Quantity & Quality of Carbohydrates & Understanding Glycemic Index
Carbohydrates play an important role in managing diabetes because of the changes these foods cause on blood sugar after consumption and insulin secretion. The quantity and quality of carbohydrates are very key in determining your after-meal (post-prandial) glucose levels.
Quality of Carbohydrates; High vs. Low
We’ve heard it said severally that carbohydrates are bad for you. Nothing could be further from the truth since carbohydrates are an integral part of a healthy diet. For example, glucose is the primary fuel used by the brain and central nervous system, and foods that contain carbohydrate are important sources of many nutrients, including fiber, water-soluble vitamins and minerals. However, carbohydrates are created equal!!! Some have better effects on your blood sugar than others.
What are high-quality carbohydrates? High-quality carbohydrates provide a wide range of nutrients, including fiber and health-promoting plant chemicals called phytonutrients. Fiber helps to slow the digestion of sugars and starches, sugar and insulin, which is associated with diabetes, heart disease, and weight gain. The healthiest carbohydrates come from fruits, vegetables, beans, legumes, and whole grains.
Whole grains contain three components: the fiber-rich outer bran, the nutrient-rich central germ, and the starchy middle layer (endosperm).
What are low-quality carbohydrates? Low-quality carbohydrate foods often contain refined grains, which means the grain’s natural composition has been modified by stripping away the bran and germ. Typically low-quality carbohydrates include white bread, white rice, pastries, and sweetened juices and beverages. Processed foods with low-quality carbs may contain a narrower range of nutrients than whole foods, even in cases where these foods are artificially fortified with certain essential vitamins and minerals. They may also contain added sugar, fat, sodium, preservatives, and other substances to make them more appealing to consumers. The low-quality carbohydrates in such foods are digested quickly, trigger spikes in blood sugar and insulin.
Quantity of Carbohydrates: Know how much you require
The amount of carbohydrates you consume will influence the amount of glucose levels in your blood after a meal (post-prandial). This simply means that the more carbohydrates you eat at one sitting the higher your blood sugar level may rise. As much as we ensure that we consume high quality carbohydrates, we should also ensure we eat these foods in the right quantity. Use the Lishe Living tool to establish the amount of carbohydrates (in grams) that you’re supposed to be eating. Remember the quantity recommended to you depends on your age, sex, physical activity (how much exercise/ how involving your work is) and health condition you wish to address.
Carbohydrates and Insulin-dependent diabetes
Fixed insulin doses
If you have a fixed dose of insulin, make sure your carbohydrate intake on a day-to-day basis remains the same, based on time and amount of carbohydrates. This means estimating how much carbs are in the individual foods and meals you eat in order to get the amounts right. More carbohydrate than usual can cause blood glucose levels to go too high, and less than usual can cause a hypo (low blood glucose levels).
Adjustable insulin doses
If your insulin can be adjusted, you can be much more flexible in how much carbs you eat and when you eat. The amount of insulin will change depending on how much carbohydrate one is eating. Other factors are also important, such as any physical activity you have done or plan to do, previous episode of hypos (low blood sugar) and any infection.
1) Carbohydrate Counting by Carbohydrate Exchanges
Carbohydrate counting as the name suggests involves counting your carbohydrates.
An exchange refers to a certain amount (serving) of a particular food that contains about 15 grams of carbohydrates. These foods with similar amount of carbohydrate per serving size are normally grouped together. One food from that list can be exchanged with another in the same group without change in the amount of carbohydrate content. For example: 1/4 cup of granola contains the same amount of carbohydrate as 1/3 cup of rice.
Table 2: Carbohydrate exchanges
CEREALS, GRAINS AND PASTA
1 Serving= 15g of carbohydrates, 3g proteins, 0-1g fats, 80 calories
|Couscous, cooked||1/3 cup|
|Granola, regular or low fat||Granola, regular or low fat|
|Grits, cooked||½ cup|
|Millet, cooked||¼ cup|
|Pasta, cooked||1/3 cup|
|Polenta, cooked||1/3 cup|
|Quinoa, cooked||1/3 cup|
|Rice, white or brown, cooked||1/3 cup|
|Tabbouleh, prepared||½ cup|
|Wheat Germ, dry||3 Tbsp|
|Wild rice, cooked||½ cup|
The glycemic index ranks food according to how fast they are digested and absorbed. We use this index to rank only carbohydrate -containing foods; the faster food is digested/absorbed into the body the faster blood sugar rises. Glucose (in powder or tablet form) has a glycemic index of 100% and other foods are ranked on this index as having low, medium or high GI, depending on how rapidly these foods increase the levels of blood sugar in your blood. This minimizes the risk of hypoglycemia(very low blood sugar)/hyperglycemia (very high blood sugar).
Based on these, foods are categorized into three based on their glycemic index.
- Low: 55 or less
- Moderate: 56-69
- High: 70 +
The use of GI as the basis of making food choices by individuals managing their sugar levels has been found effective in reduction of HbA1C since most of the low to moderate GI foods tend to be whole grain cereals, legumes, fruits and vegetables. It is important to note that not all foods that have a low GI are healthy choices e.g. potato chips have a GI of 51, sponge cake has a GI of 46 and sausages have a GI of 28 hence other factors such as saturated/trans fat content and other components of the food that might affect its health profile. On the other hand watermelon has a very high GI, of 72, although healthy it can rapidly raise your blood sugar.