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Low Glycemic Index vs. High Fiber Diet: Which is Better for Diabetics?
There's been a lot of talk about low-glycemic-index diets being better for helping diabetics control their blood sugars, but the studies that have been done tend to be small and of short duration. Back in 2008 researchers in Canada decided to improve on past studies by designing a larger, more long term study to compare the effects of a low glycemic index diet with a high cereal fiber diet.
Hunger, Blood Glucose, and the Glycemic Index
We don't exactly know how the feeling of hunger is caused in the body. One theory, first formulated in the 1950's, is that low levels of glucose in the brain are a cause of the feeling of hunger and the increase in appetite that goes along with it. More recent theories expand on that theory by speculating that it's the changes in blood glucose levels that lead to the feeling of hunger.
When the Glycemic Index Doesn't Measure Up
A couple of months ago I wrote about the link - or lack thereof - between dietary Glycemic Index and the risk of developing type 2 diabetes. The Glycemic Index is of interest to those seeking to help prevent or treat diabetes because it measures the effect that a specific food has on a person's blood sugar after the person eats it. Unfortunately, the results of studies assessing the link between GI and diabetes risk have been mixed.
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Some studies have linked high glycemic index (GI: how quickly a carbohydrate is absorbed) and high glycemic load (GL: the glycemic effect of carbs in the diet) with an increased risk of Type 2 diabetes. In Western diets, these foods include bread, potatoes, and sweet foods like desserts or sweetened soft drinks - a large portion of the typical Western diet. The Chinese (and other Asian populations) have a very different diet: rice is their main staple food. Would the association between GI, GL, and the incidence of Type 2 diabetes be different for those following a Chinese-style diet?
Researchers in Shanghai (Arch Intern Med 2007;167(21):2310-2316) made use of data from a large-scale, five-year study of almost 75,000 women who were between the ages of 40 and 70 at the start of the study. In addition to the usual assessments of height, weight, and demographic background, the researchers also interviewed the participants about their typical dietary intake.
For these women, their typical carbohydrate-rich foods included rice, noodles or steamed breads, potatoes and sweet potatoes, and bread. (Note that sweets are not a large part of their diet.) After assessing the diet of those women who developed Type 2 diabetes and comparing their diet with those women who did not, the scientists concluded that women whose diets provided the highest levels of GL and GI were up to 20% more likely to develop Type 2 diabetes than those women with the lowest levels of GL and GI. Simply put, eating more rice, noodles and steamed breads, and bread were associated with higher levels of Type 2 diabetes.
This study is about eating high vs. low glycemic foods - it doesn't appear to matter what type of food it is (sweets or rice, for example). One way you can help minimize your glycemic index and glycemic load is to look for higher-fiber (therefore lower GI) options for those high-GI foods: brown rice instead of white rice, wheat bread instead of white bread, and whole-wheat pasta instead of plain.
First posted: November 28, 2007