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Merville C. Marshall, Jr., M.D., F.A.C.P., F.A.C.E Responds:
Merville C. Marshall Jr., MD, FACP, FACE, founder and president of the Endocrine Institute, in White Plains, New York, responds: The glycemic index ranks carbohydrate foods according to their effects on blood glucose levels. Here's how it works: After eating them, some carbs make blood glucose rise higher and faster than others do. For example, carbs that raise blood glucose the fastest, such as white bread and potatoes, rank high on the glycemic index (GI). Apples, whole wheat bread, and oatmeal have less dramatic effects on blood glucose, so they rank lower on the index.
Using the GI was intended to help patients with diabetes better control their blood glucose levels. But the usefulness of the GI has been called into question lately, and the American Diabetes Association does not recommend a low GI diet for people with diabetes. One reason is that the GI can change according to how food is cooked or processed, how long it's been stored, and even how ripe it is. Also, the GI depends on whether a food is eaten alone or as part of a complete meal.
For example, fat slows the digestion and absorption of glucose—so eating a food that contains both fat and carbs may have a lower GI than one containing just carbs. Bottom line: For people with or without diabetes, the key is portion control and eating only as many calories as your energy needs require. To learn more about specific foods and how they influence your blood glucose, check glucose levels with a glucometer before meals and one to two hours after meals.
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Merville C. Marshall, Jr.
M.D., F.A.C.P., F.A.C.E
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