Blood Sugar Control

In the first of a series of articles nutritionist Matt Lovell will be taking you through the process
of becoming diet and supplement aware. This first article explores the relationship between
carbohydrate and insulin. Its fairly detailed reading but the messages are really important to
athletes, so concentrate
Blood Energy
!ever before have there been as many low fat or fat free products available and yet "estern
society is more obese than ever. Much of this has to do with people not understanding the
link between carbohydrate and insulin, and how these two things relate to body composition.
#re$uently very fit and talented athletes struggle with poor body composition due to
misinformation about carbohydrate consumption.
History of sporting activity and the obsession with carbs.
The aim of the competitive athlete is to win. There is an ever%increasing amount of research
being produced that if correctly applied may improve your chances of winning. Looks like
good news. &onse$uently, athletes seem to have to spend an ever%increasing amount of
their time sieving through this information in an attempt to identify a gem that may give them
the edge. 'lternatively, they take advice from more accessible sources like the media articles.
(ere nutritional generalisations seem to have passed on like folklore. It is perhaps not
surprising then that there is a problem. The research that is conducted is usually very
specific. )pecific to the sport or activity being studied. 'll too often these specific results
have become generalised to *all athletes+ and for *all sports+ and herein lies the problem.
Much of the early sports research focussed on the nutritional re$uirements for endurance
events. "hat has been clearly established is that when competing in endurance events,
especially those lasting for more than ,- minutes, carbohydrates limit performance.
.ndurance athletes who are effectively able to carbohydrate load before an event, consume
carbs during the event and ade$uately replenish the bodys stores /muscle and liver
glycogen0 after an event, will maximise their performance. The timing, type and $uantity of
the carbohydrate are also all important factors.
This has led to an 1obsession with carbohydrates which has spilled over into other sports
almost without exception. This misapplication of knowledge can lead to a reduction in
performance. The performance of many power%based sporting activities may suffer, as both
protein and essential fat intake have been seen to assume less importance in the athletes
diet. Many athletes added insult to in2ury by adopting the general changes that are seen to be
occurring in the rest of society where an increasing proportion of calories are being consumed
from refined carbohydrates especially due to low%fat foods that contain many hidden sugars.
More on this later in the article.
' diet that is high in sugar and refined carbohydrates will lead to an increase in body fat. 'fter
eating, the gut breaks down carbohydrates into glucose, the glucose is absorbed from the gut
and it is burnt for energy or stored. If the carbs you eat re$uire little digestion, glucose
becomes rapidly available in the gut and is absorbed $uickly.
&arbohydrates are measured in their ability to raise blood glucose levels through a variety of
methods3
4lycemic Index
4lycemic load
Insulin Index
)atiety Index
#or a full list of foods by 4I and 4L go to3 http566www.mendosa.com6gilists.htm
Individual tolerance for carbohydrates varies, something often termed insulin sensitivity. (ave
a read through the $uestions and answers below to get an indication whether you are
someone who struggles with processing higher levels of carbohydrates. If you think you might
be and want to take things further, your 47 can arrange for you to do an insulin sensitivity test
or glucose tolerance and insulin profile blood test.
.ven if you are someone who does not suffer from the symptoms listed you may do well to
become carbohydrate aware and 1clean up on refined carbohydrates.
What happens when you eat carbohydrates? The insulin response.
The level of glucose in the blood is controlled by insulin. Insulin acts to ensure that blood
glucose levels do not rise above the normal range. It moves glucose from the blood into cells.
The faster blood glucose rises the more insulin is produced.
What are the consequences of too uch or the wrong type of carbohydrate?
The simple conse$uence of excess or inappropriate calorie intake from any source,
carbohydrate, protein or fat will be their conversion into body fat. Most athletes are acutely
aware that *fats+ are best avoided and typically aim for a *low%fat+ diet. "hilst reducing their
saturated fat intake is a good thing, athletes not uncommonly reduce their essential fat intake
and inadvertently further increase their intake of refined carbohydrates. This is because when
food manufacturers remove the fat from food, to ensure they remain palatable, they add
additional sugars and salt to replace the lost taste.
8eduction in essential fat intake, in particular omega 9 intake can lead to insulin resistance
over time.
Hypoglyceia Hyperglyceia
!ow glucose levels High glucose levels
Irritability :"ired:
#orgetfulness ;igestive problems
(eadaches
7alpitations
#atigue
7oor concentration
;ifficulty in losing weight
What "oes Wrong?
7oor blood glucose control occurs for a number of reasons. The most common and most
important reasons are consumption of rapidly absorbed sugars, over stimulation of the
pancreas and nutrient deficiencies, which reduce the impact of insulin in the body.
#nsulin$ the horone that can both help and hinder an athlete
<lood glucose levels rise after eating and insulin is released from the pancreas to control this
with the aim of maintaining stable blood glucose within the normal range. =utside this normal
range our bodies, and particularly our brains, do not function very well. "e become confused,
disorientated even unconscious. Insulin is the only hormone for storage and a failure of the
body to produce it in ade$uate amounts leads to diabetes.
The more rapid the rise in blood sugar the more insulin is re$uired to control this rise. Insulin,
as the hormone of storage, takes glucose from the blood and stores it away. The help that
this offers athletes is that insulin will assist the replacement of used muscle or liver glycogen
consumed during training or competing, but once the bodys glucose stores are replenished
any excess would be converted and stored as fat.
&arbohydrates that have a high glycemic index and glycemic load and that produce a very
large insulin response will, particularly when consumed away from exercise, be more readily
converted to fat. The reduction of fat consumption and the movement from an intake of
complex to refined carbohydrate sources seen in western societies has been paralleled by the
increase in obesity in these populations. 'thletes are no exception to the human race #rom
a performance perspective if sugar is converted to fat, body composition will be adversely
affected. )imilarly if inade$uate storage is achieved in muscle and liver cells /as glycogen0
the energy stores available for the next exercise session will be reduced and so will your
performance.
"hat we are increasingly seeing clinically are power%based athletes who have adopted the
dietary re$uirements of endurance athletes. 's a conse$uence they typically consume >-?
or more of their entire calorie intake from carbohydrate and increasingly from highly refined
sources. "hilst their endurance counterparts struggle to keep up their carbohydrate intake to
match their calorific re$uirements the power%based athletes are presenting with a host of
symptoms including an inability to reduce high body fats, failure to gain additional lean body
mass despite dedicated training, poor concentration and susceptibility to infection.
Top tips to anage fat%
Match your energy input /food you eat0 with energy output /energy you burn0, this is
achieved by portion control and increasing physical activity and exercise. 8educing food
intake instead will lead to muscle loss instead of fat loss.
&hoose foods that will break down slowly so the body can burn it rather than have to
store calories as fat. #oods that are absorbed slowly also have the added advantage of
making you feel full and decreasing appetite.
.at carbohydrates in expectation of activity. ;o not eat large volumes of carbohydrates
before bed when re$uirements are low.
.at fast release carbohydrates only following exercise to replenish lost energy
The 4lycemic Index /4I0 and glycemic load /4L0 are the keys to this way of eating. The 4I is
a number that is given to carbohydrate foods to show how fast blood glucose will rise when
they are eaten. To keep things simple, sugar we put in our tea /sucrose0 has the top 4I value
of @--. 'll other foods are rated against this, and lower numbers are foods that tend to be
better for you. 4I is only relevant to carbohydrates. The higher the 4I the more disruption to
blood glucose is caused. The lower the 4I the slower the food is broken down. "e can
therefore use the 4I and 4L as a guide to which carbohydrate foods one should eat, and
when they should be eaten.
To better understand the relationship between blood glucose and insulin, glycemic load is
probably more realistic than glycemic index. #or instance, an average consumed portion of
carrots has very little glycemic load /and is very good for you0 this type of carb might have
been avoided if the 4I had been taken at face value /,A0. To achieve a 4I of ,A almost a kilo
of carrots needed to be consumed
In summary 4I is the effect B-g of that carbohydrate has on blood glucose levels and 4L is
the effect a standard portion of that food might have on blood glucose levels.
There are five factors that effect blood glucose levels after a meal3
The 4I and 4L of the carbohydrate
The volume of the carbohydrate
The presence of protein in the meal, which slows down the rate at which carbohydrate is
digested.
The fibre content of the food /slows down absorption of the glucose0
The fat content of the meal /fat slows the absorption of the glucose0
The effect of a meal on blood glucose will be less when the meal includes protein, unrefined
carbohydrate, essential fats and fibre. This is a 1mixed or balanced meal. #or this reason we
recommend that protein should be included in all meals and snacks. "e also advise that
meals that are high in carbohydrate should be eaten earlier in the day when activity is
greatest and energy re$uirements are high. =r eaten following exercise.
Cou will see from your list that carbohydrate foods are ranked as high or low 4I or 4L Try to
choose most food from the low 4I list. The 4I only gives information about glucose, it should
be used as a tool in combination with all you know from your own personal diet and training
diary. ' low 4I food does not always mean that it is the healthiest choice, as it may contain
fats and sugars other than glucose /fructose0.
The insulin index provides further information as to the effects these carbohydrates have on
insulin levels. Cou can use this and more importantly your own records of energy levels and
food consumption to recognise foods which may cause peaks and troughs.
What &ou Can 'o ( "eneral "uidelines
@ )void all processed carbs including all confectionery, honey, sweetened yoghurts,
cereals, neat fruit 2uice and dried fruit. 8eplace refined carbohydrates /white bread,
potatoes, pasta, and white rice0 with unrefined carbs /whole grain bread, brown rice,
fibrous vegetables, beans, etc0.
A Eat sall frequent *i+ed, eals.
9 )lways eat brea-fast. )kipping breakfast results in low blood sugar for an extended
period of time, your symptoms will worsen and compensatory eating will often be
excessive, due to hunger.
D Watch for .hidden. sugar carefully. 8ead labels 'void those foods with modified corn
starches or syrups. These are the hidden refined sugars
B 'ilute all fruit /uice @5B with water.
E High 0ibre 0oods. Those vegetables growing above ground and whole grains tend to
have a good fibre content. #ibre slows the absorption of sugar from the gut, by
decreasing gastric emptying and glucose uptake. &ooking root vegetables /carrots and
potatoes0 alters their structure making the sugars more rapidly absorbed.
> #ncrease the inta-e of quality protein foods /i.e. fish, poultry, lean meats, vegetarian
proteins like tofu or tempeh0. 7rotein is very effective at controlling appetite and also
slows absorption of carbs when they are eaten together. 7rotein is also re$uired to build
lean muscle so it should appear in every meal.
F 'ecrease your inta-e of soft fruit /oranges, grapes, plums, bananas etc0 to @%A pieces
a day. ;ried fruit is particularly dense in sugars. #ruit should be @69 of your total
vegetables and fruit intake and you should aim for , portions each day, E veggies and 9
fruit.
The "lyceic #nde+ of 0oods
The foods with the greatest effect on blood sugar have the highest scores
H#"H
/BBG0
!1W
/-%BD0
H#"H
/BBG0
!1W
/-%BD0
Sugars Cereals
4lucose @-- 7uffed rice ,-
#ructose A- &ornflakes F-
(oney F> "eetabix >B
)ucrose /sugar0 B, &runchy nut cornflakes >A
)pecial H E,
LucoIade ,B )hredded "heat E>
Mars <ar EF Muesli EE
7orridge oats DF
0ruit 'll%<ran DA
"atermelon >A 2ulses
8aisins EF <aked beans DF
<ananas BB <utter beans 9E
'pricots B> &hick peas 9E
4rapes DD <lackeye beans 99
=ranges D- (aricot beans 9@
'pple 9E Hidney beans 9-
Lentils AB
Breads
#rench baguette ,B 'airy 2roducts
8ice cakes FA Cogurt 9E
"hite bread >E "hole milk 9D
8yvita E, )kimmed milk 9A
8ye bread EB
"hole wheat bread ED 3egetables 4coo-ed5
=at cakes BD 7arsnips ,F
"holegrain bread B@ &arrots ,A
7umpernickel D@ Mashed potato F-%,>
!ew potato >-
"rain 2roducts <eetroot ED
<rown rice pasta ,A 7eas B@
"hite rice >A Cam B@
<rown rice E- )weet potato DF
7astry B, )weetcorn DF
More 4I values can be found at www.mendosa.com.