Neil Levin on the Glycemic Index and the Glycemic Response

What is the level of consumer understanding of glycemic index and the glycemic response?
The Atkins and other low carb diets have certainly improved the awareness of the glycemic index, as have low-carb sports products, including bars. The awareness is probably fairly superficial, though, amounting mostly to alternative sweeteners and a general avoidance of grain products. And a lot of manufacturers used unapproved label claims, such as net carbs, that were not really well defined and probably confused a lot of people. I believe that the low carb category has quite properly morphed into the low glycemic category, something that Dr. Atkins foresaw and wrote about before his death and wrote about.


Who is the target consumer for low-GI foods: diabetics, dieters, health conscious?
While diabetics are the classic market for low glycemic products, and rightly so, the market has some other notable segments. Dieters, of course. People under a lot of stress where excess levels of the adrenal hormone cortisol is a problem, contributing to insulin resistance, which is a situation where cells become resistant to insulin, leaving the insulin and sugar in the bloodstream and resulting in low energy and high levels of blood sugar. This is potentially a pre-diabetic condition, and anyone suffering from chronic stress could be at risk. Yet another target market is people who follow the Blood Type Diet, especially those with the O blood type.

How do low-GI foods fit an overall healthy lifestyle?
While people need a certain amount of carbs for energy and brain fuel, the overabundance in the American diet is cause for concern. But look carefully at how the form of foods affects their glycemic index numbers. Foods containing fiber are lower on the scale than refined foods. Whole grains are lower on the index than even the same grain ground into flour, because the rate of digestion and passage through the digestive tract depends on the fineness of the food particle size and the presence of fibers that slow this passage, making the sugars from the food become, in effect, time released. Slower release of sugars into the bloodstream helps to control blood sugar levels and maintain a more desirable glycemic balance.

Avoiding high sugar food is only part of the solution, as many vegetable starches also convert to sugars. That is why the presence or absence of fiber and the physical form of the food are also important factors in glycemic control.

What type(s) of foods are available in the low-GI category, and what sets them apart from existing offerings?
It is important to note that this category should not be viewed simply as packaged products expressly created to be low GI, but rather that many of the staples health food stores have promoted for decades are, and always have been, low GI.

These include several forms of fiber, such as guar gum, oat bran, rice bran, wheat bran, apple pectin, glucomannan, grapefruit pectin, and psyllium. These are not only low glycemic, but help other foods to become low glycemic by slowing digestive and transit times in the stomach and upper intestine. (Fibers also speed transit time through the large intestine.) Stores also sell gluten flour, containing far more protein and less starch (carbs) than ordinary wheat flour. We have soy powder and some of the smaller grains (for example, amaranth, flax, quinoa) that have a higher proportion of protein and fiber than larger grains.

Textured soy protein can be added to foods to increase their protein content without adding carbs, a plus for many vegetarians who lack un-starchy protein sources. There is also dry roasted soybeans, too (soy nuts).

Use a good variety of natural and organic nuts and seeds, which are good sources of protein and healthy fats, including almonds, brazil nuts, cashews, pecans, pine nuts, pistachios, sesame and sunflower seeds, walnuts.

Nutritional oils are all low glycemic, containing no carbs. These include organic virgin coconut oil, organic virgin macadamia nut oil, extra virgin olive oil, almond oil and rice bran oil.

In the alternative sweetener category are included low glycemic choices such as erythritol (substitutes for sugar in recipes, but not quite as sweet; non-laxative), sorbitol (one of the original sugar substitutes, can be laxative in servings over 20 grams), and xylitol (substitutes for sugar in both bulk and sweetness, but can be laxative at 30-50 grams).

Stevia is a dietary supplement containing terpenes, which are compounds that are not technically classified as sweeteners. You cannot sell stevia as a sweetener, because the FDA approved it as a dietary supplement but denied a petition to approve it as a sweetener. Manufacturers do not offer substitution suggestions for using stevia in place of sugar, but several cookbooks do offer stevia recipes. Other plants containing terpenes are Lo Han and Licorice. Stevia is available in a variety of forms, including powdered, packets, tablets, liquids, etc.

How are formulators using cutting-edge ingredients to increase fiber levels and balance glycemic load?
There are more concentrated fibers on the market now for use as ingredients in bars or supplements, though they are also more costly than plain fiber sources, such as various brans from grains. Beta glucans are perhaps the best known, and also have an approved FDA health claim.

How do you suggest retailers promote these products to best effect?
I suggest that retailers be aware of their low carb/low glycemic products in order to successfully market them. A store section is appropriate for packaged goods, though some products may be better sellers in other sections, such as sweeteners. The market for products dealing with diet/stress/blood sugar should continue to grow, making this an important category for us. The key is education; an educated retailer will be able to stock and sell the products, meeting an unfulfilled need in uneducated consumers, who may be ignorant of that need without some outreach by retailers. Classes, lectures, copies of articles, in-store magazines and promotions targeting the need for controlling blood sugar are all viable options for retail merchants who want to contribute to both their customers’ health and their own bottom lines. This is also an ideal topic for retailers to write an article for a local paper educating readers about the issue and showcasing the expertise available in their store.

Cravings don't mean you have no willpower

Many women crave sugar, carbohydrates, or alcohol. In most cases, these food cravings are not true eating disorders, but instead are signs of hormonal imbalance caused by a non-optimal diet.

Your own issue may be the afternoon snack, candy, too many potato chips, an extra glass of wine after dinner, and so forth. But the underlying mechanism, and the way to curb cravings, is the same. And it may not have that much to do with willpower, as such, and more to do with metabolism and biocehmistry.

Food cravings tells us that the body is confused. When we are exhausted or blue, we have low blood sugar and/or low serotonin, and the body informs the brain that it needs a pick-me-up. This signal causes a sugar craving or carbohydrate craving.

Serotonin is our basic feel-good hormone; if serotonin is low, we feel sad or depressed. Hormonal imbalance or weak digestion can lead to low serotonin. Unfortunately, sugars and simple carbohydrates release a short burst of serotonin. We feel fine for a moment but soon go back to our low-serotonin state, again craving more sugar and simple carbs.

If you eat a low-fat diet in the hope of losing weight, you unintentionally make the problem worse. If, like millions of women, you have eaten a low-fat, high-carbohydrate diet for many years, or followed fad diets, the odds are good that you have become at least partially insulin resistant.

Insulin is responsible for maintaining stable blood sugar levels by telling the body’s cells when to absorb glucose from the bloodstream. Being insulin resistant means your body stops responding to insulin, and instead grabs every calorie it can and deposits it as fat. In this case, no matter how little you eat, you will gradually gain weight.

Meanwhile your cells cannot absorb the glucose they need, so they signal your brain that you need more carbohydrates or sugars. The result is: persistent food cravings.

What's even worse: insulin resistance leads directly to obesity, diabetes and heart disease. Many experts believe it is the root cause of the epidemic of those diseases in America today.

A low-fat diet makes it far more likely you will suffer from this condition. Millions of American women have tried the Atkins Diet or the South Beach Diet. While these diets are an improvement over the conventional low-fat, high-carbohydrate diet, they can worsen your metabolic problems, because dieting itself is stressful to the body. Many women need to reset their metabolism, first, before even considering weight loss.

Another cause of food cravings is adrenal fatigue. If you are under a great deal of stress, or suffer from insomnia or sleep deprivation, you are likely exhausted much of the time. This leads to adrenal fatigue or adrenal exhaustion which, in turn, signals the body it needs a pick-me-up. You may resort to sugar or carbohydrate snacks or coffee during the day and carbohydrates or alcohol at night, all of which exacerbate the problem.

How to curb cravings
Women who blame themselves for their food cravings only worsen their mood and increase their need for serotonin. That’s when a pattern of emotional eating can develop. Keep in mind that there are biological causes of sugar cravings, and your carbohydrate craving is rarely just a behavioral problem. The root problem is more likely inadequate nutrition.

How do we break this vicious cycle?

To reduce food cravings, the body needs help. We have seen that eating healthy foods, nutritional supplements and moderate exercise can effectively curb cravings.

Your metabolism will repair itself when given with the necessary nutritional support. If it has been damaged, the process can take some time, but it will happen. The good news is — you don’t have to give up dark chocolate!

Cravings 101

Cravings for foods, often for fatty foods or carbs, can easily sabotage our body composition and weight-loss efforts. So it's really important that we know how to cope with (and overcome) them.

Scientists don't agree about exactly why we have cravings. Some experts suggest they're physiological, that our bodies are craving certain nutrients when we want specific foods or that we are subconsciously desiring a result the food might bring (e.g. a candy bar providing a "sugar rush"). Many people who feel cravings are also depressed.

Others believe that cravings are simply force of habit or even a form of food addiction. Many of us crave foods that brought us pleasure growing up, known as comfort foods, which may have more to do with emotional security than a desire for food.