its GI.
- Some is because it changed form, like the above example of whole fruit (low GI) vs fruit juice (high GI).
- Some is because of more “industrial” refinement processes, such as whole grain wheat (medium GI) vs white flour and white flour products (high GI)
- Some is because of other changes, like starches that were allowed to cool before being reheated (or eaten cold).
Broadly speaking, a daily average GI of 45 is considered great.
But that’s not the whole story…
Glycemic Load
Glycemic Load, or GL, takes the GI and says “ok, but how much of it was there?”, because this is often relevant information.
Refined sugar may have a high GI, but half a teaspoon of sugar in your coffee isn’t going to move your blood sugar levels as much as a glass of Coke, say—the latter simply has more sugar in, and just the same zero fiber.
GL is calculated by (grams of carbs / 100) x GI, by the way.
But it still misses some important things, so now let’s look at…
Insulin Index
Insulin Index, which does not get an abbreviation (probably because of the potentially confusing appearance of “II”), measures the rise in insulin levels, regardless of glucose levels.
This is important, because a lot of insulin response is independent of blood glucose:
- Some is because of other sugars, some some is in response to fats, and yes, even proteins.
- Some is a function of metabolic base rate.
- Some is a stress response.
- Some remains a mystery!
Another reason it’s important is that insulin drives weight gain and metabolic disorders far more than glucose.
Note: the indices of foods are calculated based on average non-diabetic response. If for example you have Type 1 Diabetes, then when you take a certain food, your rise in insulin is going to be whatever insulin you then take, because your body’s insulin response is disrupted by being too busy fighting a civil war in your pancreas.
If your diabetes is type 2, or you are prediabetic, then a lot of different things could happen depending on the stage and state of your diabetes, but the insulin index is still a very good thing to be aware of, because you want to resensitize your body to insulin, which means (barring any urgent actions for immediate management of hyper- or hypoglycemia, obviously) you want to eat foods with a low insulin index where possible.
Great! What foods have a low insulin index?
Many factors affect insulin index, but to speak in general terms:
- Whole plant foods are usually top-tier options
- Lean and/or white meats generally have lower insulin index than red and/or fatty ones
- Unprocessed is generally lower than processed
- The more solid a food is, generally the lower its insulin index compared to a less solid version of the same food (e.g. baked potatoes vs mashed potatoes; cheese vs milk, etc)
But do remember the non-food factors too! This means where possible:
- reducing/managing stress
- getting frequent exercise
- getting good sleep
- practising intermittent fasting
See for example (we promise you it’s relevant):
Fix Chronic Fatigue & Regain Your Energy, By Science
…as are (especially recommendable!) the two links we drop at the bottom of that page; do check them out if you can
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Which gut drugs might end up in a lawsuit? Are there really links with cancer and kidney disease? Should I stop taking them?
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Common medicines used to treat conditions including heartburn, reflux, indigestion and stomach ulcers may be the subject of a class action lawsuit in Australia.
Lawyers are exploring whether long-term use of these over-the-counter and prescription drugs are linked to stomach cancer or kidney disease.
The potential class action follows the settlement of a related multi-million dollar lawsuit in the United States. Last year, international pharmaceutical company AstraZeneca settled for US$425 million (A$637 million) after patients made the case that two of its drugs caused significant and potentially life-threatening side effects.
Specifically, patients claimed the company’s drugs Nexium (esomeprazole) and Prilosec (omeprazole) increased the risk of kidney damage.
Doucefleur/Shutterstock Which drugs are involved in Australia?
The class of drugs we’re talking about are “proton pump inhibitors” (sometimes called PPIs). In the case of the Australian potential class action, lawyers are investigating:
- Nexium (esomeprazole)
- Losec, Asimax (omeprazole)
- Somac (pantoprazole)
- Pariet (rabeprazole)
- Zoton (lansoprazole).
Depending on their strength and quantity, these medicines are available over-the-counter in pharmacies or by prescription.
They have been available in Australia for more than 20 years and are in the top ten medicines dispensed through the Pharmaceutical Benefits Scheme.
They are used to treat conditions exacerbated by stomach acid. These include heartburn, gastric reflux and indigestion. They work by blocking the protein responsible for pumping acid into the stomach.
These drugs are also prescribed with antibiotics to treat the bacterium Helicobacter pylori, which causes stomach ulcers and stomach cancer.
This class of drugs is also used with antibiotics to treat Helicobacter pylori infections. nobeastsofierce/Shutterstock What do we know about the risks?
Appropriate use of proton pump inhibitors plays an important role in treating several serious digestive problems. Like all medicines, there are risks associated with their use depending on how much and how long they are used.
When proton pump inhibitors are used appropriately for the short-term treatment of stomach problems, they are generally well tolerated, safe and effective.
Their risks are mostly associated with long-term use (using them for more than a year) due to the negative effects from having reduced levels of stomach acid. In elderly people, these include an increased risk of gut and respiratory tract infections, nutrient deficiencies and fractures. Long-term use of these drugs in elderly people has also been associated with an increased risk of dementia.
In children, there is an increased risk of serious infection associated with using these drugs, regardless of how long they are used.
How about the cancer and kidney risk?
Currently, the Australian consumer medicine information sheets that come with the medicines, like this one for esomeprazole, do not list stomach cancer or kidney injury as a risk associated with using proton pump inhibitors.
So what does the evidence say about the risk?
Over the past few years, there have been large studies based on observing people in the general population who have used proton pump inhibitors. These studies have found people who take them are almost two times more likely to develop stomach cancer and 1.7 times more likely to develop chronic kidney disease when compared with people who are not taking them.
In particular, these studies report that users of the drugs lansoprazole and pantoprazole have about a three to four times higher risk than non-users of developing chronic kidney disease.
While these observational studies show a link between using the drugs and these outcomes, we cannot say from this evidence that one causes the other.
Researchers have not yet shown these drugs cause kidney disease. crystal light/Shutterstock What can I do if I’m worried?
Several digestive conditions, especially reflux and heartburn, may benefit from simple dietary and lifestyle changes. But the overall evidence for these is not strong and how well they work varies between individuals.
But it may help to avoid large meals within two to three hours before bed, and reduce your intake of fatty food, alcohol and coffee. Eating slowly and getting your weight down if you are overweight may also help your symptoms.
There are also medications other than proton pump inhibitors that can be used for heartburn, reflux and stomach ulcers.
These include over-the-counter antacids (such as Gaviscon and Mylanta), which work by neutralising the acidic environment of the stomach.
Alternatives for prescription drugs include nizatidine and famotidine. These work by blocking histamine receptors in the stomach, which decreases stomach acid production.
If you are concerned about your use of proton pump inhibitors it is important to speak with your doctor or pharmacist before you stop using them. That’s because when you have been using them for a while, stopping them may result in increased or “rebound” acid production.
Nial Wheate, Professor and Director – Academic Excellence, Macquarie University; Joanna Harnett, Senior Lecturer – Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, and Wai-Jo Jocelin Chan, Pharmacist and Associate Lecturer, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Hungry? How To Beat Cravings
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The Science of Hunger, And How To Sate It
This is Dr. David Ludwig. That’s not a typo; he’s a doctor both ways—MD and PhD.
Henceforth we’ll just say “Dr. Ludwig”, though! He’s a professor in the Department of Nutrition at Harvard T.H. Chan School of Public Health, and director of the New Balance Foundation Obesity Prevention Center.
His research focuses on the effects of diet on hormones, metabolism, and body weight, and he’s one of the foremost experts when it comes to carbohydrates, glycemic load, and obesity.
Why are we putting on weight? What are we getting wrong?
Contrary to popular belief, Dr. Ludwig says, weight gain is not caused by a lack of exercise. In fact, people tend to overestimate how many calories are burned by exercise.
A spoonful of sugar may make the medicine go down, but it also contains 60 calories, and that’d take about 1,500 steps for the average person to burn off. Let’s put this another way:
If you walk 10,000 steps per day, that will burn off 400 calories. Still think you can exercise away that ice cream sundae or plate of fries?
Wait, this is interesting and all, but what does this have to do with hunger?
Why we get hungry
Two important things:
- All that exercise makes us hungry, because the more we exercise, the more the body speeds up our metabolism accordingly.
- Empty calories don’t just add weight themselves, they also make us hungrier
What are empty calories, and why do they make us hungrier?
Empty calories are calories that are relatively devoid of other nutrition. This especially means simple sugars (especially refined sugar), white flour and white flour products (quick-release starches), and processed seed oils (e.g. canola, sunflower, and friends).
They zip straight into our bloodstream, and our body sends out an army of insulin to deal with the blood sugar spike. And… that backfires.
Imagine a person whose house is a terrible mess, and they have a date coming over in half an hour.
They’re going to zoom around tidying, but they’re going to stuff things out of sight as quickly and easily as possible, rather than, say, sit down and Marie Kondo the place.
But superficially, they got the job done really quickly!
Insulin does similarly when overwhelmed by a blood sugar spike like that.
So, it stores everything as fat as quickly as possible, and whew, the pancreas needs a break now after all that exertion, and the blood is nice and free from blood sugars.
Wait, the blood is what now?
The body notices the low blood sugar levels, and it also knows you just stored fat so you must be preparing for starvation, and now the low blood sugar levels indicate starvation is upon us. Quick, we must find food if we want to survive! So it sends a hunger signal to make sure you don’t let the body starve.
You make a quick snack, and the cycle repeats.
Dr. Ludwig’s solution:
First, we need to break out of that cycle, and that includes calming down our insulin response (and thus rebuilding our insulin sensitivity, as our bodies will have become desensitized, after the equivalent of an air-raid siren every 40 minutes or so).
How to do that?
First, cut out the really bad things that we mentioned above.
Next: cut healthy carbs too—we’re talking unprocessed grains here, legumes as well, and also starchy vegetables (root vegetables etc). Don’t worry, this will be just for a short while.
The trick here is that we are resensitizing our bodies to insulin.
Keep this up for even just a week, and then gradually reintroduce the healthier carbs. Unprocessed grains are better than root vegetables, as are legumes.
You’re not going to reintroduce the sugars, white flour, canola oil, etc. You don’t have to be a puritan, and if you go to a restaurant you won’t undo all your work if you have a small portion of fries. But it’s not going to be a part of your general diet.
Other tips from Dr. Ludwig:
- Get plenty of high-quality protein—it’s good for you and suppresses your appetite
- Shop for success—make sure you keep your kitchen stocked with healthy easy snack food
- Nuts, cacao nibs, and healthy seeds will be your best friends and allies here
- Make things easy—buy pre-chopped vegetables, for example, so when you’re hungry, you don’t have to wait longer (and work more) to eat something healthy
- Do what you can to reduce stress, and also eat mindfully (that means paying attention to each mouthful, rather than wolfing something down while multitasking)
If you’d like to know more about Dr. Ludwig and his work, you can check out his website for coaching, recipes, meal plans, his blog, and other resources!
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“The Longevity Vitamin” (That’s Not A Vitamin)
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The Magic of Mushrooms
“The Longevity Vitamin that’s not a vitamin” is a great tagline for what’s actually an antioxidant amino acid nutraceutical, but in this case, we’re not the ones spearheading its PR, but rather, the Journal of Nutritional Science:
Is ergothioneine a “longevity vitamin” limited in the American diet?
It can be found in all foods, to some extent, but usually in much tinier amounts than would be useful. The reason for this is that it’s synthesized by a variety of microbes (mostly fungi and actinobacteria), and enters the food chain via vegetables that are grown in soil that contain such (which is basically all soil, unless you were to go out of your way to sterilize it, or something really unusually happened).
About those fungi? That includes common popular edible fungi, where it is found quite generously. An 85g (3oz) portion of (most) mushrooms contains about 5mg of ergothioneine, the consumption of which is associated with a 16% reduced all-cause mortality:
However… Most Americans don’t eat that many mushrooms, and those polled averaged 1.1mg/day ergothioneine (in contrast with, for example, Italians’ 4.6mg/day average).
Antioxidant properties
While its antioxidant properties aren’t the most exciting quality, they are worth a mention, on account of their potency:
The biology of ergothioneine, an antioxidant nutraceutical
This is also part of its potential bid to get classified as a vitamin, because…
❝Decreased blood and/or plasma levels of ergothioneine have been observed in some diseases, suggesting that a deficiency could be relevant to the disease onset or progression❞
Source: Ergothioneine: a diet-derived antioxidant with therapeutic potential
Healthy aging
Building on from the above, ergothioneine has been specifically identified as being associated with healthy aging and the prevention of cardiometabolic diseases:
❝An increasing body of evidence suggests ergothioneine may be an important dietary nutrient for the prevention of a variety of inflammatory and cardiometabolic diseases and ergothioneine has alternately been suggested as a vitamin, “longevity vitamin”, and nutraceutical❞
~ Dr. Bernadette Moore et al., citing more references every few words there
Source: Ergothioneine: an underrecognised dietary micronutrient required for healthy ageing?
Good for the heart = good for the brain
As a general rule of thumb, “what’s good for the heart is good for the brain” is almost always true, and it appears to be so in this case, too:
❝Ergothioneine crosses the blood–brain barrier and has been reported to have beneficial effects in the brain. In this study, we discuss the cytoprotective and neuroprotective properties of ergotheioneine, which may be harnessed for combating neurodegeneration and decline during aging.❞
Source: Ergothioneine: A Stress Vitamin with Antiaging, Vascular, and Neuroprotective Roles?
Want to get some?
You can just eat a portion of mushrooms per day! But if you don’t fancy that, it is available as a supplement in convenient 1/day capsule form too.
We don’t sell it, but for your convenience, here is an example product on Amazon
Enjoy!
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The Modern Art and Science of Mobility – by Aurélien Broussal-Derval
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We’ve reviewed mobility books before, so what makes this one stand out?
We’ll be honest: the illustrations are lovely.
The science, the information, the exercises, the routines, the programs… All these things are excellent too, but these can be found in many a book.
What can’t usually be found is very beautiful (yet no less clear) watercolor paintings and charcoal sketches as anatomical illustrations.
There are photos too (also of high quality), but the artistry of the paintings and sketches is what makes the reader want to spend time perusing the books.
At least, that’s what this reviewer found! Because it’s all very well having access to a lot of information (and indeed, I read so much), but making it enjoyable increases the chances of rereading it much more often.
As for the rest of the content, the book’s information is divided in categories:
- Pain (what causes it, what it means, and how to manage it)
- Breathing (yes, a whole section devoted to this, and it is aligned heavily to posture also, as well as psychological state and the effect of stress on tension, inflammation, and more)
- Movement (this is mostly about kinds of movement and ranges of movement)
- Mobility (this is about aggregating movements as a fully mobile human)
So, each builds on from the previous because any pain needs addressing before anything else, breathing (and with it, posture) comes next, then we learn about movement, then we bring it all together for mobility.
Bottom line: this is a beautiful and comprehensive book that will make learning a joy
Click here to check out The Modern Art and Science of Mobility, and learn and thrive!
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How To Escape From A Despairing Mood
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When we are in a despairing mood, that’s when it can feel hardest to actually implement anything we know about getting out of one. That’s why sometimes, the simplest solutions are the best:
Imagination Is Key
Despairing moods occur when it’s hard to envision a better life. Imagination is the power to envision alternatives, such as new jobs, relationships, or lifestyle, but sadness can cloud our ability to imagine solutions like changing careers, moving house, or starting fresh. With enough imagination, most problems can be worked around—and new opportunities can always be found.
Importantly: we are not bound by our past or present circumstances; we have the freedom and flexibility to choose new paths. That doesn’t mean it’ll always be a walk in the park, but “this too shall pass”.
You may be thinking: “sometimes the hardship does pass, but can last many years”, and that is true. All the more reason to check if there’s a freer lane you can slip into to speed ahead. Even if there isn’t, the mere act of imagining such lanes is already respite from the hardships—and having envisioned such will make it much easier for you to recognise when opportunities for change do come along.
To foster imagination, we are advised to expose ourselves to different narratives, preparing ourselves for alternative ways of living. Thus, we can reframe life’s challenges as intellectual puzzles, urging us to rebuild creatively and find new solutions!
For more on all this, enjoy:
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Want to learn more?
You might also like to read:
Behavioral Activation Against Depression & Anxiety
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The Vitamin Solution – by Dr. Romy Block & Dr. Arielle Levitan
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A quick note: it would be remiss of us not to mention that the authors of this book are also the founders of a vitamin company, thus presenting a potential conflict of interest.
That said… In this reviewer’s opinion, the book does seem balanced and objective, regardless.
We talk a lot about supplements here at 10almonds, especially in our Monday Research Review editions. And yesterday, we featured a book by a doctor who hates supplements. Today, we feature a book by two doctors who have made them their business.
The authors cover all the most common vitamins and minerals popularly enjoyed as supplements, and examine:
- why people take them
- factors affecting whether they help
- problems that can arise
- complicating factors
The “complicating factors” include, for example, the way many vitamins and/or minerals interplay with each other, either by requiring the presence of another, or else competing for resources for absorption, or needing to be delicately balanced on pain of diverse woes.
This is the greatest value of the book, perhaps; it’s where most people go wrong with supplementation, if they go wrong.
While both authors are medical doctors, Dr. Romy Block is an endocrinologist specifically, and she clearly brought a lot of extra attention to relevant metabolic/thyroid issues, and how vitamins and minerals (such as thiamin and iron) can improve or sabotage such, depending on various factors that she explains. Informative, and so far as this reviewer could see, objective and well-balanced.
Bottom line: supplementation is a vast and complex topic, but this book does a fine job of demystifying and simplifying it in a clear and objective fashion, without resorting to either scaremongering or hype.
Click here to check out The Vitamin Solution, and upgrade your knowledge!
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