World Diabetes Day 2023: Decoding the Glycemic index chart and its relevance in diet planning

As per the Indian Council of Medical Research - India Diabetes (ICMR INDIAB) study published in 2023, India has over 101 million people with diabetes. This testifies to the label of India being the diabetes capital of the world. A sedentary lifestyle, stress and unhealthy diet are some of the most common causes of diabetes especially among the young. Although this disease is incurable, doctors state that a combination of proper diet and regular physical exercise is effective in managing blood sugar levels.

Easier said than done, most diabetics struggle to chalk out the perfect diet plan for themselves. Many also feel frustrated given the availability of limited food options as a majority of food items today have sugar content in them. This makes diet planning daunting and calls for a list that clearly lays down the foods one can and cannot eat. Well, you have one.

The glycemic index chart is one such list that can be of great help for diabetics to plan their diet. On World Diabetes Day 2023, Mid-day Online roped in two diabetes experts who tell us how to read the chart and plan meals accordingly for a guided way to beat the menace of diabetes.

Decoding the term glycemic index
"To state simply, the glycemic index is a measure of how quickly certain foods raise blood sugar levels," says Dr Rajiv Kovil, diabetologist, chairperson, Zandra Healthcare, co-founder, Rang De Neela initiative, secretary at United Diabetes Forum. Adding to this, Dr Dheeraj Kapoor, chief endocrinologist, Artemis Hospital, Gurugram states, "GI ranks foods on a scale from zero to 100 based on how fast foods cause a spike in blood sugar levels after consumption."

High-GI foods, like sugary snacks and white bread, provide a quick energy boost but lead to a rapid drop in energy. Low GI foods, such as whole grains, fruits, and vegetables, release sugar more slowly, offering a steady and lasting energy source. Choosing more low-GI foods helps maintain stable energy levels and can be beneficial for overall health, especially for conditions like diabetes.

Imagine your body as a car, and food as the fuel that powers it. The glycemic index tells us how fast or slow that fuel (food) will be converted into energy (sugar) in our bloodstream.

Reading the glycemic index chart
The glycemic index chart ranks foods based on how they affect blood sugar levels. The chart is typically divided into three main categories:

1. Low-GI foods: These foods have a score below 55. They release energy gradually, helping to maintain steady blood sugar levels. These include whole grains, fruits, and vegetables.

2. High-GI foods: These foods have a score above 70. They tend to cause a rapid spike in blood sugar. These include sugary snacks, white bread, and certain cereals. While they provide a quick energy boost, it's often followed by a crash, leaving you feeling tired.

3. Medium-GI foods: These are foods that score between 56-69. Foods falling under this category include sweet corn, bananas, raw pineapple, raisins, cherries, oat breakfast cereals, and multigrain, etc.

Kapoor says, "By referencing the GI chart, diabetic patients can create a balanced and sustainable diet, incorporating foods that have a minimal impact on blood sugar and further reducing the risk of complications associated with diabetes."

To use the chart effectively, focus on selecting predominantly low-GI foods such as whole grains, legumes, fruits, and vegetables. Be mindful of portion sizes and consider the overall nutritional value of the food. Combining low-GI foods with sources of fibre and protein can further mitigate blood sugar fluctuations.

However, Kovil says, "One must note that the GI chart is simply a tool and not a strict rule. Every individual responds to each food differently and must be used alongside other dietary considerations."

While the chart is a helpful guide, consulting with a healthcare professional or nutritionist can provide personalised advice tailored to individual dietary needs and health goals.

The GI has its own limitations too which is also another reason why the chart cannot be the only thing guiding your diet plan. The GI chart doesn't account for the quantity of carbohydrates consumed or the overall nutritional content of the food.

For example, a small amount of high-GI food might have a different impact than a larger serving. Additionally, the GI of a food can be influenced by various factors, including cooking methods and the presence of other nutrients or fibre. Therefore, while the GI is a valuable tool for managing blood sugar, it's advisable to consider it alongside other aspects of a balanced diet and consult with healthcare professionals for comprehensive dietary guidance.

Importance of portion control in diet planning for diabetics
"Portion control involves managing the quantity of food consumed in a single sitting. For individuals with diabetes, it is crucial to maintain blood sugar levels. Eating large portions, even of healthy foods, can lead to spikes in blood sugar, making it challenging to manage diabetes effectively," says Kapoor.

Additionally, Kovil says, "Portion control ensures a balanced intake of essential nutrients, promoting overall health and preventing excessive calorie consumption. Without proper portion control, individuals with diabetes may experience blood sugar fluctuations, weight gain, insulin resistance, and heightened cardiovascular risks. Seeking guidance from healthcare professionals and adjusting portion sizes based on blood sugar levels is essential for effective diabetes management."

Planning meals for individuals with diabetes involves distributing food intake throughout the day to help manage blood sugar levels. Even if you are a working individual, it is essential that you aim for three main meals (breakfast, lunch, and dinner) and two to three small, balanced snacks.

Spreading meals helps prevent large spikes or drops in blood sugar. This frequent meal habit will help you with portion control. Further, if you mindfully consume water in adequate quantity you will be able to manage hunger spikes.

Both Kovil and Kapoor share a guideline to plan your daily diet:

1. Choose whole grains
Opt for whole grains like brown rice, quinoa, barley, and oats instead of refined grains like white rice or Maida (refined wheat flour). Whole grains have a lower glycemic index and provide more fibre, which helps in better blood sugar control.

2. Exercise mindful portion control
Pay attention to portion sizes to avoid consuming excessive carbohydrates in one sitting. This applies to all sources of carbohydrates, including whole grains.

3. Include fibre in your diet
Foods high in fibre, such as vegetables, fruits, legumes, and whole grains, can help slow down the absorption of sugar, promoting better blood sugar control.

4. Make healthy carb choices
Incorporate healthy carbohydrate sources like sweet potatoes, lentils, and beans, but manage the quantity. These foods release glucose more gradually, preventing rapid spikes in blood sugar.

5. Balance carbs with protein and healthy fats
Combining carbohydrates with lean proteins and healthy fats can help mitigate the impact on blood sugar levels. For example, pair whole grain bread with avocado or have brown rice with grilled chicken.

6. Limit added sugars
Minimise the consumption of foods and beverages with added sugars. Opt for natural sweetness from fruits instead.

7. Educate yourself
Read food labels diligently. Check for added sugars and choose products with lower glycemic index values. Being informed and proactive empowers individuals with diabetes to navigate food choices confidently and maintain better overall health.

8. Monitor your blood sugar from time to time
Regular monitoring of blood glucose and working with a healthcare professional or dietitian can help tailor a personalised plan. Experimenting with different foods and observing individual responses aids in creating a sustainable, enjoyable, and blood sugar-friendly eating routine.

Healthy and unhealthy food choices
For individuals with diabetes, it's essential to focus on a balanced diet that includes a variety of nutrient-dense foods. Here's a general guide:

Foods to include

1. Vegetables
Incorporate leafy greens, broccoli, cauliflower, bell peppers, carrots, and other non-starchy vegetables, in your diet

2. Fruits
Consume berries, apples, citrus fruits, and other fruits in moderation. Opt for whole fruits over fruit juices.

3. Whole grains
These include quinoa, brown rice, oats, whole wheat, and barley. These are high in fibre and have a lower impact on blood sugar.

4. Lean proteins
Consume skinless poultry, fish, tofu, legumes, lentils, and beans.

5. Healthy fats
Avocado, nuts, seeds, olive oil, and fatty fish (e.g., salmon, mackerel) can be added to your daily diet.

6. Dairy or dairy alternatives
This includes low-fat or fat-free options such as yoghurt and milk. Choose unsweetened varieties.

7. Herbs and spices
Choose flavoured foods with herbs and spices instead of excessive salt or sugar.

Foods to limit or avoid

1. Refined carbohydrates
White bread, white rice, and products made with refined flour (Maida) must be strictly avoided.

2. Processed, sugary beverages and food
Candy, pastries, cookies, and other high-sugar snacks, soda, sweetened juices, and energy drinks are usually high in sugar content and must be discontinued for effective management of blood sugar.

3. Fried and fatty Foods
Limit deep-fried items as they can be high in unhealthy fats. Further high-fat cuts of red meat and processed meats like sausages and bacon must also be avoided.

4. Excessive alcohol
Limit alcohol consumption, and if you choose to drink, do so in moderation.

Snacking in office
With regards to snacking in the office, experts say that consuming packaged snacks like potato chips, an easy snacking option can pose specific risks for individuals with diabetes. Here is why:

1. High in simple carbohydrates
Packaged chips often contain refined carbohydrates that can lead to rapid spikes in blood sugar levels, challenging for diabetes management.

2. High in unhealthy fats
Many packaged chips are fried and high in unhealthy fats, contributing to weight gain and potential insulin resistance.

3. Excessive sodium content
Chips and other packaged or processed foods are typically high in salt, which may contribute to high blood pressure, a common concern for individuals with diabetes.

4. Low in nutrients
These snacks offer little nutritional value and may lead to overconsumption of empty calories.

Healthy snacking alternatives for diabetics

1. Nuts and seeds
Choose unsalted almonds, walnuts, or sunflower seeds for a satisfying and nutrient-rich snack.

2. Fresh fruits
Opt for whole fruits like apples, berries, or oranges. They provide fibre and natural sweetness.

3. Vegetable sticks with hummus
Enjoy cucumber, carrot, or bell pepper sticks with a side of hummus for a crunchy and nutritious snack.

4. Greek yoghurt
Select plain, low-fat Greek yoghurt for a protein-rich option. Add fresh fruit or a sprinkle of nuts for flavour.

5. Cheese cubes
Choose small portions of low-fat cheese for a satisfying and protein-packed snack.

6. Popcorn (Air-popped):
Air-popped popcorn can be a whole-grain snack with fibre. Avoid excessive butter or salt.

7. Whole grain crackers with nut butter
Whole grain crackers paired with almond or peanut butter offer a balance of carbohydrates and protein.

8. Hard-boiled eggs
A convenient and protein-rich snack, hard-boiled eggs help keep one feeling full.

9. Low-sugar granola bars
Look for granola bars with minimal added sugars and whole-grain ingredients.

10. Homemade trail mix
Combine nuts, seeds, and a small number of dried fruits for a customisable and nutrient-dense snack.

These alternatives provide a healthier balance of nutrients, including fibre, protein, and healthy fats, while minimising the risks associated with processed and sugary snacks.

It's important to note that individual responses to food can vary, and the specifics of a diabetes-friendly diet may differ based on personal health goals, medication, and other factors. Consultation with a healthcare professional or dietitian is advisable to create a personalised and effective dietary plan.

Diet during festivities
Striking a balance is key, say the two experts. Maintaining control during festive times like Diwali can be challenging for individuals with diabetes. Here are some tips to strike a balance:

1. Portion control
Enjoy festive treats in moderation. Smaller portions help manage blood sugar levels more effectively.

2. Choose wisely
Opt for healthier alternatives when possible. For instance, prefer baked or grilled snacks over fried ones.

3. Stay active
Engage in physical activities to help regulate blood sugar. Consider taking a short walk after meals or incorporating festive dances into celebrations.

4. Plan ahead
If attending gatherings, communicate your dietary preferences to hosts. Bringing a diabetes-friendly dish ensures there's a healthier option available for you as well as other with diabetes.

5. Hydration is key
Drink plenty of water to stay hydrated and curb unnecessary snacking. Sometimes, our bodies mistake thirst for hunger. Remember, it's about making informed choices and enjoying festivities without compromising health.

Disclaimer: This information does not replace professional medical advice. Consult a qualified specialist or your physician for personalised guidance.