10) GLYCEMIC INDEX
e) Glycemic Index Controversy
The Glycemic Index has generated far too much controversy, with some weighing in that it should be the major consideration for a person with diabetes, others weighing in that it is virtually worthless. It is unfortunate that such controversy tends to harden the positions of the organizations involved and they become vocal proponents of either one extreme or the other extreme, seemingly failing to recognize the middle ground. There are those for the glycemic index and those against and both sides are holding onto their positions like two pit bulls. It should be noted that the ADA recommends using the glycemic index.
The Glycemic Index is neither the most important tool in diabetes management nor is it worthless. The most important tool in diabetes management is weight control, followed closely by exercise. The major tools for controlling blood sugar are controlling the total amount of carbohydrates consumed and the timing of that consumption. Controlling the amount and timing of carbohydrate intake can drop the A1c by up to 2 to 4 points. Eating only low and moderate glycemic index foods can drop A1c another 0.4 to 0.7 points. There is research which says eating only small amounts of only very low (and the emphasis is on "small amounts" and "very low") glycemic index foods drops the A1c by up to 1.5 more points. These drops are significant and needs consideration by a person with type 2 diabetes, especially if that person doesn't need insulin injections.
It is ironic that virtually all the people who criticize the glycemic index then turn right around and indirectly recommend it. It all turns into a matter of semantics. Some experts see no value in the glycemic index yet they recommend that someone with diabetes eat "high quality, high fiber, unrefined carbohydrates". Well, "high quality, high fiber, unrefined carbohydrates" are all low glycemic index carbohydrates! Some experts recommend avoiding "refined carbohydrates full of empty calories with very little nutritional value". "Refined carbohydrates full of empty calories with very little nutritional value" are all high glycemic index foods (potatoes, rice, bread, sugars, etc.)! Some of the high protein proponents list some extremely low glycemic index carbohydrates on their particular list of "allowed food" yet they disagree with the concept of the glycemic index. There is a huge body of research being developed that indicates that refined "modern" or "refined" carbohydrates (i.e. high glycemic index carbohydrates) are bad for everyone, indeed just as bad as saturated fats.
Sometimes the medical establishment can be very, very slow to accept ideas which go against standing dogma. Two classic examples are the ten years of disbelief that an Australian doctor met with when he proved that bacteria cause most stomach ulcers. Turned out the established medical community was incorrect, he was correct, and he was awarded a Noble prize in 2005 for his achievement. Another case is the treatment of the worms that cause elephantiasis in India and elsewhere. For many years physicians in India used antibiotics to treat the disease, and western physicians said they were wasting good antibiotics, that antibiotics could not possibly be useful against the worms. Turns out the mitochondria (the energy producing organs in the worms) were actually entrapped bacteria. If the elephantiasis worms were treated with antibiotics, their mitochondria were destroyed and the worms died.
Could this be what is happening with the Glycemic Index? The Glycemic Index concept came out of the "medical backwaters" of Canada and Australia (hhmmm…. is history repeating itself?).
Current Chapter: 10) GLYCEMIC INDEX
a) Introduction
b) Types of Common Carbohydrates
c) Glycemic Index and A1c
d) Glycemic Index and Losing Weight
e) Glycemic Index Controversy
f) Using Bad Statistics to Judge the Glycemic Index
g) The Occasional High Glycemic "Splurge"
h) Glycemic Load
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