Glycemic Index and Diabetes

The glycemic index, or GI, measures how a carbohydrate-containing food raises blood glucose.  Foods are ranked  based on how they compare to a reference food-either glucose or white bread.

A food with a high GI raises blood glucose more than a food with a medium or low GI.

Meal planning with the GI involves choosing foods that have a low or medium GI.  If eating a food with a high GI, you can combine it with low GI foods to help balance the meal.

Examples of carbohydrate-containing foods with a low GI include dried beans and legumes (like kidney beans and lentils), all non-starchy vegetables, some starchy vegetables like sweet potatoes, most fruit, and many whole grain breads and cereals (like barley, whole wheat bread, rye bread, and all-bran cereal.

Meats and fats don’t have a GI because they do not contain carbohydrate

Below are examples of foods based on their GI.


* 100% stone-ground whole wheat or pumpernickel bread

* Oatmeal (rolled or steel-cut), oat bran, muesli

* Pasta, converted rice, barley, bulgar

* Sweet potato, corn, yam lima/butter beans, peas, legumes and lentils

* Most fruits, non-starchy vegetables and carrots

MEDIUM GI (56-69)

* whole wheat, rye, and pita bread

* Quick oats

* Brown, wild or basmati rice, couscous


* White bread or bagel

* Corn flakes, puffed rice, bran flakes, instant oatmeal

* Shortgrain white rice, rice pasta, macaroni and cheese from mix

* Russet potato, pumpkin

* Pretzels, rice cakes, popcorn, saltine crackers


Fat and fiber tend to lower the GI of a food.  As a general rule, the more cooked or processed a food, the higher the GI; however, this is not always true.

Below are a few specific examples of other factors that can affect the GI of a food:

* Ripeness and storage time – the more ripe a fruit or vegetabe is, the higher the GI

* Processing – juice has a higher GI than whole fruit; mashed potato has a higher GI than soft-cooked pasta)

* Cooking method – how long a food is cooked (al dente pasta has a lower GI than soft-cooked pasta)

* Variety – converted long-grain white rice has a lower GI than brown rice but short-grain white rice has a higher GI than brown rice.


The GI value represents the type of carbohydrate in a food but says nothing about the amount of carbohydrate typically eaten.  Portion sizes are still relevant for managing blood glucose and for losing or maintaining weight.

The GI of a food is different when eaten alone than it is when combined with other foods.  When eating a high GI food, you can combine it with other low GI foods to balance out the effect on blood glucose levels.

Many nutritious foods have a higher GI than foods with little nutritional value. For example, oatmeal has a higher GI than chocolate. Use of the GI needs to be balanced with basic nutrition principles of variety for healthful foods and moderation of foods with few nutrients.


There is no one diet or meal plan that works for everyone with diabetes.  The important thing is to follow a meal plan that is tailored to personal preferences and lifestyle and delps achieve goals for blood glucose, cholesterol and triglycerides levels, blood pressure, and weight management.

Research shows that both the amount and the type of carbohydrate in food affect blood glucose levels. Studies show that the total amount of carbohydrate in food, in general, is a stronger predictor of blood glucose response than the GI.

Based on the research, for most people with diabetes, the first tool for managing blood glucose is some type of carb counting.

References.  American Diabetes Association  02/06/2017

What Foods Have Gluten?

Gluten is found in wheat, rye, barley and any foods made with these grains.

Avoiding wheat can be expecially hard because this means you should avoid all wheat-based flours and ingredients.  These include but are not limited to:

*  White flour

*  Whole Wheat Flour

* Durum Wheat

* Graham Flour

* Triticale

* Kamut

* Semolina

* Spelt

* Wheat Germ

* Wheat Bran

Common foods that are usually make with wheat include:

* Pasta

* Couscous

* Bread

* Flour Tortillas

* Cookies

* Cakes

* Muffins

* Pastries

* Cereal

* Crackers

* Beer

* Oats (see the section on Oats below)

* Gravy

* Dressings

* Sauces

This may seem like a long list, but there are still plenty of gluten-free foods out there!  Choose from many fresh, healthy foods like fruits, vegetables, beans, dairy, nuts and gluten-free grains like quinoa or rice.

There are also gluten-free versions of many of the foods above available in most grocery stores.  You just have to look for them!`

You may not expect it, but the following foods can also contain gluten:

* broth in soups and bouillon cubes

* breadcrumbs and croutons

* some candies

* fried foods

* imitation fish

* some lunch meats and hot dogs

* malt

* matzo

* modified food starch

* seasoned chips and other seasoned snack foods

* salad dressings

* self-basting turkey

* soy sauce

* seasoned rice and pasta mixes

There are also many additives and ingredients in packaged foods that may contain gluten.  Always check labels and ingredient lists for these.  For a more comprehensive list of gluten-containing additives, contact your local celiac support group.


Don’t forget that ingredients in food products change freqquently, so always check the label before buying packaged foods.

* Remember that “wheat free” does not automatically mean “gluten free.”  While a product may not contain wheat, it can still contain rye or barley in some form.

* If you have any question about whether a food contains gluten, contact the manufacturer.


Pure oats are a gluten-free food, but most commercially processed oats have been contaminated during the growing, harvesting or processing stages.  In the past, many experts recommended completely avoiding oats those on a gluten-free diet in addition to wheat, barley, and rye.  Now some oats are grown and processed separately, and can be labeled “gluten-free.”

Many people with celiac disease are still advised to avoid oats initially.  However, oats can help provide fiber and other important nutreints.  Over time, most people with celiac can reintroduce pure oats in small amounts (about 1/2 cup of dry oats per day) without any trouble.

If you do choose to include them, let your doctor know and only eat oats that are marked “gluten-free.”

References:  The American Diabetes website.  02/06/2017




Where you eat makes a difference in now much you eat.  According to a study, people eat more in spaces with open floor plans.  Researchers offered 57 college students buffet-style meals in a laboratory where folding screens were used to create different arrangements of the kitchen and dining areas.  When the kitchen area was open and visible from the dining area, the students served themselves an average of 170 calories more than they did when the kitchen and dining areas were separated.  You can use this information at home by serving dinner from the kitchen, rather than at the dining room table.  At work and in restaurants, try sitting where you can’t see the kitchen.

Source:  Environment and Behavior, published online 9/8/2016


Laughter is the best medicine.  No, really:  In a study, older adults in assisted-living centers participated in a program called LaughActive, which included two 45-minute sessions per week.  In between strength, balance, and flexibility exercises, the seniors were instructed to laugh for 30-60 seconds, no jokes necessary—the body can’t tell the difference between real and forced laughter.  Either way, it relaxes and strengthens muscles.  After six weeks, participants showed major improvements in mental health and endurance.  The laughter also prompted the seniors to exercise more, which means they may be more likely to stick with it, giggles and all.

Source:  The Gerontologist, published online 9/15/2016



Caregiving often comes with difficulties and lack of cultural support, even though it can offer the caregiver unexpected joys and possible tighter family bonds, experts say.

We see a primarily negative view of caregiving in our culture,” explained Dr. Barry Jacobs, a clinical psychologist who has spent his life helping patients build stronger relationships with family members who have had heart attacks or stroke.  “But people can get positive rewards from caregiving – confidence, competence dealing with medical staff and issues, spiritual rewards and renewed family closeness, to name a few.”

During National Family Caregivers Month this November, Jacobs and his wife, Dr. Julia Mayer, who is also a clinical psychologist, are working to encourage caregivers to repair rifts and be grateful for “this gift of time.”

“We worked clients who were caregivers for years, but you don’t know what it is like until you are in it.  The anger, guilt, feeling you wish you could do more, negotiating with your siblings – you have to experience it,” said Mayer, director of Behavioral Sciences for the Crozer-Keystone Family Medicine Residency Program in Springfield, Pennsylvania, and a co-author with Jacobs of AARP Meditations for Caregivers – Practical, Emotional and Spiritual Support for You and Your Family.

The couple, who have been married for 26 years, found new meaning in their work when they took on caregiving for their own parents.

It was harder than expected, they found.

“But at the end of the day, it’s the right thing to do and we’re glad to have done it,” said Jacobs.

If tension is rising among adult siblings caring for an aging parent, Mayer offers this advice:

  • Don’t hide from your family. Have an honest discussion about the workload and balance.
  • Know that the level of care each person provides won’t be equal, but do expect a contribution from each person.
  • Long-distance caregivers can struggle to find a role. “Not all help is helpful,” Mayer said.  “Don’t criticize or suggest, but instead ask how the primary caregiver is doing, support them and visit or call when you can.”
  • Develop a plan to keep all caregivers on the same page about the patient’s medical condition, treatment and caregiving plan. “Knowing who will do what for whom helps everyone feel connected and when the caregiving job is done, the family will feel better knowing they rallied together,” said Jacobs.


Caregiving is a chance for family – no matter how far-flung – to pull together toward a common foal.


“Everyone is watching your choices,” Jacobs said.  “You don’t need to make the same sacrifices as someone else, but you do need to be on the same team.”




Gels, gummies and bars have a time and place, but these energizing edibles are chemical-free and easy to make yourself.  


Eating a combo of protein and carbs 60-90 minutes ahead of your run will give sustained energy.  Oatmeal (with soy or 1% milk) and nuts digests quickly. Bonus: Walnuts can reduce inflammation and endurance.


For training runs of 90+ minutes, simple sugars, like a banana and a packet of honey, break down fast for energy.  Experiment with timing to find your biggest payoff.


Eat carbs and protein within 30 minutes of your run to replenish glycogen stores and speed recovery.  Baby carrots and hummus are an ideal snack.  Sip water, too!


SOURCE:  SELF MAGAZINE 3/2016  pg. 86



More than half of the food Americans consume, such as frozen dinners and cereal bars, is “ultra-processed” and contains too much sugar, according to a survey of 9,317 people.  Respondents reported that, on average, about 58 percent of their daily food and drink was ultra-processed- manufactured for convenience using individual chemical ingredients not found in kitchen cabinets.  (Not to be confused with processed foods, which are any non-fresh foods-even frozen veggies, applesauce, and steel-cut oats.)  Soft drinks, packaged snacks, and “instant” meals are also among foods called ultra-processed.  These contain far more added sugar than unprocessed or minimally processed vegetables, fruits,nuts whole grains, and meats.  Experts recommend that our diets contain less than 10 percent of calories from added sugar.  Study participants who reported consuming a higher portion of ultra-processed food were more likely to exceed that level.

Source:  BMJ Open, published online March 9th, 2016/ Diabetes Forecast Magazine                    July/Aug. 2016



Can a cup of joe prevent type 2 Diabetes?

You probably know that coffee seems to help wake you up in the morning-and afternoon, and sometimes in the evening, too.  But did you know it might help prevent diabetes?

Studies examining the links between diet and diabetes risk have shown that coffee drinkers have a slightly reduced risk of cardiovascular disease, cancer, Parkinson’s disease- and type 2 diabetes.  Of all the foods we consume, “coffee has the most potential to prevent type 2 diabetes,” says Marilyn Cornelis, PhD, a nutritionist and assistant professor at Northwestern University Feinberg School of Medicine.  “With diabetes, the more coffee the better, according to epidemiological studies.”

With the help of a grant from the American Diabetes Association, Cornelis is beginning to investigate why that might be.  Caffeine may not be one of those reasons-it has been shown to increase blood glucose levels.

Instead, Cornelis thinks other substances in coffee could be at play.  “Coffee is an important source of caffeine, but it’s also got other chemicals that might be protective,” she says.  The complex aromas that coffee buffs savor come from hundreds of different chemical compounds released in the roasting process, for example, and coffee is known to contain high levels of antioxidants.

When those chemicals are ingested, they interact with the body in ways we don’t yet understand-hence the mystery behind coffee’s protective effects.  Cornelis wants to learn how these chemical interactions might help to prevent type 2 diabetes.  But first she has to figure out what chemicals are produced when we drink a cup of coffee.  “When we consume a food, it’s broken down into smaller elements that we find in the blood,” she says.  ” I’m interested in seeing what (smaller elements) are derived from coffee consumption.”

Protective Benefits

In technical terms, those smaller elements are known as “metabolites,” the process of breaking down nutrients into components we can use.  To find out what they are, Cornelis turned to a colleague in Finland.  The Nordic nation consumes more coffee per capita than any other: an average of 2.6 cups per day per person, three times the U.S. average.

Using data from a Finnish study, Cornelis compared blood samples of 46 Finns after four coffee-free weeks with blood from those same participants after a month of drinking a whopping eight cups of coffee daily.  She hopes she can identify chemical compounds that show up when the body processes coffee.  Because she already knows the metabolic signature of caffeine from earlier work, identifying more metabolites might help identify what’s uniquely protective about coffee.  “The next step is (determining) whether any of these metabolites are protective of diabetes,” Cornelius says.

Even before the results are in, Cornelius says it’s time to rethink coffee’s reputation as a bad habit.  This year, the Food and Drug Administration acknowledged coffee’s benefits for the first time and suggested five cups as a healthy upper limit, more than in the past.

Gene Pool

So why not encourage everyone in America to drink coffee like the Finns?  “In general, people are already consuming the amount they appear to tolerate,” Cornelis says.  “If someone’s had too much coffee, they can tell.”

Thanks to their genes, some people are simply better at metabolizing caffeine.  For example, some people can down an espresso after dinner and sleep soundly all night, while others get the jitters all day from a single cup with breakfast.

Someone who metabolizes caffeine faster is going to get less of a jolt per cup and be more likely to drink more coffee each day-and therefore might get more of the chemicals that reduce diabetes risk.

It’s also important to remember that the studies showing coffee’s benefits are broad surveys that include hundreds of thousands of people, and the benefits are measurable but still small compared with more familiar recommendations targeting with management and adequate exercise.  “If you feel you can’t tolerate coffee, I wouldn’t recommend drinking more,” Cornelis says.  “but if you’ve been avoiding coffee because you thought it was bad for you, allowing yourself a cup or two a day might be good.”

One important thing to remember: Most of the studies in people and animals have used black coffee, rather than sugary, milky concoctions.  The extra calories in a Frappucino, in other words, probably offset any benefits the coffee inside may convey.  “With this in mind, black coffee would be the preferred choice,” says Cornelis.

Reference:   Diabetes Forecast Magazine  July/August 2106  Author: Andrew Curry

Subject:  Marilyn Cornelis, PhD, Nutritionist, Northwestern University Feinberg School of Medicine, Epidemiology,  ADA Research Funding : Junior Faculty




CHECK IT OUT!  Ingredients in yogurts can differ significantly.

Choosing a healthful yogurt is not very straightforward with the seemingly endless options at the supermarket.  Many are laden with excess sugars and other undesirable ingredients.  Here’s what to watch out for, according to the experts at the UC Berkeley Wellness Letter:

SPOONFULS OF SUGAR Yogurt naturally contains the milk sugar lactose, but many have added sweeteners.  A single 6-ounce serving of sweetened yogurt has about 18 grams of added sugar- more than 4 teaspoons- making it a big source of empty calories.

THE FAT FACTS Low-fat and nonfat yogurts have less fat, but they aren’t necessarily lower in sugar.  In fact, some have as many calories as full-fat yogurts due to added sugars.

BOTTOM LINE Look for labels with a short list of ingredients.  Milk and live cultures are all you really need.  Add your own fruit or a touch of honey, maple syrup or other sweetener to plain yogurt to cut sugar.

reference:  THE DIABETES FOCUS MAGAZINE   pg.6, summer 2016



Next time you feel a whopping headache coming on, slather on a little mint-infused menthol gel across the back of your neck, behind your ears, and on your forehead.  The trick worked wonders for migraine sufferers in a study at Thomas Jefferson University: 52 percent said their symptoms improved within two hours, and 28 percent reported that their headaches vanished.  “Even topically, menthol appears to stimulate nerves that communicate with the brain to ease pain,” explains study author Stephen Silberstein, Ph.D.  The researchers used a 6 percent menthol gel called Stopain ($6,


Reference:  Shape Magazine pg. 30  3/2016