The ill effects of sugar on your health are well known today. But sugars come in many forms – and while cutting refined sugar out of your life entirely can be healthy, it is not the only approach you need take. Rather than banning sugar from your diet outright, taking an approach that lets you manage your blood sugar spikes could let you have your cake and eat it too.
Not all the sugar in your body comes from sweets. During the digestive process, carbohydrates get broken down into glucose or blood sugar, which fuels the energy demands of the body. In excess, however persistently over time, it can lead to diabetes.
It is important to track the spikes in your blood sugar, as this can have an adverse effect on insulin production, possibly leading to the pre-diabetic stage. The conventional approach towards managing diabetes has been to fully give up sweet foods. But for managing high blood sugar, a smarter approach would be to look at how its levels can spike depending on the food you eat.
Sugary foods like chocolates or candies can lead to a sudden spike in blood sugar levels—which puts strain on the pancreas. The faster the absorption of carbs, the steeper is the blood sugar spike and herein lies the danger. Conversely, foods that are absorbed slower lead to a more gradual—and manageable—spike in blood sugar.
Worldwide, more than 422 million people suffer from diabetes, according to the World Health Organization, with 95 percent of these individuals afflicted with Type 2 Diabetes. In India, which is emerging as the diabetes capital of the world, 8.7 percent of the population has diabetes. Whether you have diabetes or are at risk of developing it, keeping control over your blood sugar could have a lasting impact on your long-term health.
Back to the conventional approach: Cutting out sugary foods is key. But in order to make the healthy choice between different foods – be it apples or potatoes, rice or pasta – you will need to go beyond just counting carbohydrates or calories. This is where a glycaemic index calculator could become your best friend.
How to calculate the impact of food on blood sugar: Glycaemic Index and glycaemic load
A food’s glycaemic index (GI) reflects how quickly and how by much it causes a spike in your blood sugar: Basically, the rate at which your body can convert carbohydrates into glucose after having it.
We can gauge how healthy our food is by its glycaemic load (GL): This is a measure of both the amount and kind of carbs (with fibre, nutrition or only starch) in a serving of food. You can calculate GL by multiplying you GI with the number of carbs and dividing by hundred: (GI x Carbs)/100.
Imagine if you have to choose between white rice or pasta for a meal. 250 grams of cooked white rice has a GI of 85, while as the same amount of pasta would have a GI of 55. In this comparison, the white rice looks like the obvious villain – but rice contains a lower number of carbs than pasta, which means the GL for the same quantity of rice and pasta is 34. Neither is necessarily worse than the other – though the GL is still above recommended levels.
Another good example is watermelon. A hundred grams of watermelon would have a GI of 72 – which seems very high – but it would also have less than 8 grams of carbs, giving it a GL of just 6. This makes watermelon safe to consume in moderate amounts, even for diabetics.
“Keeping carbs in check should be the priority not only if you are diabetic but also for long-lasting health,” says Dr Randhir Singh Dahiya, Professor in the Department of Pharmacology, Central University of Punjab, Bathinda.
To maintain good health, we need to choose foods with a low GL: Below 10, or at a moderate level of 11-19, while limiting the consumption of foods that have a GL above 20. Consuming high-GL foods continuously over a prolonged period is the major cause of pushing healthy people into pre-diabetes and from pre-diabetic to a diabetic state.
The link between low-GL diets and diabetes risk
Research has shown that individuals who consume low-GL foods are at a lower risk of developing Type-2 Diabetes than those consuming high GL foods. This is because consumption of high-GL foods demands that the body increase insulin production to enable cells to absorb glucose and convert it into energy.
Over a prolonged period, this demand for increased insulin puts a load on the pancreas, while other cells also start getting resistant to insulin. At some point, the body loses its ability to stabilise the amount of glucose in the blood, a hallmark of Type-2 diabetes, that also increases risks of cardiovascular disease and damage to nerves, kidneys and blood vessels.
“Type-2 Diabetes develops gradually over the years due to insulin resistance – a condition where the skeletal and fat-storing cells in the body stop responding to insulin,” says Dr Abhimanyu Parashar, a safety and pharmacovigilance specialist at Syneos Health, Gurgaon.
“Due to insulin resistance, the blood glucose levels along with insulin start rising. Eventually, this compromises the pancreas due to excessive insulin demand that results in reduced levels of natural insulin in the body,” he adds.
Undoubtedly, refined sugar is far more harmful to your body than carbs. But if you do not watch and curb overconsumption of carbohydrates in foods, it can lead to diabetes in the long run.
Sugar spikes
A study led by Nguyen Thi Diep Anh, a researcher from Vietnam’s National Institute of Nutrition, analysed blood sugar spikes after consuming nutritious foods and after consuming a plain glucose solution, with both containing the same amount of carbohydrates.
They found that the rise in blood sugar level, which is around 5 millimoles per litre of blood at normal levels, was almost double when glucose solution was consumed compared to when nutritious food was eaten. The chart shows the composition of the foods:
| Contents | Glucose | Nutritious product |
| Weight (grams) | 50 | 99 |
| Energy (Cal or Kcal) | 200 | 436 |
| Carbohydrate (grams) | 50 | 50 |
| Protein (grams) | 0 | 19.6 |
| Fat (grams) | 0 | 17.5 |
BGR – Blood glucose response
BGR (G) – blood glucose response for glucose
BGR (NP) – Blood glucose response for nutritional product
Source: Determining the Glycemic Index of Nutritional Product for Diabetes Mellitus
Junk the junk
A simple way to ensure that the carbs you consume raise blood sugar levels gradually is to mix in nutrients such as fat and fibre into your diet. This delays the breakdown of the carbohydrates in our guts and can help control blood sugar if you are healthy, pre-diabetic or even diabetic.
It is important to cut processed or refined foods as they lack many nutritional components.
White rice lacks the bran which contains fibre and the germ that contains nutrients. The endosperm that remains is predominantly made up of starch. This is why brown rice or unpolished rice scores over white rice.
An apple contains a lot of dietary fibre, vitamins and other ingredients that slow down the absorption of carbohydrates. A potato, on the other hand, has a high amount of starch – a plant-derived sugar that is easily broken down and absorbed – and lacks nutrition and fibre.
Shalmali Sharma, a nutritionist and dietician who founded Re-vive, has this tip for people who crave an ice cream or similar foods which are full of simple carbohydrates that raise blood sugar levels.
“Make that ice cream nutritious by adding fruits to it. It will not only satisfy your sweet tooth but also provide nutrition with better blood sugar control,” she says.
However, this aligns with most of the Indian population that ends their meal with a sweet dish to satiate their sweet tooth, as the sweet dish cannot raise much blood sugar as it should when eaten alone.
