1 May 2007

Feedback—Your FAQs Answered

Dietitians Kaye Foster-Powell and Alan Barclay, co-authors of The Diabetes and Pre-diabetes Handbook answer your questions in feedback this month.

I have just been diagnosed with type 2 diabetes. I am not overweight, have a balanced diet and exercise now and again. I am just 20. I have not told my family yet. Can you give me some advice on eating, the GI and other tips?
It’s rare, but not unheard of, for us to see young people who aren’t overweight, diagnosed with type 2 diabetes. In such cases referral (from a general practitioner) to an endocrinologist really needs to be considered to confirm the type of diabetes (you need to make sure that it isn’t type 1) and work out the most appropriate management for you. It isn’t unusual that you are reluctant to tell people you have diabetes. The diagnosis can be a shock and you have every right to take your time to come to terms with it yourself. You are to be congratulated for seeking information on how to best manage it. We would encourage you to see a diabetes educator and dietitian with experience in managing diabetes. They can provide personal advice on the diet and lifestyle aspects of managing diabetes, which is essential given the serious and life-long nature of the condition.

[TYPE2]

I read in one of your books that dairy food causes a higher insulin response than would be expected by its low GI. Does cheese cause a high insulin response or just milk and yoghurt?
Protein is what called an insulin secretagogue (this means it stimulates insulin secretion). It isn’t necessarily a high insulin response. For most foods the glycemic response parallels the insulin response, so low GI would also be low insulin. However with foods that are sources of both carbs and protein (like dairy foods), this relationship is clouded by the insulin-stimulating action of protein. In response to your specific question, we expect that cheese (being a source of protein) would also stimulate some insulin secretion.

[CHEESE]

Just wondering if herbal teas have been known to raise blood glucose levels? Particularly peppermint tea? finding that since I have been taking it my levels seem higher? Could it be a coincidence?
Assuming you aren’t adding sugar or honey we would say coincidence. Though caffeine may cause transient rises in those who are not habitual drinkers of tea or coffee, regular consumption appears to attenuate the response. Most herbal teas do not contain much caffeine – usually!

[HERBAL TEA]

In The New Glucose Revolution you discuss the benefits of vinegar. I have read in other books that the only benefits to be derived from vinegar are if it is ‘mother vinegar’ or raw and unprocessed. Do apple cider vinegar and red wine vinegar have the same effects?
Yes they do. So will balsamic vinegar and white wine vinegar. A realistic amount (say a tablespoon) of acid in foods like vinegar, lemon juice, lime juice, some salad dressings and even pickled vegetables slow down stomach emptying, thereby slowing the rate at which starch can be digested.

[VINEGAR]

7 comments:

Anonymous said...

Dairy food causes a higher insulin response? Does this mean that I need to stop eating yogurt if I am showing signs of insuline resistance?

Normally, I enjoy and understand all your answers, but that one seemed a bit tricky. Hope you'll dig deeper into that at a later time.

Maryellen said...

Also, protein causes an insulin response? So, we should limit protein? I'm confused.

gi group said...

Alan Barclay says: 'It is thought to be the protein in these dairy foods that is responsible for the increased insulin secretion when they are eaten. It is most likely due to the unique amino acid composition of the dairy protein stimulating the Beta cells of the pancreas to produce more insulin. As milk is the sole food for mammals for the first 6 months or so (depending on the species) of life, it is probable that the insulinergic effect is no accident. Insulin is anabolic – promotes the development of muscle tissue – so this is an important beneficial “side-effect” for the rapidly growing infant.

Cheese, like other dairy foods, would also be insulinergic as it has essentially the same amino acid profile (some of the proteins are altered in the process of making cheese). Most are also high in total and saturated fat. It would be a good idea for someone with insulin resistance to limit their cheese intake.'

feemarzinotto said...

I would like to know if carrots raw from Australia are a high GI food. I am getting conflicting information from books and websites.

Anonymous said...

I am new to the group and have a question that may be obvious but, it appears that fiber helps reduce carb conversion/insulin response - would a fiber supplement prior to a meal be helpful?

Dean

gi group said...

We asked dietitian Alan Barclay about this. The answer is maybe. It would depend on the type of fibre supplement (a 'soluble' type like Metamucil might, but not an 'insoluble' type like wheat bran) and the amount. The mechanism would be slowing absorption of the carb – not a direct impact on digestion (which it would if it was intact fibre – encapsulating the carb), nor insulin metabolism.

Anonymous said...

OK, per A.B., soluble fiber may have an effect. The supplement I have claims to have 2.7 grams of 'soluble' fiber per dose. Might this have a positive effect, again, if taken @ 10 minutes prior to a meal?

Dean