By Adriane
Happy National Diabetes Awareness Month! Did you know that 12.3% of Americans over the age of 20 have diabetes? This may not seem like a high percentage, but it adds up to 29.1 million people in our country who suffer from this growing disease (Centers for Disease Control and Prevention, 2014). I'm sure you can name at least 1, 2, maybe 5 close friends or relatives that have diabetes. This month our goal is to empower you to make decisions that will decrease your risk of not only diabetes, but heart disease and obesity. Those affected by diabetes are not as receptive to insulin, a hormone produced by your pancreas. Insulin normally transports sugars from our blood into our cells to fuel our bodies. If our body becomes resistant to insulin or our pancreas cannot produce enough insulin, diabetes may result. Follow along to find out why simple sugars may not be the "sweetest" thing to fuel your body and what exactly causes diabetes. Hope you enjoy!
I'm just going to start off by clearing the stage of a common nutrition myth that misleads much of us Americans... Carbohydrates are not your enemy. Yes, some carbohydrates are better sources of fiber and nutrients than other sources, but cutting carbohydrates out of your diet will not improve your health. Everyone needs carbohydrates, including those people with diabetes. All carbohydrates are broken down into glucose, the simplest sugar, and all carbohydrates will increase your blood sugar to some degree. There are complex carbohydrates and simple carbohydrates. Simple Carbohydrates mostly consist of simple sugars. What is a simple sugar you may ask? Simple sugars are sugars that are quickly digested and absorbed by the body to create energy. Because they are broken down so quickly by our bodies, simple sugars increase our blood sugar (AKA blood glucose) more rapidly than complex sugars which are slowly absorbed into our blood after eating.
Simple sugars also have a higher glycemic index (GI) than complex carbohydrates. Eating a food that has a higher glycemic index results in a faster and higher spike in insulin and glucose levels. Those who consume a high GI diet are at increased risk for several cancers (breast, prostate, colorectal, and pancreatic), diabetes, and heart disease. In contrast, benefits of a low GI diet include weight loss and weight maintenance. Glucose is the simplest type of sugar and the final product of the breakdown of both simple and complex carbohydrates. The glycemic index of glucose is 100 and all foods are given a glycemic index in comparison to glucose. For example, a food with a glycemic index of 25 will affect your blood sugar 25% as much as pure glucose. All carbohydrates affect blood sugar levels by releasing glucose, but simple carbohydrates have a higher glycemic index than complex carbohydrates resulting in a larger, shorter spike in blood sugar (see graph above).Breaking It Down: Types of Carbohydrates and Glycemic Index
Choose more low GI foods, Moderate amounts of medium GI foods, Less high GI foods
Choose More Low GI (55 or less)
- most fruits - apples, grapefruit, oranges, peaches, pears, pitted prunes
- most vegetables - green peas, carrots, yams, parsnips
- grains - 100% whole grain bread, brown rice, converted white rice, bulgur, pasta, quinoa, corn and wheat tortillas
- most dairy - skim milk, full-fat milk, reduced-fat yogurt with fruit
- all beans & nuts - baked beans, blackeye peas, black beans, chickpeas, navy beans, kidney beans, lentils, soy beans, cashews, peanuts
- few breakfast cereals - oatmeal, All-Bran
- some fruits - banana, grapes, raisins
- some vegetables - sweet corn
- grains - white basmati, couscous, white pita bread, pumpernickel bread, hamburger bun
- few dairy - ice cream
- some snacks & desserts - shortbread, rye crisps
- some breakfast cereals - cream of wheat, Raisin Bran, Special K, muesli
- few fruits - watermelon
- some vegetables - boiled white potato, sweet potato, mashed potatoes, baked russet potato
- grains - Wonder white bread, white baguette, whole wheat bread, white rice, white bagel, rice cakes, waffles
- no dairy
- most snacks & desserts - graham crackers, vanilla wafers, soda crackers, cakes, doughnuts, croissants
- most breakfast cereals - instant oatmeal, instant cream of wheat, Coco Pops, Cornflakes, Grapenuts, puffed whea
Tip 2: The amount of carbohydrate you are eating matters too! GI should not be the only tool you use to choose healthy foods and decrease your risk of diabetes because it does not always indicate that a food is a good choice. For example, Coca Cola has a moderate GI of 63 but provides only empty calories from simple sugars. Some low and moderate GI foods, including candy and soda, have no nutritional value.
Little changes can make a big difference. Here are some easy food swaps that you can make to increase the amount of fiber and low GI foods in your diet. Overall, aim to choose foods that are high in fiber (3+ grams per serving) and whole grains ("whole grain" instead of "refined" grains in the ingredients list). These foods are more likely to have a low GI.
- choose brown (GI 50) or converted rice (GI 38) over white rice (GI 89)
- choose steel-cut oats (GI 55) over instant oatmeal (GI 83)
- choose bran flakes (GI 55) over corn flakes (GI 93)
- choose 100% whole-grain bread (GI 51) over white bread (GI 73)
- hint: "whole grain" should always be the first 2 words on the ingredients list if the bread is truly whole grain
- choose bulgur (GI 48) or whole grain pasta (GI 42) over baked or mashed potatoes (GI 111)
- choose peas or leafy greens (GI 51) over corn (GI 60)
- T2D is by far the most common type of diabetes. T2D is characterized by insulin resistance to glucose (the most simple sugar). Insulin normally transports glucose from our bloodstream into our cells. We need glucose to replenish our cells and fuel our bodies.
- Those who have T1D do not produce enough insulin to transport glucose into the blood and are normally diagnosed as a child. This type of diabetes is rarer than T2D. Every day for the rest of their life, an individual with T1D has to either give themselves injections of insulin or get a pump to inject insulin into their body. Signs that a child may have T1D are if they are constantly thirsty, constantly hungry, and peeing much more than usual.
- A woman who is pregnant may be diagnosed with Gestational Diabetes if her blood sugar is high when she is carrying the baby. If a woman does have gestational diabetes, there is a high risk that she will develop T2D. 5-10% of women with gestational diabetes continue to have high blood sugar after pregnancy and are diagnosed with diabetes. A baby of an individual with Gestational Diabetes is at higher risk of being obese and developing diabetes as well.
1. Centers for Disease Control and Prevention. (2014). National diabetes statistics report: estimates of diabetes and its burden in the United States, 2014. Atlanta, GA: US Department of Health and Human Services.
2. Harvard Medical School. (2012). Choosing good carbs with the glycemic index.
http://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2012/November/choosing-good-carbs-with-the-glycemic-index
3. Atkinson, F. S., Foster-Powell, K., & Brand-Miller, J. C. (2008). International tables of glycemic index and glycemic load values: 2008. Diabetes Care, 31, 2281-2283.
