1 February 2006

GI News—February 2006

collage

In This Issue:

  • There May Not Be a Magic Bullet, But We still Have Commonsense
  • The Protective Power of Plant Protein
  • Did Your Kids Eat Breakfast This Morning?
  • If You Want to Give Your Kids a Headstart, Give Them Oatmeal for Breakfast

  • Pita Bread: The Perfect Pocket
  • Pure Maple Syrup: The Real Thing
  • Chinese Combination Soup for One

  • Success Stories—One day in the summer of 1998, Leigh Hatcher’s life turned upside down. A simple virus took him into the wilderness of Chronic Fatigue Syndrome for more than two years—until he found low GI …
  • The New Glucose Revolution (direct mail edition)

  • I haven't been able to find a reference as to what GI number a person should shoot for when trying to diet. Is there a formula, such as ‘take goal weight, multiply by age, divide by activity level?
  • I’m confused. What’s the difference between GI and GL? Should I use GI or GL and does it really matter?
  • How do you figure out the GL numbers?
  • Does Low Carb automatically mean low GI?
  • Does Sugar Cause Diabetes?
  • Is sugar the worst thing for people with diabetes?
If you have posted a question in our newsletter, be assured that the GI Group will answer this as soon as possible. We welcome your views about our articles and other reader’s suggestions. Please POST your comments on the site.

We receive a great deal of FEEDBACK from readers and visitors to our website about how a low GI diet has made a real difference to their lives along with some inspiring weight loss and blood glucose control stories. Please share your success. Your experiences really can motivate others. If you feel you have a story that will inspire or help others and you are prepared to give permission for it to be published in GI News, please send your story to us HERE.

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‘Carbohydrate is nature’s primary fuel.
The simplest carbohydrate, glucose, is the main source of energy for our muscles, it’s also the essential fuel for our brain, for our red blood cells and for helping a growing foetus become a healthy baby.’

jbm
Jennie Brand-Miller

GI News Editor: Philippa Sandall
Web Design and Management: Scott Dickinson

Food for Thought

There May Not Be a Magic Bullet, But We Still Have Commonsense
While numerous studies have consistently shown the glycemic index (GI) to be an effective tool in reducing blood glucose and insulin levels and the risks of certain diseases, it sometimes comes under criticism for not being the ‘magic bullet’ people sometimes expect in weight management.

The glycemic index is a powerful tool when used in the right way—that is, in combination with healthy eating, regular exercise, and medications as needed. The glycemic index is not intended to be used in isolation, with a disregard to commonsense. When used appropriately (ie in the context of a good diet), the GI can benefit overall health, promoting satiety and minimising diabetes risk and complications. The concept of the GI improves outcomes because it involves a more complete understanding of how carbohydrates are digested in the human body, recognising differences between different carbohydrate-containing foods (not just sugars versus starches), and how this will affect our physiological responses after consumption.

This leads to what some view as criticisms of the GI—that there is a such a broad range of GI values for different types of potatoes, for example, or that the GI of bananas will change depending on their stage of ripeness. However, we should not hold the GI to higher standards than we apply to other nutrient factors. We know the carbohydrate and fibre content of a banana will vary with ripeness, or its vitamin C content with storage. We would never expect the fat content of the local supermarket’s sausages to be exactly the same as that listed in the national tables of food composition.

While there are notable variances in GI (eg for different varieties of rice), there is also notable consistency. Apples, oranges, legumes and pastas have GI values in the 40s, white bread in the 70s, cornflakes in the 80s. Moreover, clinical intervention studies suggest that current GI tables are sufficiently accurate to produce differences in average blood glucose values in people with diabetes (Brand-Miller et al, Diabetes Care 2003).

Many people today are ready and willing to be active participants in their own health care, wanting to learn more about their conditions and how to manage them, even if this entails more than a few simple rules, and requires a deeper understanding of how their body works. Those who put the effort into understanding their physical condition and how they can help themselves will surely reap the long-term rewards and health benefits relating to the GI and beyond.

—Atarah Grysman, MSc, Glycemic Index Laboratories, Toronto

GI News Briefs

The Protective Power of Plant Protein

High in fibre and low in fat, it’s long been acknowledged that fruit, vegetables and legumes (pulses) play a central role in a healthy heart diet. In fact, increased consumption of these healthful foods is associated with a lower incidence of cancer, cardiovascular disease and other age-related diseases. Now a four-country study led by Prof Paul Elliott of Imperial College London has found that diets rich in vegetable protein tend to reduce blood pressure. High blood pressure is associated with an increased risk of heart disease and stroke and is the biggest cause of preventable mortality worldwide. During Elliot’s study, 4,680 volunteers aged 40–59 in Japan, China, UK and the US had their blood pressure read eight times and wrote down everything they had consumed in the 24 hours before each of the four checkup sessions over a 6-week period. Writing in the January issue of the Archives of Internal Medicine, the researchers report ‘an inverse relationship between individual’s vegetable protein intake and their blood pressure’—the higher the vegetable protein intake, the lower the blood pressure.
Archives of Internal Medicine, Vol 166, pp79–86

chickpeas
Photo: Ian Hofstetter, www.ianhofstetter.com.au The Low GI Diet Cookbook

GI Group: You don’t need to eat meat, chicken or fish every day (or at all) to get enough protein. Plant proteins can provide us with all the essential and non-essential amino acids we need so long as we eat a wide variety of foods. These plant proteins include many low GI foods such as legumes (pulses), wholegrains such as barley and traditional oats, foods rich in soy protein like tofu, nuts and seeds, and vegetables. There’s no need to worry about special combinations of plant foods at the same meal, the body keeps a short-term supply of essential amino acids so that ‘protein combining’ can happen over the whole day.

Did Your Kids Eat Breakfast This Morning?
Most of us have been told (countless times) that breakfast is the most important meal of the day. But a lot of us skip breakfast. Not a good example because alarmingly around 40 per cent of kids are breakfast skippers too. Why? Well, the usual suspects. Too tired. Needed more sleep. Rushed. Not hungry. Don’t like breakfast. Dieting.

classroom

Writing in the Journal of the American Dietetic Association last year, Dr Ruth Striegel-Moore reported that the older a girl gets, the more likely she is to skip breakfast. They found that 77 per cent of white nine-year-old girls and 57 per cent of the black nine-year-old girls regularly ate breakfast. By age 19 this had plummeted and less than 32 per cent of the white girls and 22 per cent of the black girls in the study were regularly eating breakfast. The researchers analysed dietary information from the nine-year National Heart Lung and Blood Institute Growth and Health Study from 2,379 girls who entered the study at age 9 or 10. They also report that the breakfast eaters’ diets were consistently higher in calcium and fibre than the skippers and that they had a lower BMI.
Journal of the American Dietetic Association, Volume 105, Issue 6, June 2005, Pages 938–45


If You Want to Give Your Kids a Headstart, Give Them Oatmeal for Breakfast
In recent years, numerous studies have shown that eating breakfast can improve speed in short-term memory tests, alertness (which may help memory and learning), and mood, calmness and reduce feelings of stress. Breakfast also helps school children perform better in creativity tests. Breakfast helps to replenish blood glucose levels, which is important since the brain itself has no reserves of glucose, its main energy source...

kids

Reporting in Physiology & Behavior in 2005, Tufts University psychologists confirmed previous studies that when kids eat breakfast they do better in tests that require processing brainpower for complex visual display (such as puzzles) than when they skip brekkie. Taking it a step further this time, the Tufts team gave the kids different breakfasts on different occasions—oatmeal and milk one day and Cap’n Crunch with milk another and then compared the test results. They found that the 60 elementary school students performed better on a raft of tests after tucking into stick-to-the-ribs oatmeal rather than firing up on Cap’n Crunch. Children aged 9–11 notched up improvements in their spatial memory (things like puzzles, drawing, and geography, as well as some technical skills used in math and science); while the 6–8-year-olds listened better and also scored higher on spatial memory. The researchers believe that their results show that what kids eat for breakfast really matters. They say ‘due to compositional differences in protein and fiber content, glycemic scores, and rate of digestion, oatmeal may provide a slower and more sustained energy source and consequently result in cognitive enhancement compared to low-fibre high glycemic ready-to-eat cereal.’
Journal of Physiology and Behavior, Volume 85, Issue 5, 2005, Pages 635–45

GI Values Update

Pita Bread: The Perfect Pocket
Top it, stuff it, wrap it, cut it into wedges and dip it, or split it open and bake it to make ‘crisps’—pita is the ultimate meal-in-a-bread to have around for all occasions. The original value for white unleavened pita bread was from Canada (GI 57). New results have been published for pita breads available through Tesco stores in the UK including ‘Mini White Pitta’ (GI 68), Value ‘White Pitta’ (GI 69) and ‘Wholemeal Pitta’ (GI 56). (British Journal of Nutrition (2005, 94).

pita

Try these simple serving suggestions to boost your vegetable and legume intake.

  • Wrap up with hommous, shredded lettuce, felafel, tabbouli and a tangy tomato salsa; or avocado, mushrooms, bean salad, shredded lettuce and capsicum strips; or tuna, borlotti beans, onion rings, cucumber, feta and a drizzle of oil and vinegar.
  • Use pita bread as an instant pizza base—top with tomato paste, mushrooms, capsicum, finely sliced onion, olives and a sprinkle of Parmesan cheese.
  • Serve dips such as hommous and babaghanoush with pita crisps—simply cut the pita bread into triangles, open out the ‘halves’ and spray with a little olive oil, sprinkle over paprika for extra flavour and bake at 180ºC (350ºF) for about 5 minutes, or until crisp.
—From Low GI Eating Made Easy (available in Australia, New Zealand, the UK, the US and Canada)

Low GI Food of the Month

Pure Maple Syrup: The Real Thing
With sugar maple sap about to flow in northern US and Canada, it seems timely to look at this deliciously natural sweetener. The sugars in fruit and honey have provided carbohydrate energy in human diets for millions of years. Sweetness is not a learned taste: everyone could be said to be born with a ‘sweet tooth’. We don’t know why this is so, but it may be related to our brain’s dependence on glucose as its sole source of fuel. What we do know is that our hunter-gatherer ancestors relished honey and other concentrated sources of sugars such as honey ants, dried fruit and maple syrup tapped straight from the tree.

maple syrup

Pure maple syrup (GI 54) was one of the first foods that was glycemic index tested (by Profs David Jenkins and Tom Wolever at the University of Toronto). As demand outstrips supply, it is probably the most expensive sweetener on your supermarket shelf. Made by boiling and concentrating the sap from maple trees, it takes approximately 40 gallons (about 150 litres) of maple sap to make one gallon (about 3½ litres) of pure maple syrup. So beware and be aware and check that label to make sure you are buying ‘Pure Maple Syrup’ as the gap in the market unfortunately is filled by those high GI, corn syrup toppings that have been blended with as little as 3 per cent maple syrup. Not the real thing at all!

Use a little maple syrup instead of sugar or honey in your tea or coffee; to sweeten your porridge oats or low GI breakfast cereal; to drizzle over buckwheat pancakes or a scoop of low-fat vanilla ice-cream. You can also use it to glaze meats such as ham, chicken or pork or vegetables such as sweet potato, yams, parsnips, squash or pumpkin. Or instead of sugar in many recipes from baked beans to rice puddings or muffins. One very simple way is to use maple syrup instead of sugar or honey is in marinades or in dressings.

Balsamic Vinaigrette with Maple Syrup
Try this vinaigrette tossed with a roasted vegetable salad (eggplant/aubergines, zucchini/courgettes, capsicum/peppers, leeks and pumpkin) or add a pasta shapes to make a meal of it. The dressing is also delicious made with a nutty oil such as walnut or macadamia oil. Makes about 1/3 cup (65 ml) dressing, enough for a salad for 4 people.

1 clove garlic, peeled and crushed
2 tablespoons olive oil
2 tablespoons balsamic vinegar
1 teaspoon pure maple syrup (or to taste)
freshly ground black pepper, several twists
a pinch of salt (optional)

Combine all the ingredients in a screwtop jar and shake well.

Per serving (4 teaspoons)
Energy 368 kJ; Fat 9.1g (Saturated 1.3g); Carbohydrate 1.3g; Dietary fibre 0.2g

Low GI Recipe of the Month

Chinese Combination Soup for One
You can buy boiled wontons, lean barbecued pork and Chinese chicken stock in Chinese markets and Asian produce stores. Frozen wontons are also available in larger supermarkets. In this recipe, you can use any other Asian greens or vegetables such as handful of raw bean sprouts, baby corn, champignon mushrooms instead of the choy sum. For a seafood combination soup replace the pork slices with 2 or 3 prawns, 2 or 3 cubes diced white fish and 2 or 3 small pieces of squid or calamari and make it with a seafood stock.
Preparation time: 10 minutes

4 boiled wontons
40 g (small handful) egg noodles, blanched and drained
½ bunch choy sum, washed, leaves separated and blanched
3 slices of lean barbecued pork
2 cups (500 ml) hot Chinese chicken stock (or regular chicken stock)

To serve
1 tablespoon finely chopped shallots (spring onions)
1 tablespoon chopped fresh coriander (cilantro)
½ teaspoon finely chopped red chilli

Place the wontons, egg noodles, choy sum and pork in a single-serve large Chinese bowl. Ladle the hot stock over. Garnish with the shallots, coriander and chilli.

Per serve
KJ/Cal 1860/445; Protein 36 g; Fat 10 g (saturated 4 g); Carbohydrate 50 g; Fibre 4 g; GI Low

To make a traditional Chinese stock
Place 1 chicken, skin removed and cleaned under cold water, 4 large slices of ginger, ½ bunch shallots (spring onions), washed and roughly chopped, 2 cloves of garlic, 1 carrot, roughly chopped (optional), and 2 litres of cold water in a large stock pot. Bring to the boil then reduce the heat to low and simmer for 2 hours. Skim off any residue. Freeze in 500 ml (2-cup) containers and use as required.

linda
Linda Cumines

This recipe is from Linda Cumines who has been in private practice as an Accredited Practising Dietitian for the past 23 years. This has given her an extensive knowledge of how people respond to diet trends. Linda is a fourth generation Australia-born Chinese who finds great satisfaction in helping people to eat well. Linda is committed towards encouraging every one of us to enjoy eating, and eating healthily.

Your Success Stories

Leigh Hatcher has been an Australian TV and radio journalist and newsreader for 32 years. One day in the summer of 1998 his life turned upside down. A simple virus took him into the wilderness of Chronic Fatigue Syndrome for more than two years—until he found low GI. Here he tells his story.
"It began simply and suddenly. I was in the middle of our annual holiday at a great Aussie beach and after a marvellous morning in the surf, I laid down for my daily 10-15 minute ‘power nap’. For once I woke up 2 hours later, feeling as if I’d been run over by a truck.

By the end of that week, still feeling below par, I was sent off for some blood tests which showed I’d contracted a viral hepatitis. I was told to take two weeks off work and I’d be fine.

However, I kept returning to the doctor for weeks – months, struggling to describe a body and brain that were both running on empty. It seemed like something toxic was flowing through my veins. I was overwhelmed by crushing fatigue and weakness.

Within six months, I lost my high profile job as a frontline TV reporter and news reader. After a year of increasingly rarefied tests which came back ‘normal’ – (normal was the last thing I was feeling!) – I was diagnosed as suffering ‘Chronic Fatigue Syndrome’.

I remained in this ‘wilderness’ for another year until a doctor friend discovered some research which said that for a proportion of CFS sufferers, it’s worth looking at their metabolism. I went for a 5 hour glucose tolerance test, where both glucose and insulin were tested and just for once ‘abnormal’ readings came back – in the ‘pre-diabetic’ range.

A dietitian put me on a low GI diet, with graded activity, then graded exercise, with a prediction that I’d notice an improvement in my health in two weeks! A fortnight later I returned to see her and announced – ‘You’ve given me a life again!’

Today, five years later, I’m still on the low GI diet, swimming 5 kilometres a week again and continue to revel in good health. I’m not back to 100% - probably 90-95%.

Low GI is not the ‘key’ for every CFS sufferer, but it has transformed my life and the lives of numbers of sufferers I’ve known. Coupled with exercise and a decent amount of sleep – it’s given me a life again."

leigh
Leigh Hatcher

—Leigh Hatcher has written about his journey through the wilderness of Chronic Fatigue Syndrome in I’m Not Crazy, I’m Just A Little Unwell. See his website at www.notcrazy.net

Books, DVDs, Websites: What’s New?

Now Available—The New Glucose Revolution
now available in the US and Canada in a hardcover direct mail edition published by Rodale. This expanded edition includes:

  • Scientific evidence to support the health benefits of choosing low-GI foods
  • Strategies for making the transition to a low-GI diet
  • 50 delicious, easy-to-prepare recipes, all with low to moderate GI ratings
  • Glycemic index values for approximately 800 foods
  • Targeted guidelines for using the glycemic index to lose weight, protect against diabetes and heart disease, and enhance mental and physical performance
  • Answers to the most common questions about the glycemic index
For more information visit www.rodalestore.com

NGR

The Low GI Diet Cookbook is now available in the UK at all good book stores or online at Amazon..

cookbook

Low GI Eating Made Easy is now available in the US at all good book stores or online at Amazon.

Feedback—Your FAQs Answered

My husband and I are following the 12-week Action Plan in The Low GI Diet. However, I am currently breastfeeding and I wonder whether you need to eat a little more than usual to allow for lactation or pregnancy?
Increased energy intake is recommended during pregnancy and lactation. The greatest requirement is for lactation—add 2000 kJ (500kcal) to daily requirements. In early pregnancy there is no greater need but by the 3rd trimester an extra 2000 kJ (500kcal) are recommended daily. This is based on a normal/healthy pre-existing body weight. If you are already overweight then you wouldn't need to increase by so much.
Estimations of energy requirement should always be taken as a guide only. Differences between people can be enormous. Often it is more realistic to use appetite as a guide to whether you are eating enough.

feeding

The increased calories can come from any source (carbohydrate, protein or fat) but it is safest to increase calories from carbohydrate or protein if you are unsure about amounts, because these nutrients have the greatest effect on satiety.

I haven't been able to find a reference as to what GI number a person should shoot for when trying to diet. Is there a formula, such as "take goal weight, multiply by age, divide by activity level?
The simple answer is no, there’s no formula. You don’t need to add up the GI each day. In fact there’s no counting at all as there is with calories/kilojoules. The basic technique for eating the low GI way is simply ‘This For That’: swapping the high GI carbs in your diet with low GI foods. This could mean eating muesli at breakfast instead of wheat flakes, low GI bread instead of normal white or wholemeal bread, or a sparkling apple juice in place of a soft drink. So, what you need ‘to shoot for’ is identifying the high GI carbs in your current diet and swapping them for some quality low GI carbs. Dietitian Kaye Foster-Powell says in Low GI Eating Made Easy: ‘We have found that many people who substitute low for high GI foods in their everyday meals and snacks reduce the overall GI of their diet, gain better blood glucose control and lose weight.

kaye
Kaye Foster-Powell

If you are looking for some guidelines, here’s how she answers the ‘what do I eat’ question. Every day you need to:

  • Eat at least three meals—don’t skip meals. Eat snacks too if you are hungry.
  • Eat fruit at least twice—fresh, cooked, dried, juices.
  • Eat vegetables at least twice—cooked, raw, salads, soups, juices and snacks.
  • Eat a cereal at least once—such as bread, breakfast cereal, pasta, noodles, rice and other grains in a wholegrain or low GI form
  • Accumulate 60 minutes of physical activity (including incidental activity and planned exercise).
  • Every week you need to:
  • Eat beans, peas and/or lentils—at least twice. This includes baked beans, chickpeas, red kidney beans, butter beans, split peas and foods made from them such as hommous and dhal.
  • Eat fish and seafood at least once, preferably twice, each week—fresh, smoked, frozen or canned.
  • Eat nuts regularly—just a tiny handful.
I’m confused. What’s the difference between GI and GL? Should I use GI or GL and does it really matter?
Your blood glucose rises and falls when you eat a food or meal containing carbohydrate. How high it rises and how long it remains high depends on the quality of the carbohydrate (its glycemic index value or GI) as well as the quantity of carbohydrate in your meal. Researchers at Harvard University came up with a term that combines these two factors—glycemic load (GL). Some people think that GL should be used instead of GI when comparing foods because it reflects the glycemic impact of both the quantity and quality of carbohydrate in a food. But more often than not, it’s low GI not low GL that predicts good health outcomes. So which one should you use?

We are often asked this question. Our advice is to stick with the GI rather than GL—the reason being that following the low glycemic load (GL) route can lead you straight to a low carb diet: ie fatty meats and butter, for example have a low GL. .
But if you eat plenty of low GI foods, you’ll find that you are automatically reducing the GL of your diet and at the same time you’ll feel fuller for longer with these satisfying carbohydrate-containing foods, as well as improve many health parameters.

We also emphasise that there’s no need to get overly technical about this. Think of the GI as a tool allowing you to choose one food over another in the same food group—the best bread to choose, the best cereal to choose etc.—and don’t get bogged down with figures. A low GI diet is about eating a wide variety of healthy foods that fuel our bodies best—on the whole these are the less processed and wholesome foods that will provide carbs in a slow release form.
The take-home message:
  • Slow carbs, not low carbs
  • Use GI to identify the best carbohydrate choices.
  • Take care with portion size with carb-rich foods to limit the overall GL of your diet.
How do you figure out the GL numbers?
Glycemic load is calculated simply by multiplying the GI of a food by the amount of carbohydrate in the portion (in grams) you are eating and dividing by 100. Here’s how
Glycemic load = (GI x carbohydrate per serving) ÷ 100
Let’s say you wanted to have an apple for a snack. Apples have a GI of 40 and 1 medium apple contains 15 grams of carbohydrate.
So, the glycemic load of your apple snack is (40 x 15) ÷ 100 = 6.
If you were very hungry and tucked into 2 apples you be eating 30 grams of carbs and the GL of your snack would be 12. The GI doesn’t change, but you are eating more carbs because you are eating 2 apples.

apples

Does Low Carb automatically mean low GI?
Not at all. Here’s why. Low carb is just about quantity; it simply means that a food or meal does not contain much carbohydrate at all. It says nothing about the quality of the carbs in the food or meal on your plate. You could be eating a low carb meal but the carbs have a medium or high GI. Low GI on the other hand is all about quality.

fruit
Photo: Ian Hofstetter, www.ianhofstetter.com.au The Low GI Diet Cookbook

Whether you are a moderate or high carb eater, low GI carbs (wholegrain breads, legumes /pulses, many fruits and vegetables) will have significant health benefits—promoting weight control, reducing your blood and insulin levels throughout the day, and increasing your sense of feeling full and satisfied after eating. We suggest that you make the most of quality carbs and reap the add-on health benefits such as:
  • Vitamin E from wholegrain cereals
  • Vitamin C, beta-carotene and potassium from fruits and vegetables
  • Vitamin B6 from bananas and wholegrain cereals
  • Pantothenic acid, zinc, iron and magnesium from wholegrains and legumes
  • Anti-oxidants and phytochemicals from all plant foods
  • And fibre which comes from all of the above and doesn’t come from any animal food

Dispelling Some Myths About … Diabetes

Myth: Sugar causes diabetes.
Fact: There is an absolute consensus that sugar in food does not cause diabetes. Type 1 diabetes (insulin-dependent diabetes) is an auto-immune condition triggered by unknown environmental factors such as viruses. Type 2 diabetes (non-insulin dependent diabetes) is strongly inherited, but lifestyle factors such as a lack of exercise or being overweight increase the risk of developing it. Because diabetes treatment in the past involved strict avoidance of sugar, many people, wrongly, believed that sugar was in some way implicated in the cause of the disease. But while sugar is off the hook, high GI foods are not. Studies at Harvard University indicate that high GI diets that produce high blood glucose levels increase the risk of developing both diabetes and heart disease.

Myth: Sugar is the worst thing for people with diabetes.
Fact: For a long time strict avoidance of sugar was the mainstay of diabetes diets. Health-care professionals were taught that simple sugars were solely responsible for high blood glucose levels. But research shows that moderate consumption of refined sugar (around 40 grams/1½ oz or 2–3 tablespoons) a day doesn’t compromise blood glucose control. This means people with diabetes can choose foods that contain refined sugar or even use small amounts of table sugar.

What should you do? Try to spread your sugar budget over a variety of nutrient-rich foods that sugar makes more palatable. Remember, sugar is concealed in many foods—a can of soft drink contains about 40 grams of sugar—your entire daily allowance! Most foods containing sugar do not raise blood glucose levels any more than most starchy foods. Kelloggs Cocopops™ (GI of 77) contains 39 per cent sugar while Rice Bubbles™ (GI of 87) contains very little sugar. Many foods with large amounts of sugar have GI values close to 60—lower than white bread. Sugar can be a source of enjoyment and help you limit your intake of high fat foods, but the blood glucose response to a food is hard to predict. Use GI tables and your own blood glucose monitoring as a guide.
—Source: The New Glucose Revolution

© ® & ™ The University of Sydney, Australia