1. Glycemic Index

2. Not All Carbs are Created Equal Cola and chips snack vs. Raisins and peanuts (Equal calories from sugar) (Equal calories from sugar) 75% more insulin mobilized over two hours (p<.001) Oettle GJ et al. Am J Clin Nutr 1987; 45:86 Oettle GJ et al. Am J Clin Nutr 1987; 45:86

4. The Overshoot

5. Short Term Benefits of Eating Low GI Decrease hunger, urge to snackDecrease hunger, urge to snack Decrease mood swings and fatigue related to swings in blood sugarDecrease mood swings and fatigue related to swings in blood sugar Assist weight lossAssist weight loss

6. Glycemic Index and Snacking High-GI breakfast (instant oatmeal) vs. Low-GI breakfast (eggs, fruit) equal calories 81% more snacking in next 5 hours Ludwig DS et al. Pediatrics 1999; 103:E26

12. Glycemic Index and School Performance

13. All-Bran vs. Coco Pops 35g 35 g 35g 35 g Appetite 49(1):240-244 2007 KcalPro- tein CHOFatFiberGI All Bran984.916.11.69.542 Coco pops 1331.629.80.90.777

14. Persistence with Frustrating Task Kids age 6-7 Also imp verbal memory, fewer lapses in attention Physiology & Behavior 92(4):717-724, 2007 High, Medium, or Low GL breakfast High: 39 cornflakes, waffle Medium: 14.8 scrambled egg, toast and jam, yogurt Low: 5.9 Ham, cheese, Burgen bread (soy, flax)

15. Long-term Benefits Decrease risk of getting diabetesDecrease risk of getting diabetes Decrease blood sugar in diabeticsDecrease blood sugar in diabetics Decrease breast and colon cancer riskDecrease breast and colon cancer risk Increase HDL (good cholesterol)Increase HDL (good cholesterol) Decrease CRP (inflammation)Decrease CRP (inflammation) Probably decrease hypertension and cardiac events (Stop-NIDDM Trial)Probably decrease hypertension and cardiac events (Stop-NIDDM Trial)

24. What Affects Glycemic Index/Load Eating Pattern (Nibbling vs. Meals)Eating Pattern (Nibbling vs. Meals) Food Composition and PreparationFood Composition and Preparation

25. Sipping Sipping

26. Bolus vs. Grazing

27. Nibbling vs. 3 Meals

28. What Affects Glycemic Index/Load Eating Pattern (Nibbling vs. Meals)Eating Pattern (Nibbling vs. Meals) Food Composition and PreparationFood Composition and Preparation

29. Glycemic Index – What Makes it High or Low? Think Primitive! Think Primitive!

30. “Whole wheat flour” ≠ Whole grain Surface area exposed to enzymes will raise the GI (i.e. grinding flour) Lack of fat, protein, fiber will raise the GI

31. Blood Glucose Increments After Spaghetti vs. Bread

32. Glycemic Load Some High-GI foods have so little carbohydrate in an average serving, their impact will be low.Some High-GI foods have so little carbohydrate in an average serving, their impact will be low. Examples includeExamples include –Watermelon –Popcorn

33. Glycemic Index vs Glycemic Load Carrots GI 47Spaghetti noodles GI 44 40g carb – 6 2/3 cups carrots40g carb = 1 C cooked noodles 1 cup carrots (1 large carrot) 1 Cup Spaghetti Glycemic Load 3 Glycemic Load 18

34. Summary of Benefits Low glycemic index diets – –Slow absorption – –Protective for a number of chronic diseases – –Assist weight loss

35. Resources for Patients http://mendosa.com/gi.htmhttp://mendosa.com/gi.htmhttp://mendosa.com/gi.htm The GI Diet by Rick GallupThe GI Diet by Rick Gallup

36. Bonus: some slides I use to explain glycemic index and load to lay people

37. Amylase Pancreas Enzymes Insulin

38. Amylase Pancreas Enzymes Insulin

39. Amylase Pancreas Enzymes Insulin

40. Amylase Pancreas Enzymes Insulin

41. Amylase Pancreas Enzymes Insulin

42. Amylase Pancreas Enzymes Insulin

43. Amylase Pancreas Enzymes Insulin

44. Amylase Pancreas Enzymes Insulin

45. The Great Fake-out... Amylase Pancreas Enzymes Insulin

46. Glycemic Index vs Glycemic Load Carrots GI 47Spaghetti noodles GI 44 40g carb – 6 2/3 cups carrots40g carb = 1 C cooked noodles 1 cup carrots (1 large carrot) 1 Cup Spaghetti Glycemic Load 3 Glycemic Load 18