making the connection between nutrition & health

Best Health Tip for 2013 to Prevent Metabolic Disease

The new year always is a time to reflect and try to introduce habits that will result in a better year.  Health is often a primary area that individuals realize should be one of top focus.  Perhaps the top health tip for 2013 is to understand and control the glycemic load of one’s diet.

The discussion of this should start with simply understanding what glycemic load is.  It is simply the degree of “stress” that the metabolism of carbohydrates and sugars creates on our system.  Care should be taken not to confuse glycemic load with glycemic index.  Glycemic index is simply the rate at which sugars that are in a serving of any carbohydrate are digested and absorbed into the circulation. 

Two whole carbohydrates can have the exact same grams of inherent sugars and yet release them during digestion into the system at much different rates.  The one that releases the sugars faster causes greater metabolic stress to manage.  This may or may not be a problem.  If the sugars are released quickly but the total sugars per serving are low, the stress is reduced. 

Glycemic load combines both variables, the rate at which the sugars are released but also the total amount of carbohydrate/sugars in a serving of that particular food.  Foods are not covered in the Declaration of Independence so, no, not all foods are created equal.

While both glycemic index and glycemic load correlate with metabolic disease risk such as with diabetes, heart disease and some cancers, glycemic load has greater correlation or predictive value.

Generally the per serving glycemic load of a given carbohydrate is classified as high or low by these values:

It is better from a disease risk standpoint to look at the total daily glycemic load.  One snack of high glycemic load creates short-term metabolic stress.  Eating all high glycemic load carbohydrates during a day creates sustained metabolic stress.  A total daily glycemic load (sum of the GLs of all carbs eaten) generally should be below 140.  Total daily GL above 140 progressively raises blood triglyceride levels and depresses HDL or good cholesterol.  Both of these blood lipid changes have been correlated with heart disease risk.

In the above study the highest daily glycemic load group had a doubling of their 10-year coronary artery disease risk compared to those eating the lowest glycemic load.








From a practical perspective, it is difficult to keep track of the glycemic load of everything eaten and totaling it for the day.  A simple alternative is to build the “pattern” of carbohydrate sources.  Most carbohydrates in the western diet come from added sugars, grain products and starches.  Ironically, these foods are all high glycemic load.  Other carbohydrates such as fruits and vegetables have low glycemic loads.

Generally, grains and starches have a per serving glycemic load of 12-30. Grain products are one of the most likely foods to have added sugar which further increases their value.  Fruits have intermediate glycemic loads of between 3 and 10.  Vegetables have glycemic loads of 1-3.

A typical day where 40-45% of the calories come from carbohydrate will contain about 10 servings.  If those 10 servings are built with vegetables>fruits>grain and no added sugars, the total daily glycemic load cannot exceed 110.  Below is an example of such a day:

Carbohydrate servings                               Glycemic load

5 vegetables (GL of 1-3 each)                   5-15

3 fruits (GL of 3-10 each)                            9-30

2 grains or starches (GL of 10-30              20-60

                                        Total GL         34-105

The typical western diet contains on 1.5 vegetable servings, 1 fruit, 6 grain and starch servings, and 2 to 4 “pure sugar” carbs such as ice cream, juice or soft drink.  This yields a much different glycemic load picture:

Carbohydrate servings                               Glycemic load

1.5 vegetables (GL of 1-3 each)                1-5

1 fruit (GL of 3-10 each)                              3-10

6 grains or starches (GL of 10-30)            60-180

3 “sugar” carbs                                        60-90

                                        Total GL         124-285

With this typical pattern, the average glycemic load is about 200-210, well within the highest coronary artery disease risk group found in the above study.  Heart disease risk is just one of several increased by high glycemic load eating.  Perhaps diabetes risk is the greatest.  The percentage of the population with diabetes is doubling about every 15 years.  This rise almost parallels the increasing glycemic load pattern of the western diet.

Perhaps the best health tip for 2013 is to control dietary glycemic load.  Keep it simple:

  • ·         Remove the added sugars from the diet
  • ·         Carbohydrate sources should be  –  vegetables>fruits>grains

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