food and health

The “right” food is food with little impact on glycemia

Faced with an epidemic of type 2 diabetes, the category most closely linked to lifestyle, experts have developed a few qualitative indexes to help people choose what to eat. The Glycemic Index, for example, indicates the effects of carbohydrates on glycemia and insulin production, in turn linked to the development of various diseases. We talked about it with Camillo Ricordi, a member of the BCFN Advisory Board and one of the world’s leading experts on diabetes and nutrition.

In a world where people still suffer from hunger, obesity is one of the leading causes of death, a fact confirmed by the World Health Organization’s most recent report on the state of global human health. Overweight is an issue even in developing nations, where many eat poorly with grave consequences for glycemia and the metabolism. It is a paradox  that can only be solved by educating on how to eat a healthier, more balanced diet with little waste and how to check the nutritional value of the food on one’s plate.

“The BCFN created the double pyramid to help guide individuals in the choices they make in terms of food sustainability, without sacrificing proper nutrition”, explained Camillo Ricordi, Director of the Diabetes Research Institute in Miami, Florida, and member of the BCFN Advisory Board. “But generic indications, those limited to category alone (proteins, carbohydrates, etc.), may not be sufficient to combat the epidemic we’re seeing of type 2 diabetes, that most closely linked to lifestyle and the accumulation of fat.”

Dangerous relationships

The relationship between obesity and diabetes is a relatively recent discovery. Significant deposits of fat on the abdomen produce an increase in fatty acids (one of the main components of what we commonly call “fat”) in the liver, causing it not to function properly. In turn, the body’s tissues are less sensitive to insulin, which is important for sugar metabolism. “Abdominal fat can be deposited either under the skin (called subcutaneous fat) or within the abdominal cavity, wrapped around all the organs found there”, Ricordi continued. “It is this second, inner type of fat which is found in excess in central obesity and which gives people the typical ‘apple’ shape, as opposed to ‘pear’ shaped obesity in which mostly subcutaneous fat deposits are found primarily on the thighs and hips. Only in the 1980s did we understand that the internal deposits are more dangerous and indicative of the onset of diabetes and cardiovascular diseases. Since then, all guidelines have included the measurement of the abdomen’s diameter among the parameters used to calculate an individual’s risk of illness.”

Not all carbohydrates are created equal

To reduce abdominal fat, a diet which restricts calories alone isn’t enough. It’s also necessary to calculate how the food one eats influences glycemia, the level of glucose in the blood, commonly known as the Glycemic Index (GI) of each food.“It is useful to remember that carbohydrates are the food with the greatest (and quickest) impact on glycemia. 100% of carbohydrates ingested are transformed into glucose in a time span which ranges from 15 minutes to two hours, according to the type. Proteins have an intermediate impact, with only 60% being transformed into glucose, generally within 2-3 hours from the meal. Fats have the lowest impact: only 10% become glucose and that takes up to 3-4 hours”, Ricordi explained.

Carbohydrates which contain plenty of fibre are suitable for everyone, but especially for diabetics, who should eat 30-40 grams of fibre per day. There are two types: the first is soluble, considered the most important because it helps reduce or slow the absorption of sugar in the intestines and also helps reduce blood lipids. It’s found in fruit, vegetables and in a few seeds. Pectin and mucilage, which expand in size when they come into contact with water, are also part of this category. The second type, non-soluble fibre, is found in bran, whole grains and seed membranes. 

“It isn’t enough to just measure the quantity of carbohydrates on your plate as, according to the type of food containing them, they may have quite varied effects on glycemia. This is why it is best to avoid sugary drinks and simple carbohydrates, sugar, sweets, white bread and potatoes, which rank high on the Glycemic Index, opting instead for complex carbohydrates, including durum wheat semolina pasta, where the starch is trapped in a three dimensional protein lattice which allows it to be released slowly, thereby giving it a lower number on the Glycemic Index”, Ricordi further clarified. Even cooking methods can influence a food’s Glycemic Index value: the same volume of dry pasta which has been cooked “al dente” has a lower GI ranking than that which has been overcooked. 

The Glycemic Index for foods can also vary from individual to individual, a factor which is particularly important to know if you are diabetic and if you need to calculate how much insulin to take after a meal. According to a study recently published in the American Journal of Clinical Nutrition carried out by the researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging (USDA HRNCA) at Tufts University in Medford, Massachusetts, a given food’s GI can vary by 20% in the same person depending on the conditions of consumption (for example, if the person exercised before eating or not) and by 25% between one individual and another. 


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