[beefy]

I've been wanting to post this for a while, but never really got around to it.

I know there is some confusion on glycemic LOAD. At first glance it may seem somewhat confusing, especially when we say things like:

"The glycemic load of a food is calculated by multiplying the glycemic index by the amount of carbohydrate in grams provided by a food and dividing the total by 100"​

That's not a particularly user-friendly way of talking about it...

In a nutshell, the glycemic load looks at both the glycemic index of a food AND it's portion-size (especially the amount of carbohydrate in your portion) in determining it's value for a serving/portion of a carbohydrate containing food.

Although the glycemic load for a food is expressed in a value of 1-100, it's also broken into low, medium and high 'load' rankings, as follows:

• Low: 10 or less
• Medium: 11 - 19
• High: 20 and over

For diabetics, it is my opinion that we should stick to only the LOW foods, and the lower the better. I personally like to look at a total glycemic load per meal/snack of a maximum of 10, depending on what I'm doing. (my meals and snacks either pre- or post-exercise may have a slightly higher glycemic load. Either way though, I try to keep to a maximum daily glycemic load of 50-60.)

Examples:
For a detailed example, let's start at watermelon:

Watermelon has a glycemic index of 76. Because of this high GI value, many diabetics avoid watermelon. However, when you bring the glycemic load into consideration, we find that 1 cup of watermelon scores only 8 (low) on the glycemic LOAD... Here's the breakdown:

One cup of watermelon has only about 11g of carbohydrates
11 (grams of carb) x 76 (glycemic index) = 836
836 / 100 = 8.36

As such, the glycemic LOAD of 1cup of watermelon is 8.36, which is considered low on the scale.

Of course, many people would eat MUCH more than 1 cup of watermelon at a sitting, so trying to utilize the glycemic load concepts may involve measuring until you're sure of serving sizes. Personally, I stick with about 3/4c of watermelon in my servings to keep my sugar in check.

Other examples:

Banana, Medium
An average medium banana contains about 27g of carbohydrate and is roughly 55 on the Glycemic Index. 27x55 = 1485. As such, a medium banana has roughly a glycemic load of 14.85. (I sometimes use bananas in my smoothies, but now regularly limit to 1/3 of a frozen, mostly-green banana, for a glycemic load of < 5.)

Mashed Potato
1 little cup of mashed potato has about 40g of carbohydrate and is about 76 on the GI. 40x76/100 = a glycemic load of 30.4 ... If 20 is considered 'High' I don't want to know what 30.4 is considered... (and baked potato is even HIGHER, fyi)

Strawberries
1C of strawberries has about 15g of carbohydrate and is roughly 36 on the GI. 15x36/100 = a glycemic load of 5.4 ... roughly 1/6th the load of mashed potato.

Breakfast
2 strips bacon, 2 eggs fried, 1 slice sprouted grain toast with butter. This meal contains 13g of carbohydrate (bread) which is roughly 45 on the GI scale. 13x45/100 = a glycemic load of roughly 5.85.

The reason I bring this up is that the GL (Glycemic Load) is starting to be a more recommended dietary concept to be familiar with than the glycemic index.

• Many experts in the field are pushing to have the Glycemic Load placed on nutritional labels.
• Many research articles are touting the effectiveness of diets based on the glycemic load.
• Many organizations such as the IDF (International Diabetes Federation) and others are pushing for more education and awareness on glycemic load, etc..

That gives you a bit of a primer on it, and I hope you all understand it better, if you're at all interested...

 

[jwags]

I remember the first book I bought when I was dx'd D was the GI Book. I thought it was great until I realised all the variations in the food lists. Even the same food by different manufacturers will have a different GI and GI load. It eventually occurred to me that the only things that worked for me were the things close to 0. It is way too much math for me and we all know different foods affect different D's differently. It frustrates me when I see a list of food that I am suppose to be able to eat without a spike and it still spikes me.

 

[d33na]

I used to find that GI was really confusing but if you break it down with the GI Load it makes so much more sense...

So it's food (the carbs in the portion you're going to eat) x GI/100...it's easier because you're stating how much of a food you're eating... food x GI/100

Thinking out loud here...so if you were to have a 1/2 cup of watermelon with some cheese that would slow down the rate of spike...hmmm I'll have to test that one

 

[beefy]

I remember the first book I bought when I was dx'd D was the GI Book. I thought it was great until I realised all the variations in the food lists. Even the same food by different manufacturers will have a different GI and GI load. It eventually occurred to me that the only things that worked for me were the things close to 0. It is way too much math for me and we all know different foods affect different D's differently. It frustrates me when I see a list of food that I am suppose to be able to eat without a spike and it still spikes me.

You're so correct about the differing GI ratings...

Different GI ratings come from different testing and methodology. Potatoes vary wildly in GI just on how long you cook/bake them... Fruit varies in it's GI by how ripe it is... earlier studies regarding such common things as carrots were flawed. Some GI studies use as few as 5 or 10 subjects, etc. etc.

For me it comes down to this: What enjoyable foods might I be able to eat that I'm NOT eating?

Certainly there's foods that common-sense tells me not to try, but when I was first diagnosed, and was looking at the glycemic index, there were foods I avoided altogether because of their rating - Watermelon being one of those.

I never understood that the GI was based on tests from eating 50 grams of available carbohydrate for the food source... It turns out that the amount of watermelon required for a 50g carbohydrate sample is FIVE FULL CUPS of watermelon!

When I learned about the concept of Glycemic Load, I looked at watermelon and determined that a serving that I'd be happy with (around 1cup or so) might not spike my blood sugar, so I tried it... and now I know that having 3/4 - 1c of watermelon keeps my blood glucose under 6.5 (117) which is exactly where I like to be post-snack.

The bottom line is (as you mentioned) we ARE all different. For me, I like having tools like the GI and GL to help me determine if I should try something... and then I test.

Ultimately, it's the results of my testing that tells me whether I should add a food item to my diet, not any number given to me by a website or the results of some calculations.

However, as I mentioned, there's things I would have avoided had I not had an understanding of Glycemic Load and relied solely on the Glycemic Index.

 

[Insulation Tim]

Great Post. Even though I'm an old fart, I'm learning quite a lot on this forum. Keep up the good work.

 

[Kylyssa]

I just found a website that lists glycemic load for many foods. It also has an excellent breakdown of nutrients as well.

NutritionData.com

 

[Shanny]

I just found a website that lists glycemic load for many foods. It also has an excellent breakdown of nutrients as well.

NutritionData.com

I use this website nearly every day. Thanks for posting this, Kylyssa!

 

[Daytona]

So the glycemic load of a cup of halved strawberries is 3 (according to this site). But when I have tested, I get a large spike from eating even less than that. When I first started dieting I (blindly) followed GI/GL but it seems that there is more to it than just those #'s. I dunno, it's good to understand the difference but it's still quite important to test these out against your meter.

 

[Shanny]

I haven't used the GI/GL because I don't really need to know how fast something is going to spike me - I need to know if it will spike me AT ALL. I just don't get the purpose of GI/GL, dense old dingbat that I am . . . much rather know the carb content & use my meter to determine the rest of the story.

 

[naynay]

It all seems so confusing to me. I will just stick to the meter reading and what I can and can't eat. Realistically, I get to the point where I don't really want to eat anything, or have a taste for anything anymore. If I get a really bad hankering for something forbidden, I either find a substitute, or I throw caution to the wind and indulge a little bit. I pay the price for it later, but sometimes that little indulgement will go very far in the satisfaction area. It also shows me that I can be disciplined when I want to indulge and not splurge too much.

 

[optimist]

So the glycemic load of a cup of halved strawberries is 3 (according to this site). But when I have tested, I get a large spike from eating even less than that. When I first started dieting I (blindly) followed GI/GL but it seems that there is more to it than just those #'s. I dunno, it's good to understand the difference but it's still quite important to test these out against your meter.

I eat berries each day, but if I eat them as they are, it spikes me, but if I eat them together wit fat (cream or in a cottage cheese vaffel) it doesn`t spike me.
I doesn`t follow GI or GL blindly, but I do like to test how the food works for me, and those list can be very helpful when to choose if it is possible at all to introduce a new thing in my diet.
Sonce I am born curious, I always do a lot of testing of my BG when I try new thing.....

 

[beefy]

So the glycemic load of a cup of halved strawberries is 3 (according to this site). But when I have tested, I get a large spike from eating even less than that. When I first started dieting I (blindly) followed GI/GL but it seems that there is more to it than just those #'s. I dunno, it's good to understand the difference but it's still quite important to test these out against your meter.

And because EVERYONE is so different, it's important that we all continue to test regularly.

I know one person that USED to be able to eat certain foods with no spike, but a few years later, that same food started to spike him. So not only are we all different, but the one constant in this life is change

 

[smorgan]

I don't find either calculation to be of any use whatsoever. Simple grams of carbs is much simpler and gives me all the information I need. I suppose GI/GL might be useful if you are trying to eat as much carbohydrate as you can without exceeding a certain limit. So, for example you could use them to have a long slow curve instead of a sharply ascending one.

I'm much more concerned about the "area under the curve" or the TOTAL amount of glucose I'm dumping on my impaired system. GI/GL offers nothing in this regard whereas simple grams of carbs is a virtually perfectly correlated measure. We can get into how much to subtract for fiber, etc. but aside from that grams of carbs is a precise measure of total glucose you'll be inflicting on yourself. It is also much easier, more available and less in dispute than GI/GL.

That's just my $.02 on the matter.

 

[beefy]

I don't find either calculation to be of any use whatsoever. Simple grams of carbs is much simpler and gives me all the information I need.

And that's great if that works for you. It doesn't necessarily work for me.

For me, 15g of carbs from banana reacts immensely differently than 15g of carbs from blueberries, and I have found the same to be true for many of the foods I eat.

So there may be many of us that can't simply go by the grams of carbs. As such, having a few other tools in the belt can be handy.

The most important tool we have is testing though, period.

 

[smorgan]

Absolutely, that's like what I was trying to say. When you eat the banana, it acts quickly. Using spot checks at 1 hour or 2 hours or any other time may or may not give you the whole picture. Usually, you can't even be sure if it is on the way up or the way down.

Let's say for example you hooked up a constant glucose monitor. With the banana, the curve would rise sharply and then come back down, probably in a short period of time. It would look like a steep mountain like say the Matterhorn.

On the other hand, with the blueberries, the curve would rise much more slowly and come down more slowly. It's the same 15g of carbs and it is the same amount of glucose entering your bloodstream but it takes longer to get there giving your pancreas more time to respond with insulin and dispose of it. It's the area under the curve which I'm looking at and which corresponds to total grams of carbs.

I don't think it is about 'working' or not working, it's about what you are trying to accomplish. Most take as their first objective avoiding high peaks and rightly so. So, GI/GL calculations can be very useful for this.

In my case, I haven't had any peak to worry about in a very long time and I have another objective: to strictly limit the total amount of incoming glucose. So, for THAT objective, GI/GL is of no use and the much simpler grams-of-carbs gives me what I need.

So, I only intended my comments with regard to my particular approach to diabetes which I guess is pretty unusual.

I've developed a personal conviction that just avoiding highs - which is definitely step one and an excellent idea - is not sufficient to maintain health and avoid both complications AND most importantly progression.

Among other things, I base this on the fact that for a typical T2, this disease PROGRESSED gradually for 5 - 10 years before diagnosis all the while blood sugars were completely normal (only insulin is high). If I only achieve those levels now, what would stop progression? Yes, high BG is worse and accelerates progression and complications, but I'm not convinced just eliminating that is sufficient.

I guess I won't know if my theories are correct for a decade or two!

And that's great if that works for you. It doesn't necessarily work for me.

For me, 15g of carbs from banana reacts immensely differently than 15g of carbs from blueberries, and I have found the same to be true for many of the foods I eat.

So there may be many of us that can't simply go by the grams of carbs. As such, having a few other tools in the belt can be handy.

The most important tool we have is testing though, period.

 

[kantim]

Diabetes Update: Search results for glycemic index

Diabetes In Control points today to a study published in Diabetes Care that proves what I've been saying for years.

The Glycemic Index is meaningless for people With Type 2 Diabetes.

Interindividual Variability and Intra-Individual Reproducibility of Glycemic Index Values for Commercial White Bread
Interindividual Variability and Intra-Individual Reproducibility of Glycemic Index Values for Commercial White Bread


The glycemic index is a measure of the impact a food has on blood sugar. The study found that while the average glycemic index of white bread was 71, in the individuals who participated in the study the actual glycemic response could be anything from 44 to 132. In short, it was meaningless.

This is no surprise. As I wrote in an earlier blog entry, The "glycemic index" is meaningless for people with diabetes because all that supposedly "high glycemic" foods do is slow down the digestion of the carbohydrates they contain.

If you have enough phase two insulin to mop up carbs 2 or 3 hours after eating, a slower digesting high carb food will be a bit better for your blood sugar. But most people with longstanding Type 2 diabetes have little or no second phase insulin. So it doesn't matter how long it takes a food to digest. Every gram of carb they eat will hit their blood sugar and raise it. For them, it doesn't matter if they're eating Oatmeal or drinking regular Pepsi, 50 grams of carbs in either form will push up their blood sugar to damaging levels.

(snip)

Because there is so much individual variation in response to a given amount of carbohydrate, the only way you can decide what foods make a healthy diabetes diet--FOR YOU--is to test each food you eat with your meter. If the food keeps you at a healthy blood sugar target, which, at a minimum should be under 140 mg/dl at 1 hour and under 120 mg/dl at 2 hours, eat it. If it doesn't, cross it off your list.

 

[smorgan]

Diabetes Update: Search results for glycemic index

Diabetes In Control points today to a study published in Diabetes Care that proves what I've been saying for years.

The Glycemic Index is meaningless for people With Type 2 Diabetes.

Interindividual Variability and Intra-Individual Reproducibility of Glycemic Index Values for Commercial White Bread
Interindividual Variability and Intra-Individual Reproducibility of Glycemic Index Values for Commercial White Bread


The glycemic index is a measure of the impact a food has on blood sugar. The study found that while the average glycemic index of white bread was 71, in the individuals who participated in the study the actual glycemic response could be anything from 44 to 132. In short, it was meaningless.

This is no surprise. As I wrote in an earlier blog entry, The "glycemic index" is meaningless for people with diabetes because all that supposedly "high glycemic" foods do is slow down the digestion of the carbohydrates they contain.

If you have enough phase two insulin to mop up carbs 2 or 3 hours after eating, a slower digesting high carb food will be a bit better for your blood sugar. But most people with longstanding Type 2 diabetes have little or no second phase insulin. So it doesn't matter how long it takes a food to digest. Every gram of carb they eat will hit their blood sugar and raise it. For them, it doesn't matter if they're eating Oatmeal or drinking regular Pepsi, 50 grams of carbs in either form will push up their blood sugar to damaging levels.

(snip)

Because there is so much individual variation in response to a given amount of carbohydrate, the only way you can decide what foods make a healthy diabetes diet--FOR YOU--is to test each food you eat with your meter. If the food keeps you at a healthy blood sugar target, which, at a minimum should be under 140 mg/dl at 1 hour and under 120 mg/dl at 2 hours, eat it. If it doesn't, cross it off your list.

Thanks for the post! It's about time to hear some sanity on this silly issue.

However, I'd take it a step further. Note the part about INTRAindividual differences. That means the SAME individual can have widely different responses to the same food. This throws a big wrench into one of our most cherished activities - indicting or clearing individual foods by using meter readings - which you also mention in your concluding paragraph. This misses the significance of these intra-individual variations.

Ironically, the most reliable and useful criteria is also the simplest: SIMPLE GRAMS OF CARBS (minus indigestible fiber), PERIOD. That tells you pretty accurately how much glucose will result and that is by far the most important thing. I think we waste a lot of time and develop a lot of myths for ourselves and each other by drawing conclusions from meter readings.

This was driven home to me once when a poster said that they drank herb tea with two packs of stevia and had a huge spike - something like 160 - which they then attributed to stevia. Their conclusion? "Stevia spikes my blood sugar." NOT. Not unless pigs have flown! Worrying about steiva maybe, but not stevia itself. Not possible.

In the end, all we really need to do is read labels!