June 08, 2022
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When people eat food containing carbohydrates, the digestive system breaks down the digestible ones into sugar, which enters the blood.
In the past, carbohydrates were commonly classified as being either “simple” or “complex,” and described as follows:
These carbohydrates are composed of sugars (such as fructose and glucose) which have simple chemical structures composed of only one sugar (monosaccharides) or two sugars (disaccharides). Simple carbohydrates are easily and quickly utilized for energy by the body because of their simple chemical structure, often leading to a faster rise in blood sugar and insulin secretion from the pancreas – which can have negative health effects.
These carbohydrates have more complex chemical structures, with three or more sugars linked together (known as oligosaccharides and polysaccharides). Many complex carbohydrate foods contain fiber, vitamins, and minerals, and they take longer to digest – which means they have less of an immediate impact on blood sugar, causing it to rise more slowly. But other so-called complex carbohydrate foods such as white bread and white potatoes contain mostly starch but little fiber or other beneficial nutrients.
Dividing carbohydrates into simple and complex, however, does not account for the effect of carbohydrates on blood sugar and chronic diseases. To explain how different kinds of carbohydrate-rich foods directly affect blood sugar, the glycemic index was developed and is considered a better way of categorizing carbohydrates, especially starchy foods.
The glycemic index ranks carbohydrates on a scale from 0 to 100 based on how quickly and how much they raise blood sugar levels after eating. Foods with a high glycemic index, like white bread, are rapidly digested and cause substantial fluctuations in blood sugar. Foods with a low glycemic index, like whole oats, are digested more slowly, prompting a more gradual rise in blood sugar.
Many factors can affect a food’s glycemic index, including the following:
One thing that a food’s glycemic index does not tell us is how much digestible carbohydrate – the total amount of carbohydrates excluding fiber – it delivers. That’s why researchers developed a related way to classify foods that take into account both the amount of carbohydrates in the food in relation to its impact on blood sugar levels. This measure is called the glycemic load. A food’s glycemic load is determined by multiplying its glycemic index by the amount of carbohydrate the food contains. In general, a glycemic load of 20 or more is high, 11 to 19 is medium, and 10 or under is low.
The glycemic load has been used to study whether or not high-glycemic load diets are associated with increased risks for type 2 diabetes risk and cardiac events. In a large meta-analysis of 24 prospective cohort studies, researchers concluded that people who consumed lower-glycemic load diets were at a lower risk of developing type 2 diabetes than those who ate a diet of higher-glycemic load foods. A similar type of meta-analysis concluded that higher-glycemic load diets were also associated with an increased risk for coronary heart disease events.
Here is a listing of the low, medium, and high glycemic load foods. For good health, choose foods that have a low or medium glycemic load, and limit foods that have a high glycemic load.
Low glycemic load (10 or under)
Medium glycemic load (11-19)
High glycemic load (20+)
Source: Harvard T.H. Chan School of Public Health
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