Carbohydrate Counting, Glycemic Index, and Glycemic Load: Putting Them All Together

Diabetes treatment. A meta-analysis of 14 studies that compared low-glycemic-index diets with conventional or high-glycemic-index diets found that study subjects who followed a low-glycemic-index diet had an HbA1c level of about 0.4 percentage points lower at the end of the study than those subjects following a higher-glycemic-index diet. This was true of both subjects with Type 1 diabetes and those with Type 2. Any reduction in HbA1c level lowers the risk of long-term diabetes complications.

Heart disease. People who follow diets with a high glycemic load tend to have increased triglyceride levels and lowered high-density lipoprotein (HDL) cholesterol levels, both of which raise the risk of heart disease. In a large study involving 750,000 female nurses, over a 10-year period, the women who followed the diets with the highest glycemic load were almost twice as likely to develop coronary heart disease as those following a diet with a lower glycemic load. Among the women who followed a high-glycemic-load diet, overweight and obese women were more likely to develop coronary heart disease than normal-weight women.

An Italian study involving almost 1,000 (nondiabetic) men and women compared a low-glycemic-index diet to a high-glycemic-index diet and found no overall increased risk of having a heart attack with the higher-glycemic-index diet. However, the researchers found an increased risk in overweight or obese volunteers and people over the age of 60.

Putting it all together
Both the amount and type of carbohydrate you eat affects your after-meal blood glucose levels. The American Diabetes Association’s “Standards of Medical Care in Diabetes — 2011″ note that monitoring carbohydrate intake “remains a key strategy in achieving glycemic control.” They additionally note that “…the use of the glycemic index and glycemic load may provide a modest additional benefit for glycemic control” over carbohydrate counting alone.

Choosing more carbohydrate foods with a medium or low glycemic index in place of foods with a high glycemic index is one way to lower the overall glycemic load of your meal plan. Another way is to consume less carbohydrate overall. A general rule of thumb for remembering which carbohydrate-containing foods have a lower glycemic index is the less processed a food is, the lower its glycemic index is likely to be.

Lowering your glycemic load has been shown to make a difference in blood glucose levels, weight control, and prevention of heart disease. Best of all, the benefits you reap can help you feel good and have more energy to do the things you enjoy. The menu here (along with these recipes) is an example of a low-glycemic-load day of meals. Use it to get started, then create more of your own.