Glycemic Index and Load Explained

Glycemia is a fancy term used to denote glucose in the blood. It is a food source for skeletal muscle and the brain. In addition, excess glucose is stored in the liver if the supply is in jeopardy. If the liver runs out, the body is prepared to make glucose from fat or protein. The keto diet is based on this very premise. The body is starved of carbohydrates (CHO)s and maintains enough protein to sustain lean body mass while fat is burned.

Common table sugar is made up of 50 percent glucose, and it is also one of the sugars resulting from the breakdown of CHOs. It is a food component that makes managing prediabetes and type II diabetes very challenging. We tend to demonize all CHOs as a food source, but the glucose response is highly individual, and all carbohydrates are not created equal. Fiber is an important component of CHOs that can slow the release of glucose into the bloodstream. The method of cooking also plays a role in how quickly the carbohydrate is absorbed into the small intestine.

The glycemic index (GI) is the benchmark for measuring the impact of carbohydrates on blood glucose levels. Pure glucose measures 100 on the scale. A GI of 55 or less is low, 56–69 is medium, and 70 or above is high. It makes sense to consider food in this context to avoid or manage type II diabetes because certain foods can spike blood glucose levels. There isn’t a hard and fast rule regarding types of foods, which makes GI somewhat confusing. For example, a russet baked potato scores 111 on the GI scale. How can higher blood glucose result from ingesting a baked potato than pure glucose? It is complicated and has to do with the glucose bonds in a polysaccharide and the temperature of the potato when consumed. The point is that food we think is “healthy” may fall into the unhealthy category for the glucose intolerant. Another great example is whole wheat bread, which has a GI of 74.

We must move beyond the GI measurement to Glycemic Load (GL) because we know the amount of (CHO)s in food also impacts blood glucose. An example of this point is the comparison of a doughnut with a watermelon, both with a GI of 76. One medium doughnut has 23 grams of (CHO)s per serving, while one cup of watermelon (one serving) has 11 grams of (CHO)s. Let’s do the math. GI x CHO (grams) / 100 = GL. For the watermelon, the GL is (76 x 11) /100 = 8. The doughnut GL is (76 x 23)/ 100= 17. The doughnut has more impact on blood glucose levels. As mentioned earlier, what looks innocent can prove to be otherwise. A serving of 2 ounces of dried dates has a GI of 62. The carbohydrates in a two-ounce serving are 42 grams. GL = (62 x 42)/100 = 26. Many studies have concluded that diabetes risk increases with a higher glycemic load. The glycemic index foundation recommends keeping GL under 100 a day to either avoid or properly manage type II diabetes.

When I was diagnosed with prediabetes in 2009, my endocrinologist was not hopeful that I would avoid the full-blown disease state. What she failed to recognize was how badly I wanted to steer clear of it. It doesn't have to be a foregone conclusion. You can do the math.

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