Carbohydrates & Blood Sugar Balance

Carbohydrates are made up of glucose molecules. One main function of glucose is to provide energy (for example, it is the sole fuel for the brain). This dependency on glucose requires that we eat carbohydrates regularly and that our body uses glucose efficiently.

In situations of blood glucose imbalance (hypoglycemia, insulin resistance or diabetes), mental and physical energy and function is affected. This could be expressed as poor concentration, poor memory, irritability and depression.

Blood Sugar Metabolism

The body’s response to an increase in blood sugar is to secrete a hormone called insulin from the pancreas. Insulin sends glucose into the cells where it is metabolised to produce energy.

The excess is stored as glycogen in the muscle and liver cells or is converted to fat and stored in adipose tissues around the body. The result of this process is a decline in blood sugar. When blood sugar levels fall below normal, the pancreas releases a second hormone called glucagon, which has the opposite effect of insulin. Glucagon promotes the conversion of glycogen from the liver and muscle cells back to glucose for energy, and encourages fat burning.

It is the carbohydrates we choose and the amount we eat that commonly cause conditions of glucose imbalance. Left unchecked, the result may be insulin resistance (Syndrome X), diabetes, obesity and/or heart disease.

Blood Sugar Imbalances

• Diabetes mellitus is a failure to properly metabolise glucose due to either reduced secretion of insulin from the pancreas, or more commonly, from insulin resistance. This results in dangerously elevated blood glucose levels.

• Insulin resistance is an inability of the cells to respond to insulin. As a result, the body releases more insulin in an attempt to elicit a response. In this case there is both high glucose and insulin in the bloodstream.

• Hypoglycemia occurs when there is an exaggerated insulin response to a rise in blood glucose. As a result there is a dramatic drop in blood glucose, causing physical and mental symptoms, including irritability and sugar cravings. Blood glucose is volatile throughout the day.

Choosing Carbohydrates according to the Glycaemic Index (GI)

The rates at which different carbohydrates are broken down into glucose have been measured using a scale known as the Glycaemic Index (GI). The GI is a direct measure of the effect a carbohydrate has on your blood glucose levels.

Carbohydrates that break down into glucose during digestion will be absorbed into the bloodstream quickly and therefore have a high GI. Carbohydrates that break down slowly, releasing glucose gradually into the bloodstream, have low GI ratings.

In short, a low GI carbohydrate will help keep blood sugar levels more stable and sustained, and energy levels consistent. A high GI carbohydrate will cause a surge in blood glucose, triggering a stressed response from the pancreas. This can contribute to the conditions described previously.

The GI scale is measured from 1 to 100, with glucose being given the score of 100. Foods with a score of 0-55 are considered low, 55 to 70 is considered moderate and above 70 high. In general it is best to consume the majority of your carbohydrates from the 0-50 range while avoiding those with a score above 70.

If you consume foods with a score of between 50 and 70, try to combine them with a low scoring carbohydrate to even out the overall score. For example, bananas have a high score, whereas oats and skimmed milk have a low score. If you combined all three at breakfast, you would bring down the overall score and still be able to enjoy the odd banana.

Factors affecting Glycaemic Index (GI)

• Amount of cooking: starches in food swell when cooked. The starch grains in a baked potato swell to bursting point, whereas the starch grains in brown rice remain relatively unchanged. The former has a high GI, the latter a moderate GI.

• Type of starch: amylopectin and amylose are both starches found in carbohydrate. The amount and ratio of these two in a food will make the difference between a fast breakdown and slow breakdown. For example, wheat, corn and rice are high in amylopectin, making them fast-releasing, whereas barley, rye and quinoa are higher in amylose, making them slower releasing. Basmati and Doongara rice is higher in amylose and therefore lower in GI compared to normal white rice.

• Processing: when grains are rolled, ground, smashed or pre-cooked (i.e. instant), the protective (and harder to digest) outer jacket is removed, exposing the soft easily digested starch. Whole oats have a lower GI than instant or quick-cook oats.

• Fibre: acts as a bulking agent to slow down glucose absorption. Some foods naturally have higher amounts of fibre (e.g. beans and legumes). It is better to eat whole foods such as brown rice and wholegrain breads rather than their white, refined alternatives. It also means that whole fruit with its higher fibre content is better than a fresh juice without pulp. Always dilute fresh juices with water and maybe add back some pulp.

• Protein: will lower the GI of a meal by slowing down digestion and gastric emptying time. Protein also has a higher satiety level, meaning you will be kept satisfied for longer. Aim to make up at least one-third of your meal from protein.

• Fat: reduces gastric emptying time and as a result slows down the absorption of glucose from the meal. It is essential to consume the right kind of fats from raw nuts and seeds, fish, avocado and cold pressed oils.

• Acidity: foods containing acid will slow the gastric emptying time. A simple tip is to add vinaigrette dressing to salad or vegetables.

Glycaemic Load (GL)

The latest development in blood glucose regulation techniques is Glycaemic Load (GL). The GL considers the amount of carbohydrates per serving. For example, the carbohydrate in watermelon is high GI but the carbohydrate level is low so the resulting GL is low. On the other hand, pasta (which has a lower GI than watermelon) has a very high carbohydrate content, which results in a high GL. Understanding the GL appears to be a more accurate way to judge carbohydrates.

Top Tips

• Chose carbohydrates with GL values of 0-10 most frequently and 11-19 occasionally. Foods with a GL of 20 or above should be avoided or consumed with a low GL carbohydrate, protein and good oil.

• When making a blind choice, avoid anything processed and look for grain products that are high in fibre.

• Foods with an acidic value or taste tend to have a lower GL, for example, sourdough bread and acidic fruits and vegetables.

• Below-ground vegetables or vegetables which are sweet and sticky when cooked will often have a high GL (although not always). For example, potatoes and sweet potatoes have a high GL compared to broccoli or other greens.

• When planning meals, always include one-third protein and two-thirds low GL carbohydrate and essential fats (from oily fish, avocado, nuts, seeds and olive oil).

• Allow some fat each day preferably from vegetable and fish sources.

Summary

GL values are useful but they’re available on a limited basis, and don’t take into account any valuable vitamins and minerals found in a particular food. To be healthy, get sufficient nutrients and fibre, and avoid a blood sugar spikes by adopting the following rules:

• Choose a wide variety of non-starchy vegetables (five to seven serves daily).
• Replace refined foods with wholegrain products.
• Eat fruits and starchy vegetables with high protein or high fibre foods.
• Use healthy fats such as nuts, seeds, grains, fish and liquid oils (olive, sesame, soybean, flaxseed).
• Lose weight if you’re overweight and exercise regularly.
• Manage stress.

Long-term weight loss is achieved by eating a good ratio of protein, carbohydrates and good fats. Emphasise complex carbohydrates that have a low GI and GL. By controlling your blood sugar levels your body will burn energy, not store it.

Good health is a matter of balance. It is achieved by adopting a lifestyle that includes eating a wide range of nutritious food in moderation, regular exercise and a positive mental attitude.

For a personalised appointment and prescription to help with blood sugar imbalances and natural weight loss, click here to make a booking for phone and online consultations.

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