Glycemic control, which is the monitoring of blood glucose levels, is a daily habit for all those who seek a healthy life. Combined with a routine of physical exercise and adherence to medical treatment (when indicated by the doctor), it forms the basis of the main recommendations for controlling diabetes.
But it doesn’t stop there: following a diet that is attentive to the glycemic index (GI)* of foods has non-obvious benefits, such as a reduced risk of developing cardiovascular disease and some types of cancer, such as breast and colorectal cancer. This is what Eliana Giuntini, PhD in Applied Human Nutrition and researcher at the Food Research Center (FoRC/CEPID/FAPESP) told us at Prodiet.
“Intracellular glucose is the main factor in tissue damage, with structural and functional changes and increased inflammation of the arterial walls. In addition, the ingestion of foods that provoke a high glycemic response causes high insulin releases, stimulating the activity of IGF-1 (insulin-like growth factor), which can find receptors in tumor cells”, explains Giuntini.
According to the expert, those who are watching their weight can also reap the benefits of a low GI diet. “The intake of foods that impact blood glucose requires a high release of insulin for the absorption of blood glucose by tissues. When there is no more glucose circulating, plasma insulin remains high, causing the sensation of hunger and consequent high consumption of food”, Giuntini tells us.
In the webinar, Giuntini also addressed the stages of the clinical trial of DiamaxIG, a product developed by Prodiet with a focus on glycemic control. “Diamax was already a product with excellent performance, but from the research we managed to have an even better result with DiamaxIG, which presents an even more attenuated glycemic response, and is considered to be a low glycemic index food”, comments the researcher.
Are you curious about glycemic control? Check out the exclusive interview with Eliana Giuntini.
#1 How important is blood glucose control, besides its relation to diabetes?
The consumption of foods with a reduced glycemic index and/or load is directly related to plasma glucose control, which is obvious. The slower rise in blood glucose demands a slower and more balanced release of insulin, which can minimize the risk of developing type 2 diabetes (T2D).
T2D, which occurs due to an insufficient production of insulin by the pancreas or because the body is unable to efficiently use the insulin produced, although it has a strong genetic component, has been increasing intensely due to poor eating habits, with routine consumption of foods that cause a high glycemic response, combined with sedentary lifestyle.
Keeping blood glucose within normal limits is also related to a reduction in the risk of developing cardiovascular disease, since intracellular glucose is the main factor in tissue damage, with structural and functional changes, and increased inflammation of the arterial walls. Controlled blood glucose tends to prevent dyslipidemia, which is also related to cardiovascular events.
#2 What other health problems can the lack of glycemic control cause?
Routine consumption of foods that raise blood glucose more abruptly, such as foods rich in soluble sugars, can end up triggering insulin resistance, which is the reduced use of glucose by skeletal muscle.
Insulin resistance leads to endothelial dysfunction, especially changes in vascular relaxation, compromising the induction of nitric oxide, which is a potent vasodilator stimulated by insulin. In addition, it activates MAP-kinase, an enzyme that favors cell proliferation with consequent hardening of the arteries.
This endothelial dysfunction is related to hyperlipidemia, atherosclerosis, arterial hypertension and T2D. Although a diet with low GI/GL has not been directly associated with a reduction in blood pressure, we know that events related to insulin resistance can change blood pressure and promote atherosclerosis.
#3 On the other hand, what are some non-obvious benefits of keeping blood glucose stable?
Adequate blood glucose control can contribute to a reduction in body weight and body mass index (ratio between weight and height). This is because the intake of foods that impact blood glucose requires a high release of insulin for the absorption of blood glucose by tissues. When there is no more glucose circulating, plasma insulin remains high, causing the feeling of hunger and consequent high consumption of food.
Stable blood glucose also contributes to the maintenance of the recommended level of triglycerides, which are the lipids in the human body’s energy reserve, because glucose is a substrate for the synthesis of these compounds.
Glycemic stability can also contribute a reduction of the risk of developing some types of cancer such as breast and colorectal cancer, as the ingestion of foods that provoke a high glycemic response causes high insulin releases, which stimulates the activity of IGF-1 (insulin-like growth factor), which can find receptors on tumor cells. IGF-1 has proliferative, angiogenic properties, reduces apoptosis and stimulates estrogen production.
#4 Which foods should we avoid and which ones can be allies to glycemic control?
A balanced diet should contain carbohydrate sources, preferably from grains and their whole derivatives, and vegetables and fruits – sources of dietary fiber, in addition to a reduced consumption of soluble sugars (table sugar – refined, demerara or brown), and sweets in general. Therefore, it is necessary to assess the quality of carbohydrates ingested.
Adopting a diet consisting only of low GI or low Glycemic Load (GL)* foods is not easy, but there are compensation strategies that can be adopted. Thus, when we consume foods with a high or medium GI, another low GI food should be consumed in order to control the GI of the meal.
For example: rice + beans (or another legume), Cavendish banana mashed with sugar + oatmeal, bread + cheese or butter/margarine, boiled/mashed potato + chickpeas and tomato salad or barley + string beans.
Consuming foods that are sources of dietary fiber and proteins tends to reduce the glycemic response, but if the available carbohydrates are in high amounts, especially with a lot of sugar, the food can continue to raise the glycemic response quickly.
- Some more tips:
Cooked and frozen legumes tend to have their GI lowered even further.
- Pasta is a medium level GI food, even the version with refined wheat flour, but it should be eaten “al dente”, because the more it is cooked, the higher its GI.
#5 What other healthy habits and tips would you give to those who need or would like to control their blood glucose?
Although science is always evolving and showing us new paths, some recommendations still remain. Carbohydrates should be part of our diet even though many people consider them to be the main cause of weight gain and diabetes.
Limiting your intake of carbohydrate foods can increase your absorption of lipid sources, and should be moderately ingested and are a more concentrated form of energy.
The guidance of the Food and Agriculture Organization of the United Nations (FAO), which recommends ingesting at the most 10% of total energy in the form of sugar, is also valid. This means a maximum of 50 g/day (less than 5 tablespoons or 5 individual packets) for a 8,400 kJ (2,000 kcal) diet, whether from sugar added to coffee, tea, contained in soda, in sweetened juice or in food/drink preparation. And consume a variety of raw and cooked vegetables, nuts, chestnuts and legumes, as well as different fruits throughout the day.
*Glycemic Index (GI) and Glycemic Load (GL) are indicators that measure the speed and intensity in which food changes the blood glucose level.