If you have already read our blog post this month about the Glycemic Index, you may be feeling some curiosity about how a low glycemic diet could fit into your life. If you haven’t read the other piece yet, you could start there, but the big takeaway is that most people can benefit from a low glycemic diet in one way or another.
If I’m not diabetic, why should I care about my blood sugar?
Any food with carbohydrates in it is going to raise your blood sugar. This is a good thing. Our cells, and especially our brain cells, need glucose to make energy. When blood sugar is balanced, it is available in low but steady waves throughout our waking hours, so cells can use it when they need it. Its presence is signaled by the hormone insulin, which allows cells to absorb glucose. Problems with blood sugar arise when too much sugar is available all at once, immediately after a meal. If you consider why this occurs, it’s no wonder it can lead to disease development down the road.
The hormone who cried “GLUCOSE!”
In the development of insulin resistance, which can lead to type 2 diabetes, insulin plays the part of “the boy who cried wolf”. When sugar is available, the pancreas releases insulin. Insulin tells the rest of the body’s cells “glucose is available and ready for pickup!”. BUT, because glucose from a sugar rush is only available for such a short time and in such a high abundance, cells are confused and overwhelmed by the insulin signal. If this keeps happening over and over for years, they stop responding to the insulin signal. If cells stop responding, they stop absorbing glucose, and stop making energy efficiently. Chronically high blood glucose can lead to potentially life-threatening symptoms.
The most common unfortunate consequence of chronically high blood sugar is peripheral neuropathy . Dysregulated blood sugar actually causes physical damage to nerves if not kept in check. This is why up to 70% of all diabetic patients develop some degree of neuropathy following diagnosis . Peripheral neuropathy entails tingling, numbness, and/ or pain in the peripheral nerves (usually starting in the hands and feet). It becomes a more severe problem when people cannot feel burns or sores, which can quickly lead to infection and amputation.
Why does this happen?
Our early human ancestors did not evolve to metabolize candy, or refined sugar, or white flour, and our modern bodies have not caught up with the technological advancements in food production. These foods have been designed for our taste buds, without consideration for the physiological ramifications. Essentially, the digestion of these foods starts in the factory rather than the body. For example, whole grains require time, enzymes, and stomach acid for breakdown, and cannot be fully digested by the human body (which makes them a good source of fiber). White flour, on the other hand, has already had most of the fiber (and nutrition) removed before you eat it. It is digested nearly immediately upon consumption. White bread has the highest glycemic index value of nearly any food, next to consuming pure glucose. Alternatively, many specialty whole-grain breads actually have a low glycemic index value, as it takes the body longer to digest them, slowly releasing the sugars from grains over time.
Unfortunately, most “comfort foods” are made of easy-to-digest ingredients like white flour, refined sugar, and white-fleshed potatoes. Pastries, doughnuts, macaroni, even mashed and fried potatoes: all cause a spike in blood glucose, and are therefore off the table in a low glycemic diet… Or are they?
Can I keep my blood sugar balanced and still eat my favorite foods?
While we emphasize the importance of balanced nutrition and a plant-heavy diet, there are some ways you can minimize the spike and slow the release of sugar from your favorite sweets and comfort foods.
Switch Your Sweetener
If we’ve learned anything about the glycemic index, it’s that an abundance of refined sugar (especially alone) is near the top of the “worst things you can consume” list if you are trying to prevent a blood sugar rush and crash. As such, when possible, choose an alternative sweetener. Use caution, however, not all sugar alternatives are safe and healthy for blood sugar control, diabetes, or prediabetes.
A switch to raw honey would be a slightly healthier choice, as its glycemic index value is about 5 points below sugar and it actually promotes health benefits as a natural antioxidant, antimicrobial, anti-inflammatory, antiproliferative, anticancer, and antimetastatic ingredient . However, most recommendations for diabetics suggest treating honey as you would sugar in terms of blood sugar response.
Agave should also be avoided by diabetics and prediabetics. Although agave has a low glycemic index, it has a higher fructose content than sugar. Fructose can cause reduced insulin production and put more strain on the liver during digestion .
Some great alternatives are monk fruit extract and stevia. Monk fruit contains mogrosides, an antioxidant that is naturally sweet. By extracting this antioxidant from monk fruit, scientists have developed a sugar-free sweetener that contains no calories and doesn’t affect blood sugar levels . Stevia has some calories, but far fewer than sugar, and is made from crystallized leaves from the Stevia rebaudiana plant. Again, it will not cause a blood sugar spike post-consumption .
Glycine is an amino acid with a highly sweet taste. While not practical as a baking ingredient, it is a fabulous sugar replacement in hot drinks. Especially useful at bedtime, glycine also has a mild calming effect that may aid in the onset of sleep .
Add some acid
More acidic foods tend to have lower glycemic index values. For example, sourdough bread has a lower glycemic index than white or wheat bread. Adding lemon juice or vinegar to a recipe may reduce its impact on your blood sugar balance.
When we eat carbohydrates, digestion begins with amylase enzymes in saliva and pancreatic secretions. As the food moves through the small intestine, large sugar molecules are further hydrolyzed by glycosidases into monosaccharides, the smallest sugar molecules. Monosaccharides are absorbed from the intestine through specific sugar transport systems, and then from the blood into cells in response to insulin signals. Although the mechanism has yet to be definitively determined, the hypotheses are that acetic acid in vinegar can inhibit amylase enzymatic activity (slowing the breakdown of large carbohydrate particles), inhibit glucose transport from the gut into the blood, and/or improve glucose uptake from the blood [5,6]. Taking a 2 tbsp serving of apple cider vinegar with food has been shown to result in lower blood glucose levels, both at the time of consumption and the next day, compared to a control liquid and the same food .
Fiber benefits digestion across the board. Insoluble fiber is great for bowel regularity and feeds probiotic bacteria in the gut. Insoluble fiber is not great, however, for reducing the glycemic index of food; for that, you want soluble fiber.
“Soluble” (meaning dissolvable in water) fiber forms a gel in the gut. This gel adds bulk to the food you are eating, which must also be digested, slowing down the speed at which sugars from food are available for absorption. Psyllium husk is a great soluble fiber option. It is tasteless and can be sprinkled on top of food, mixed into a recipe, or taken stirred into a drink before eating a meal to slow blood sugar changes. Other foods high in soluble fiber are citrus fruits (also high acid), legumes (like peas and beans), and whole grains such as barley. Steel-cut or old-fashioned oats are a good source of soluble fiber, but avoid “instant oats”! They have been processed in a way that makes them easily digestible and therefore much higher on the glycemic index.
Protein alone will not affect blood glucose, but when consumed with carbohydrates, protein can actually stimulate extra insulin secretion, which will help to lower blood glucose once glucose reaches the bloodstream . Before that point though, a high protein meal will slow stomach emptying, as protein breakdown in the stomach requires more time, secretory, and enzymatic processing than carbohydrates. If digesta is released into the intestines at a slower rate, it follows that the availability of glucose from the meal will be transported to the bloodstream at a slower rate, thereby reducing the likelihood of a spike in blood sugar after a meal.
Keep the Fat
We’re not going to tell you to add more fat to a recipe because we are here to support your health, and moderation is key. But, don’t try to reduce or remove the suggested amount. Fat is yet another macronutrient (like protein) that slows digestion, stomach emptying, and release of glucose from food.
Are there specific nutrients that complement a low-glycemic diet?
Yes. B-vitamins especially are a great complement to a low glycemic diet. B-vitamins are crucial for the protection of nerve health, especially in those who may be at risk for nerve damage. An excellent nutritional option is Metabolic Maintenance®’s peripheral nerve support product, NERVEsustain™.
Most importantly, NERVEsustain™ contains the highly bioavailable, activated form of folate, L-methylfolate. Folate deficiency and high homocysteine levels (potentially linked to a low folate status and/or genetic variations) are both risk factors associated with peripheral neuropathy. Many medications deplete folate, including anticonvulsants , oral contraceptives , and medications designed to control blood sugar (including Metformin). If you are taking one of these medications, a folate-containing supplement is likely necessary to meet your body’s folate needs.
NERVEsustain™ also contains vitamins B-12, B-6, and B-2. Deficiencies in these vitamins are known to contribute to neuropathy issues . The combination of L-methylfolate (B-9/folate) and methylcobalamin (B-12) is important for the reduction of homocysteine, and both B-6 and riboflavin (B-2) act as cofactors in this process .
Thiamine, magnesium, and vitamin C complete this comprehensive formula. These nutrients support potential (often alcohol-induced) thiamine deficiency, normal insulin response and nerve impulsivity, and boost the body’s response to L-methylfolate, respectively [12,14,15].
- Dansinger, Michael. “Peripheral Neuropathy and Diabetes.” WebMD. August 11, 2019. https://www.webmd.com/diabetes/peripheral-neuropathy-risk-factors-symptoms
- Samarghandian, Saeed, Tahereh Farkhondeh, and Fariborz Samini. “Honey and health: A review of recent clinical research.” Pharmacognosy research 9.2 (2017): 121.
- Kakleas, Konstantinos, Foteini Christodouli, and Kyriaki Karavanaki. “Nonalcoholic fatty liver disease, insulin resistance, and sweeteners: a literature review.” Expert review of endocrinology & metabolism 15.2 (2020): 83-93.
- Tey, S. L., et al. “Effects of aspartame-, monk fruit-, stevia-and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake.” International journal of obesity 41.3 (2017): 450-457.
- Placzek, Kate. “Anti-Aging, Hormone Balance and Weight Loss Advice.”
- Ogawa, Nobumasa, et al. “Acetic acid suppresses the increase in disaccharidase activity that occurs during culture of caco-2 cells.” The Journal of nutrition 130.3 (2000): 507-513.
- White, Andrea M., and Carol S. Johnston. “Vinegar ingestion at bedtime moderates waking glucose concentrations in adults with well-controlled type 2 diabetes.” Diabetes care 30.11 (2007): 2814-2815.
- Wolever, Thomas MS, and Claudia Bolognesi. “Prediction of glucose and insulin responses of normal subjects after consuming mixed meals varying in energy, protein, fat, carbohydrate and glycemic index.” The Journal of nutrition 126.11 (1996): 2807-2812.
- Martinez Figueroa A, Johnson RH, Lambie DG, Shakir RA. The role of folate deficiency in the development of peripheral neuropathy caused by anticonvulsants. J Neurol Sci. 1980 Dec;48(3):315-23.
- Wilson SM, Bivens BN, Russel KA, Bailey LB. Oral Contraceptive use: impact on folate, B6 and vitamin B 12 status. Nutr Rev. 2011 Oct; 69(10): 572-83.
- Wulffele MG, Kooy A, Lehert P, et al. Effects of short-term treatment with metformin on serum concentrations of homocysteine, folate and vitamin B12 in type 2 diabetes mellitus: a randomized, placebo-controlled trial. J Intern Med. 2003; 254: 455-463.
- Hammond N, Wang Y, Dimachkie M, Barohn R. Nutritional neuropathies. Neurol Clin. 2013 May; 31(2):477-489.
- Refsum H, Nurk E, Smith AD, et al. The Hordaland homocysteine study: a community-based study of homocysteine, its determinants and associations with disease. J Nutr. 2006; 136: 1731S-40S.
- Barbagallo M, Dominguez L. Magnesium and type 2 diabetes. World J Diabetes. 2015 Aug 25; 6(10): 1152-1157.
- Verlinde PN, Oy I, Hendrickx ME, et al. L-ascorbic acid improves the serum folate response to an oral dose of [6S]-5-methyltetrahydrofolic acid in healthy men. Eur J Clin Nutr. 2008; 62 (10): 1224-1230.