First of all, we should know the “food glycemic index” and “food glycemic load”.
For a long time, people have traditionally believed that diabetic patients should never eat sugar, they should not eat any sweet food or dishes with sugar, and they should not drink sugary drinks. Some people are afraid of sugar and have a great fear of sugar. They are under great mental pressure to eat and drink anything, and lose the joy of life. Some people also have a rebellious mentality, eating and drinking all day long, the more you say what not to eat, the more he will go to eat what.
In clinical work, we often meet diabetic patients who ask: “Doctor, please tell me what food I can eat? What foods can I not eat?” It seems that as long as he avoids the so-called forbidden foods for diabetic patients, his blood sugar can be well controlled. Whenever I encountered such a situation, I would tell the patient, “You can eat almost anything as long as your total calorie intake is well controlled. The diabetic diet is the healthiest diet, and not only should diabetics eat this way, but every normal person should eat this way too.” Many patients are always half-heartedly hoping to find a shortcut to controlling their blood sugar.
As we all know, for diabetic patients, how to scientifically choose and reasonably match the diet is one of the most basic and important treatment methods for diabetes, not only is it an important treatment measure to ensure that blood sugar reaches the standard and prevent serious complications of heart, brain, eye and kidney blood vessels, but also an indispensable and necessary means to enjoy the food culture, add fun to life and improve the quality of life. In the past, we have been using the food exchange method to guide diabetic patients how to choose food, many doctors and diabetic patients have some knowledge of this again, this classical method had played an important role in sugar control, however, only pay attention to chemically equivalent carbohydrates and energy, without considering the different types of equivalent carbohydrates and the influence of other food components on blood sugar, especially the exchange table does not reflect the In particular, the exchange tables do not reflect the differences in glycemic response of different foods. In addition, the dietary restrictions for diabetic patients are too harsh, and there are even some misconceptions that make the diets of diabetic patients boring, monotonous, nutritionally deficient, and with reduced quality of life.
In fact, do not look at the dietary treatment of diabetes as difficult, from a nutritional point of view, as long as you know the scientific mix and food generation nutrition principle, you can achieve food “colorful”. This requires an understanding of two concepts: “glycemic index (GI)” and “glycemic load”.
GI refers to the ability of a food to raise blood glucose in human beings from human tests, and is a method of classifying the ability of carbohydrates to raise blood glucose by comparing the effect of the same weight of carbohydrates in food on blood glucose, and is a valid physiological parameter to evaluate the postprandial blood glucose response caused by food. Foreign epidemiological studies have shown that a group that consumes low GI foods as their main diet has significant health implications for the prevention of diabetes, hypertension and obesity. Low GI diets can improve blood glucose, lower plasma total cholesterol, triglycerides and LDL, and increase HDL in diabetic patients, which can reduce the risk of diabetes and cardiovascular disease, and have not only short-term effects but also long-term health significance.
High GI food is fast digested and highly absorbed after entering the gastrointestinal tract, glucose is released quickly, and the peak of glucose entering the blood is high, which means the degree of blood glucose elevation is greater; low GI food has a long residence time in the gastrointestinal tract, low absorption rate, slow release of glucose, and the peak of glucose entering the blood is low and falling slowly, which simply means the degree of blood glucose elevation is lower. Therefore, the application of GI and reasonable arrangement of meals are of great benefit to the regulation and control of human blood sugar. Generally speaking as long as half of the food is replaced from high GI to low GI, significant improvement of blood sugar can be obtained. When the GI is 55 and below, the food is low GI food; when the GI is between 55 and 70, the food is medium GI food; when the GI is 70 and above, the food is high GI food.
However, the GI value of any food is not fixed and is influenced by many factors, including
1. ripeness. For example, the riper the banana, the higher its GI value. This applies especially to those fruits that continue to ripen after harvest.
2. The acidity of the food. When food contains acid, it reduces the rate at which the body can digest this food. A lower digestion rate means slower absorption and a more beneficial effect on blood sugar.
3, individual differences in the speed of carbohydrate digestion.
4. The type of flour (if any) in the product. The more refined white flour in the product, the higher the GI value; the more coarse grain flour, the lower the GI value.
5.Cooking time. The cooking process expands the starch molecules, thus softening the food (the longer the cooking time, the fluffier the food), making the food easier to digest and faster to absorb. the GI value usually increases with longer cooking time.
6, other ingredients. If high GI value foods and foods containing protein or fat are consumed at the same time, the GI effect of carbohydrates will be lower than when consumed alone, because fat and protein will slow down their digestion. Similarly, the GI value of low GI foods will increase if carbohydrates are added.
When we know the above knowledge of GI, many people can think of a question, then those high GI food we must not eat? For example, watermelon has a GI value of 72, which can be classified as a high GI value. But we know that watermelon is a healthy food. And there are studies that prove that moderate consumption of watermelon will not cause a significant increase in blood sugar. This shows that a high GI does not necessarily cause an increase in blood sugar, but also depends on the amount of sugar in the food. For this reason, in 1997, Harvard researchers Salmeron et al. introduced the new concept of “glycemic load (GL)”, which makes it easier and more intuitive for diabetics to choose and match their diets appropriately.
The GL is a combination of the quantity and quality of carbohydrates, and represents the magnitude of the effect of a certain weight of food on the body’s blood glucose, and is calculated as follows: the actual weight of available carbohydrates in the food consumed (diabetics can purchase the “food composition table” at the library) multiplied by the GI value of the food and divided by 100. The GL can quantify the glycemic effect of the actual food provided or the overall dietary pattern, so the GL is a more comprehensive assessment of a food’s ability to raise blood glucose than the GI. The GL, when used in conjunction with the GI, reflects the amount of available carbohydrate contained in a typical serving of a particular food, and is therefore closer to the actual diet.
A high GL is when the GL is greater than or equal to 20, suggesting that the corresponding weight of food consumed has a significant effect on blood glucose.
When the GL is between 10 and 20, it is a medium GL, suggesting that the corresponding weight of food consumed has an average effect on blood glucose.
When the GL is less than or equal to 10, it is low GL, suggesting that the corresponding weight of food consumed has little effect on blood sugar.
Now we still take watermelon as an example above. We know that watermelon has a high GI value, now calculate its GL and see how it is.
If we want to eat a piece of 3 taels of watermelon, we can find out from the food composition table that the carbohydrate content of watermelon is 5.5 grams in 100 grams (2 taels), and the available carbohydrate contained in 3 taels of watermelon is 5.5*150/100=8.25, with a GI value of 72. The GL value of watermelon is calculated as follows: 8.25*72/100=5.94, which is equal to about 6. In this way, we can Eating 3 taels of watermelon doesn’t have much effect on blood sugar, does it? Similarly, if we want to eat a 1 pound piece of watermelon, we can check the food composition table to know that the carbohydrate content of watermelon is 5.5 grams in 100 grams (2 taels), and the available carbohydrates in 1 pound of watermelon is 5.5*500/100=27.5, with a GI value of 72. The GL value of watermelon is calculated as follows: 27.5*72/100=19.8, which is approximately equal to 20. We eat 1 pound of watermelon at a time and the effect on blood sugar is more obvious. In addition, the glycemic index of soda crackers is also 72, but they contain about 76 grams of carbohydrates per 100 grams, and the available carbohydrates contained in 3 taels (150 grams) of them are 76/100*150=114, the GL of these 3 taels of soda crackers=72*114/100=82.08, which has a great impact on blood sugar; while when we consume 20 grams of soda crackers, their GL= 72*76/100*20/100=10.944, which has very little effect on blood sugar. So by applying the GL we will know that it is OK to include high GI foods in the diet plan. In other words, it is possible for diabetic patients to consume any food, only the weight of the food should be strictly controlled. Remember, by refusing to eat certain foods – especially high GI fruits, vegetables, coarse grains and legumes – you are missing out on a lot of vitamins, minerals and fiber.
Therefore, when choosing foods and matching dietary structures, diabetics should follow the concept of combining GI and GL to choose and match meals, taking into account both the quality of the carbohydrates contained in the food, i.e., the rate of digestion and absorption; and the total amount of carbohydrates contained in the food and its effect on glycemic load. A comprehensive balance of quality and quantity of carbohydrates is undoubtedly the most scientific and reasonable, diversified and humane combination of diabetic diet. Currently, the classic food exchange method of total calorie control is the most commonly used in diabetic diet control and education. This method is simple and easy to use and can be easily operated by patients in their daily life. Total calories and total sugars are calculated according to the individual’s needs and can be interchanged in different recipe groups. However, the main drawback of this method is that it does not correctly represent the differences in blood glucose and insulin response caused by each food after a meal; nor does it take into account the effects of different food processing and cooking methods on blood glucose and insulin. Incorporating the concepts of GI and GL into the health education of diabetic diet, linking it with the food exchange method, and widely publicizing it to help patients scientifically choose foods with low GI and GL is conducive to reducing the load on pancreatic islet cells, which is of great clinical significance to effectively control and stabilize blood glucose, reduce cardiovascular and cerebrovascular complications of diabetes, and improve the quality of life of patients.
Foods with a glycemic index between 115 and 90 are, in order, maltose, glucose, and corn muffins.
Foods with a glycemic index between 89 and 80 are, in order: puffed rice, glutinous rice, instant convenience rice flour, fried/baked potatoes, and caramelized sugar.
Foods with a glycemic index between 79 and 70 are, in order: fava beans, pumpkin, honey, sorghum, purple rice (early), watermelon, carrots, millet, white wheat flour bread, puffed wheat, French
fried potatoes, popped corn flower, roasted corn chips, polenta, sandwich bread, fried fritters, and fine white flour bread.
Foods with a glycemic index between 69 and 60 were, in order: whole wheat flour bread, cornmeal, barley flour bread, cassava, banana (uncooked), whole rye flour bread, oat flour bread, small round burger bread, crusty bread, pumpernickel wheat flour bread, (oat) flake mix, wheat cookies, whole rye cookies, nutritious cereal breakfast, cereal porridge, oatmeal porridge, raisins, seedless grapes (fresh), pineapple , potatoes (new), steamed/boiled mashed potatoes, black bean soup, green bean soup (canned)
Foods with a glycemic index between 59 and 50 are, in order: rice, purple rice (brown rice, brown rice), potatoes (boiled/roasted), yams, yams, sweet potatoes, buckwheat, sweet corn (ears), rice flour, seedless raisins, bananas, mangoes, kiwis, fresh peach juice (canned, thick/light), tangerine juice, orange juice, mung bean porridge, oatmeal (porridge), and popcorn.
Foods with a glycemic index between 49 and 40 are, in order: lactose, chocolate, green beans, oranges, oranges, tangerines, grapes (fresh), apple juice, grapefruit juice, pear juice, pineapple juice (unsweetened).
Foods with a glycemic index between 39 and 30 are, in order: ravioli, egg noodles, spaghetti, rye kernels, wheat kernels, nutritional (coarse) flour, lentils (kidney beans), apples, pears, unripe bananas, dried apricots, skim milk, yogurt, polenta, tomato soup, shark fins.
Foods with a glycemic index between 29 and 20 are, in order: barley kernels, mung beans, red beans, black beans, dried peas, dried beans, string beans (cloud beans), lentils, sausages, whole milk, jelly (without milk), longan, peaches (fresh), fresh peach juice (all natural), grapefruit, plums, cherries.
Foods with a glycemic index between 19 and 14 are, in order: soybeans, peanuts, low-fat milk, and canned soybeans.