In this column you are exposed to a good bit of information about the ability of certain foods to cause health problems, induce Type II diabetes, and make you overweight or obese. As you evaluate what is going on with your body, you may try different approaches. Weighing every day and checking your waist measurement weekly can give you a hint about your ongoing health status. You can check your daily blood glucose or test your urine for glucose, both of which will give you some idea of what your dietary intake is doing for you in a positive or negative manner. If you are pre-diabetic, have a family history of diabetes, or are overweight, then your daily blood glucose levels will be higher than normal, and this will serve as a marker indicating that you may be able to change your diet to a better and healthier one.
The question is, how does your blood glucose get too high, even if you don’t add sugar to your food or drinks. The answer is simple enough and can be documented daily on all of the foods that you eat. Glycemic index is a term that describes how high your blood glucose (sugar) level will rise after ingestion of a known quantity of a food product or sweetener. Glycemic load indicates how much of that measured product you have eaten and gives better predictive value to the effect of your intake on your average blood sugar levels.
By knowing the glycemic index of foods, you can determine how they will affect your glucose level. For example, white bread has a high glycemic index, but a small quantity with butter or olive oil has a lower glycemic index than bread alone and therefore does not raise your blood sugar remarkably. This is the main reason that low-fat diets are generally not good for you because these foods are usually high glycemic foods and may become a high glycemic load to your body and raise your average blood glucose.
What is the problem if you take a high glycemic load such as a glucose or fructose-based energy drink to feel better and less tired? The answer is that with any sweets, breads, baked goods, and high-energy drinks, the body produces more advanced glycation end products (called AGEs), including HbA1c, which causes more aging changes to your muscles, joints, blood vessels, organs, and even your brain.
The one easy way to measure glycosylation in your body is to check your HbA1c, which indicates what is happening in the rest of your body. If your level is constantly above normal, a protein-glucose combining reaction called the “Amadori” reaction is causing deposits of AGEs in all of the areas mentioned above, including your skin, to actually speed up the aging process. Kits to test this can be obtained from any pharmacy and are easy to use, and you can keep a “morning check” to see how well your diet is staying within the best glycemic guidelines.
Keeping track of the glycemic index and load of the foods you are eating can help prevent excess glycosylation in your body, which will in general keep you more energetic and healthier in the long run. When you reduce your glycemic load and eat less bread, baked goods, sugar, and pasta, you will end up eating more fruits and vegetables for a sustained caloric intake. From then on, because your body reacts in the right way by lowering your average blood sugar, you will shed excess pounds (of fat). On the other hand, sustained high blood sugar levels ultimately cause weight gain or obesity and stimulation of secretion of excess insulin levels.
In the body, insulin balances and maintains the blood glucose level and is more effective when there is a balanced, lower glycemic diet. This would be a diet such as the Zone, in which each small meal or snack consists of some protein, some fat, and some carbohydrates. In this type of dietary approach, your HbA1c levels are low and indicative of a healthier metabolism. This will help deter the development of diabetes in a pre-diabetic individual.
In summary, by following a good balanced diet, the reduced glycemic load gives you the needed elements for metabolism each day and helps moderate your blood glucose level. Also, aerobic exercise combined with resistance training (weight) can help keep HbA1c levels in a more normal range. Even if your genes predict that you might become a Type II diabetic, you can avoid this by taking care to eat well and increase your activity level.
Dr. Carraway is the director of the Plastic & Cosmetic Surgery Center of EVMS. Call 757-557-0300 for more information.