Diabetes och kost


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Caloric Density, Glycemic Load, and Saturated Fat: Key Players In Diabetes Reversal

Ready to take your diabetes reversal nutrition knowledge to new heights of sophistication? Hold on to your hats, we’re about to take off!!

Different eating strategies work for diabetes reversal by reducing “Caloric Density”, “Glycemic Load” and/or “Saturated Fat”. Let’s see why these three concepts are so important to understanding diabetes reversal.

Caloric density, as many already know, refers to how many calories are packed into a given amount of food, and allows us to compare different foods. What has more calories–an ounce of carrots or an ounce of hot fudge? Obviously the hot fudge! The caloric density of hot fudge is greater than the caloric density of carrots. It doesn’t matter whether we’re comparing a tablespoon of each, or a pound of each, as long as the amount of food we’re comparing is the same, the hot fudge will always have more calories because it has a high caloric density.

When considering whether a particular eating strategy will be good for achieving and maintaining a healthy body weight, it stands to reason that foods with a low caloric density, with few calories per ounce of food, should be favorable. Indeed, the average caloric density of any particular eating strategy is a very important consideration. There are charts and books that indicate and rank the caloric density of common foods. For example, Volumetrics by Dr. Barbara Rolls, provides such information and uses it as the basis for an entire eating strategy designed to minimize caloric density as a means to weight loss. The idea is to fill up on foods that are low in calories – vegetables, most fruits, low-fat proteins, low-fat dairy, soups, etc. Foods that are high in fat, high in sugar, and low in water content, tend to be higher in caloric density – fatty meats, oils, fried foods, nuts, olives, avocados, crackers, regular cheese, etc.

In fact, a major criticism against the modern human diet is that it is much too high in caloric density, and this has fueled the obesity and diabetes epidemics.

Almost all eating strategies aim to keep caloric density low, however that is not the only major consideration when it comes to effective eating strategies.

This is where glycemic load comes in. Glycemic load reflects the blood sugar raising effects of a given amount of food. Which food raises blood sugar levels more–an ounce of carrots or an ounce of hot fudge? Again, the hot fudge is the culprit! An ounce20of hot fudge raises blood sugar much more than an ounce of carrots does. The glycemic load mainly reflects the total amount of carbohydrate in a defined amount of food. It stands to reason that a good strategy for keeping the blood sugar low should be to keep the glycemic load of the eating strategy low. This generally means keeping the total number of carbohydrate grams low, but it also means choosing foods that are less processed, are higher in fiber, and do not have added sugar. For example, an ounce of white rice raises the blood sugar a bit more than an ounce of brown rice. When the fiber coating of grains, or the fibrous membranes of fruits and vegetables are disrupted or removed, the glycemic load of the food increases because the sugar and/or starch in the food is more rapidly digested and absorbed into the blood, causing a greater blood sugar elevation than when the food is digested more slowly.

Foods with high glycemic load not only raise blood sugar–they are appetite stimulants! The greater the glycemic load, the greater the appetite stimulation. This is not readily apparent to most people. After all, high carb foods like bagels, pasta, and rice seem filling when you eat them, but what many fail to realize is they can make you hungry later in the day or the next day.

Interestingly, some foods are high in caloric density, but low in glycemic load, while other foods are low in caloric density and high in glycemic load, and that’s where things start to get complicated. For example, bacon and other fatty meats are typically high in caloric density, but low in glycemic load. Same story for cheese, vegetable oils, avocados, olives, and nuts. On the other hand, lentils, beans (kidney, garbanzo, etc.) bananas, pineapple, oatmeal, brown rice, etc. are low to moderate in caloric density, but high in glycemic load. Experts often have mixed opinions on the role for these foods in eating strategy design.

To make matters more complicated, the blood-sugar raising effects of a certain food is affected by the presence of saturated fat and trans fat. Saturated fat is found primarily in red meat, poultry, dairy, and tropical oils (coconut oil, palm oil, cocoa butter). These fats, especially from meat and dairy, worsen insulin resistance on the day they’re eaten. Ice cream, cheese, whole milk, cream, hamburger, bacon, salami, etc. have enough saturated fat to significantly prolong the amount of time a high-glycemic food will raise the blood sugar.

When someone with type 2 diabetes or insulin resistance eats ice cream, the sugar in the ice cream causes the blood sugar (glucose) levels to soar, and the saturate fat in the ice cream exacerbates the pre-existing insulin resistance, thereby hindering the insulin from getting glucose into muscles and organs where it belongs. The glucose levels stay up even longer than usual! The combination of high glycemic load and saturated fat is especially unfavorable for diabetes and blood sugar control. A double whammy!

In principle, an eating strategy that is low in caloric density can work well for weight loss and diabetes reversal, but the effectiveness might be limited if the food is high in glycemic load. Appetite might be stimulated, but the food is so low in calories, and so high in fiber, that appetite stimulation does not result in a significant problem. Similarly, high glycemic load can increase blood sugar levels in the short-term, but the weight loss offsets any short-term worsening in glucose levels. The Ornish diet works this way.

On the other hand, in theory an eating strategy that is very low in glycemic load can work well for weight loss and diabetes reversal, but the effectiveness might be limited if the food is high in caloric density and saturated fat. The foods might be high in calories, but there is little appetite stimulation or excess hunger, and the total daily caloric intake can go down, leading to weight loss. Saturated fat intake might be high, but there is little opportunity for prolonged glucose spikes, with such low glycemic load. In theory, the weight loss can offset any ill effects that saturated fat would cause under more typical situations with a higher carbohydrate intake.

So, in theory, the ideal eating strategy for good health would be low in caloric density, low in glycemic load, high in fiber, and low in saturated fat. These differences characterize the differences between the “Natural Human Diet” and “Modern Human Diet” I discussed in Part 1 of “Eating for Diabetes Reversal”

Unfortunately, the theoretically ideal eating strategy does not usually work in actual practice because it is too strict for most people. They just can’t stick to it and figure out how to make it work under real world conditions. Again, the problem comes down to adherence. The more ambitious the eating strategy, the lower the adherence level, and the less effective it becomes!

My job is to help motivated people to master an eating and exercise strategy that will help them achieve and maintain diabetes remission, or get as close to it as possible. Not just in theory, but in actual practice!

How do I do it? I’m excited to share the specifics of my basic eating strategy next time!

– Michael Dansinger, MD



VD: QMI Quality Management Training Institute

Publicerat i Diabetes


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