EP.323/ What are the glycemic load and glycemic index and how can they help you manage endo?
Today is a quick episode but hopefully a helpful one.
Today I want to talk about the glycemic index and the glycemic load of foods, and how you can use these tools to help you manage endo.
The glycemic index and glycemic load are two tools to help you understand how food can affect your blood sugar levels and how quickly they can do so.
As a brief reminder, your blood sugar is the measurement of glucose in your blood stream at any one time. Glucose comes from carbohydrate containing foods, and glucose is absorbed from the intestines into your blood stream when you eat. Glucose is our body’s main source of energy.
Now, before we go into this, I want to just give a disclaimer. This conversation is about working out carb content of foods, and I am not going to be advising you to do this with every food and every meal, but if you find paying attention to macronutrients triggering due to a history of an eating disorder, then you may want to skip this episode.
For the rest of you, towards the end I’m going to share how to use these tools in a realistic way that doesn’t create obsessive eating habits.
Okay, so let’s get to it.
The glycemic index scale came first, and this is a tool that looks at foods and the impact they can have on your blood sugar, on a scale of 0-100.
A high GI index would be 70 and above, a medium GI is 56-69 and a low GI index is 55 or less. High GI foods are very, very likely to spike your blood sugar levels and do so quickly, foods with a medium GI rating tend to cause a moderate rise and low GI foods tend to keep blood sugar levels stable and steady over time with a gentle rise.
This is because low GI foods break down slowly in the gut because they are rich in fibre and slow release carbohydrates, this means that the release of glucose to the blood stream is slow and gradual. This way you get a steady drip of energy over time.
In contrast, foods like white bread, which are listed as a high glycemic index food, break down very quickly in the gut and are rapidly absorbed, meaning the glucose gets to the blood stream very quickly and all at once, creating a spike.
However, there are limitations to this method. The main limitation is that the glycemic index doesn’t consider how much of a food one would eat per serving. This means that something that is high glycemic index, may not spike blood sugar levels as much as you would assume, because you wouldn’t eat that much in one serving. And in contrast, something with a moderate glycemic index, could spike your blood sugar levels higher than you would expect, if you’re having a large serving of it.
This is where the glycemic load comes in and was developed more recently. The glycemic load takes into account the GI of a food and how much of it you’re eating in one serving and how many carbs are in that serving, to give a more realistic idea of how much it will affect your blood sugar levels.
A low glycemic load would be 10 or below, medium would be 11 to 19 and a high glycemic load would be 20 or above.
Anyone can work out the glycemic load of a food. You take the glycemic index number of a food, and then look at how many carbs are in your food per serving. You take these two numbers and multiply them, and then divide by 100, and this gives you your glycemic load rating.
So, let’s say you’re going to have some oat bran, oat bran has a glycemic index rating of 15. You’re going to have 45g of this, which is 21.7g of carbohydrates. So to work out the glycemic load we would do 15 multiplied by 21.7, which is 325.5, and then we divide that number by 100, which gives us 3.2, which gives oat bran a low glycemic load score.
If you want to find the glycemic index of a food to do this calculation, or just to start understanding the GI of foods in general, I’ve listed a website with all the foods there.
And if you want to understand how many carbs are in a food, just look at the label or Google a generic brand to get the info. For example, if you’re eating a banana, there’s probably not going to be a label on there, but if you go to a supermarket’s website and look up their bananas, the nutritional info per 100g is there. So for example, if you go to Tesco’s or Waitrose’s websites, you’ll see the nutritional values of each item they sell listed underneath the food items.
Many foods’ nutritional values are listed per 100g, but often we don’t eat 100g of a food per serving. So, to work out the carbs per serving, you would take the total carbs per 100g and divide that number by 100. This would give you the amount of carbs per gram, then just multiply that number by the amount of grams you’re eating, for example, 50g.
Now, how does that help us manage endo?
I’ve talked again and again about blood sugar management and endo, and I’ll link to some of my articles in the show notes, but in short, when we experience blood sugar spikes, types of chemicals called AGEs are formed, and this leads to oxidative stress and inflammatory reactions in our body.
Oxidative stress is higher in people with endometriosis, and oxidative stress has been linked to endo, as have various inflammatory pathways that can be triggered by oxidative stress. So, whilst we don’t have evidence that blood sugar spikes can contribute to endo directly, we do want to keep oxidative stress levels down, for endo management and overall health, because oxidative stress is damaging for the body and as I said, is linked to endo.
Additionally, blood sugar swings can cause elevated pain levels due to the increase in inflammation, as well as hormonal imbalances such as high testosterone and oestrogen dominance.
Finally, research shows a correlation with endo and blood sugar issues and a potential increased risk of developing metabolic issues like diabetes, so managing our blood sugar can prevent health complications down the line.
So, how do we use the glycemic index and glycemic load in real life? Getting to understand the glycemic index and eating in a way that minimises high glycemic foods and emphasises low and moderate glycemic foods is really a great first step to looking after your blood sugar.
With the glycemic load, this can be helpful if you find yourself pre-diabetic or diabetic, or insulin resistant. You could spend some time getting to understand the glycemic load of your regular meals, and making some adjustments to them. Additionally, the glycemic load can help you if you know you’re eating a high glycemic index food, but you want to know how much you can eat of it without it causing a significant impact. For example, you may want to know the impact of 100g dried pasta vs 70g dried pasta before cooking it, to help you decide how much is best for you.
This is what I typically use the glycemic load for, when I am making more carb heavy meals, or I’m baking or using something sweet.
And here’s a tip. If you’re eating something with a higher glycemic index or load, add some extra fibre, fat and protein - all three will help slow down the blood sugar release. So for example, if you want 100g of that pasta, eat some veggies first, then load the pasta up with olive oil and a protein like prawns.
Now remember, the glycemic load and index were originally developed for diabetes, but they can be used as helpful tools for those of us who need to pay a bit more attention to our blood sugar. But use it in that way - as helpful tools, not as a restrictive way of eating.
Once you get more familiar with the glycemic index, you won’t have to think too much about it. You’ll be able to know what kinds of foods are higher and what kind of foods are lower, and you’ll be more instinctive about adding a bit more fat or fibre, or eating a little less of that food in a meal, for example.
Okay, that’s it for this week!
Shownotes
Glycemic index and load resources
https://glycemic-index.net/glycemic-index-chart/
https://www.sciencedirect.com/science/article/pii/S0002916522004944?via%3Dihub
https://www.health.harvard.edu/diseases-and-conditions/the-lowdown-on-glycemic-index-and-glycemic-load
https://glycemic-index.net/bran-wheat-oat/
https://glycemic-index.net/glycemic-load/
Endo and blood sugar
https://endometriosis.net/living/diet-sugar
https://www.theendobellycoach.com/podcast/pcos-blood-sugar-endometriosis-megan-hallett?rq=megan
https://pmc.ncbi.nlm.nih.gov/articles/PMC5625949/
https://www.cambridge.org/core/services/aop-cambridge-core/content/view/19E868FB1BE3A08DCFC0D00D7489ACAF/S0954422410000272a.pdf/dietary-therapy-a-new-strategy-for-management-of-chronic-pelvic-pain.pdf
https://www.sciencedirect.com/science/article/abs/pii/S0140673621003895
https://pubmed.ncbi.nlm.nih.gov/3322018/
https://pubmed.ncbi.nlm.nih.gov/24168441/
https://www.sciencedirect.com/science/article/abs/pii/S0891584922001228
https://pubmed.ncbi.nlm.nih.gov/12379575/
https://www.researchgate.net/publication/385491981_Salivary_Prostaglandin_E2_Levels_and_HbA1c_Levels_in_Periodontal_Inflammation_A_Comparative_Analysis_of_Diabetic_and_Non-Diabetic_Patients
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Produced by Chris Robson