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Foods and Meals Effects on Blood Glucose

Part One

By Gary F. Zeolla

In the article Hypoglycemia: Diagnosis and Dietary Control, I discuss how I came to be diagnosed with hypoglycemia. I also discuss that the eating plan outlined in my book God-given Foods Eating Plan is ideal for controlling the blood sugar swings caused by hypoglycemia and most likely by diabetes as well. I also mentioned about getting a blood sugar monitor to test my responses to various foods and meals.

In this two-part article, I will summarize some of the things I've learned about the glycemic response of various foods and meals through this home testing. I'm hoping that by relating my experiences it will help the newly diagnosed hypoglycemic or diabetic get a handle on controlling your blood glucose.

For the most part, this home testing has confirmed what I wrote in my book, but there have been a few surprises.

Testing Method

I've found that my fasting blood glucose and my blood glucose levels two hours or more after eating are rather stable. But where wide variations exist is half an hour after eating and an hour after that. Specifically, at the half an hour mark, my blood glucose seems to peak, then after another hour it goes down to its lowest, then rises somewhat after that. So I generally test a meal at the half an hour and hour and half after eating times.

This is somewhat tedious, but most of all, expensive. I was given my blood glucose monitor by my doctor's office. Insurance will also often pay for one if your doctor prescribes it. But where the expense comes in is with buying the test strips. Insurance might pay for 100 per 30 days. But with using two test strips for each meal, I went through them much quicker than that, at least initially, so I had to purchase some myself. And they can run from $50 - $100 per 100.

However, I've found that my reaction to similar meals is generally rather stable, so once I test a particular meal, there's not much reason to test it again. As a result, I did a lot of testing the first couple of months after I was diagnosed. That gave me a good idea how I react to the different types of meals I generally eat. Now I only test a meal when I eat something different.

But it should also be noted that these home glucose monitors are not infallible. On occasions I will get readings that seem out of place with how the food or meal tested before or from what I expected. In such cases, I will retest the same meal later and discount the anomalous reading.

In my book, I discuss the glycemic index. It gives ratings for different foods based on how much they elevate blood glucose in a group of test subjects. My self-testing has confirmed for the most part the accuracy of published glycemic ratings lists, but not always. Some of my testing is at variance with the glycemic index. And most importantly, the glycemic index only give values for foods eaten in isolation, but that is not how I or most people eat. We generally consume foods in combination with other foods, and it is the reaction to that combination that matters.

For this article, I will use terms like low glycemic, low glycemic response, or low blood glucose response to refer to foods or meals that only cause a small rise then drop in blood glucose. The normal post-eating range is 70-120 mg/dl. But I have found that with my reactive hypoglycemia, it is best if the reading is less than 100 at the half an hour mark. If it goes higher than this, it will usually drop to below 70 an hour later. So by these terms, I am referring to a food or meal that peaks at less than 100 and stays above 70 at the low point.

I will use "moderate" with all of these terms if the food or meal causes a spike to 100-120 but stays above 70 at the low point. I will use "high" when it spikes above 120 and/ or drops below 70.

Basic Recommended Meal Pattern

The basic eating pattern I recommend in my book is to eat six times a day. And that does work to keep blood glucose on an even keel. My blood glucose does not fluctuate that much throughout the course of a day. It only rises and drops moderately after each small meal. But if I miss a meal and eat more at the next meal to "make up" for it, then I see a much greater rise in my blood sugar after that larger meal.

The basic meal design I recommend is for each meal to include a balance of carbs, protein, and fat, along with some low calorie veggies. This type of balanced meal does work to keep the blood glucose from rising and falling that much after eating. But if I eat mostly carbs, then I see a much greater blood sugar spike. I also state in my book that the consumption of low calorie vegetables will lessen the glycemic response, and that works as well.

So a basic meal that I often consume would be 3-5 ounces of some kind of meat, a high carb source like brown rice or potatoes, a vegetable like broccoli, and a salad with olive oil and vinegar. Note that by "meat" I am referring to red meat, poultry, or fish. If I eat a low-fat meat like chicken breast or cod, then I will usually eat a handful of nuts to provide some healthy fat.

It should also be mentioned that stress and lack of sleep can affect blood glucose levels. I mention the former in the "Diagnosis" article. The latter was reported as the results of a study on "Headline News" on January 1, 2008. So always take into account your stress and sleep levels when testing blood glucose.

Responses to Specific Foods and Meals

It is now time to look at my experience in testing different foods and meals.

Cold Cereals:

I discuss cold cereal versus oatmeal in my book and in the "Diagnosis" article. In them I state that cold cereal has a much higher glycemic response than oatmeal. In fact, eating cold cereal was one of the few things I had been doing on a regular basis that caused my blood sugar to spike too much. But if I had been more consistent with my God-given foods eating plan, I would not have been eating it in the first place. A basic principle of my book is to avoid highly processed foods, and cold cereals are very processed.

Most cold cereals will spike my blood sugar above 120, then it will crash to below 70. So they are definitely not a good food for hypoglycemics or diabetics.

However, there is couple of exceptions to this "rule" of cold cereals being high glycemic. The first would be wheat germ, yes, wheat germ. Not a cereal that many consumed, but it is a very healthy cereal and gives a low glycemic response.

Also giving a low response is granola, specifically, what I tested was Cascadian Farms' Oats ‘n Honey Granola. Another cereal with a low response is Barbara Bakery's Shredded Oats cereal.

Probably the reason these cereals are not high glycemic like most cereals is they are denser. Wheat germ is composed of small, heavy granules. The oats and other ingredients in granola are clumped together, due to the honey that is usually used. The Shredded Oats are small, hard squares. These textures are different from the light flakes and puffs that constitute most cereals.

But it should be noted that when I tried a couple of granolas that also contained "crispy rice," they produced a high glycemic response. So it would seem that the density of a cold cereal determines its glycemic response.

It should noted that all of these cereals were tested with my normal habit of adding fruit (usually berries or cherries) and nuts to the cereal, and using reconstituted protein powder rather than milk on the cereal.

Hot Cereals:

Hot cereals are generally less processed than cold cereals, so they would fit much better than cold cereals with my God-given foods easting plan. Oatmeal is the most popular hot cereal.

There are actually four different types:

Steel cut oats are whole oat groats that have been chopped into smaller pieces. Rolled oats are oat groats that have been steamed, rolled and flaked for easier cooking. Quick cooking oats are rolled oats that have been chopped into smaller pieces and "instant" oats are basically powdered oats. "Instant" oats do not produce a good bowl of oatmeal, instead forming more of a paste. For the oatmeal lover, steel cut are the only way to go. These pieces of oats take longer to cook than the other, precooked varieties, but they are worth it. The oatmeal is creamy and the oats are chewy. The texture is unlike any bowl of breakfast cereal you've ever had (Steel Cut Oats).

The reason for these varying levels of processing is to reduce the cooking times. Steel cut oats take about 40 minutes to cook on the stove top, rolled oats about five minutes, quick oats about 2-3 minutes, while instant oats are made by simply pouring in boiling water.

A basic principle I state in my book is that the more processed a food is, the higher its glycemic rating tends to be. And that holds true for oats, but only if you consider steel cut oats to be more processed than rolled oats (which are better known as old-fashioned oats). But that makes sense since the old-fashioned oats granules are processed from whole oat groats and thus are larger than the steel cut oat granules, which are cut up oat groats.

The steel cut oats and quick oats both produced low glycemic responses, spiking the blood sugar into the 90s then dropping it to the mid-70s. But the old-fashioned oats only spike the blood sugar into the mid-80s, and then it also drops into the mid-70s. So of the three, old-fashioned oats gives the lowest response. So that is my oatmeal of choice.

I usually cook up a batch on the stove-top (2 cups oats with 3 cuts water) and store it in the fridge. That gives me enough for several breakfasts. I then microwave what I need each morning. But I also keep some quick oats on hand in case I don't have any of the old-fashioned oats made up ahead of time.

I also tried some "Irish Style Oats." Like quick oats, they take two minutes to cook in the microwave, and the response was about the same as for quick oats.

However, it is a completely different story with instant oatmeal, especially if you're talking about the flavored, sugared kind that comes in a packet. I used one Apple-Cinnamon Instant Oatmeal packet for breakfast, and it caused my blood sugar to crash even more than with cold cereal. In fact, I got the lowest reading ever with that meal. So instant oatmeal, especially if it is pre-sweetened, is definitely not a good meal for hypoglycemics or diabetics.

For those who say they don't like plain oatmeal, you can try the same thing that I recommend in my book for yogurt. Put some frozen berries or cherries in a small dish the night before. Then in the morning, after you heat up the oatmeal, add in the fruit with the small amount of juice that will be present, along with some nuts. If you must, add some stevia for added sweetness. Then mix it all up. Add a cup of reconstituted protein powder, and that is my normal breakfast.

As for other hot cereals, I mention oat bran in my book, and I had been eating a version of oat bran that I purchased from the "bulk" section at Pittsburgh's East End Food Co-op. But I was very surprised when I discovered it was high glycemic. This is probably because it is highly processed, with the cereal being basically powder.

Similarly, a "Brown Rice Cream" I had been eating was also high glycemic, as was a "Barley Plus." Both are again basically powder. So it would seem that if a hot cereal is a powder, then it will be problematic.

One last hot cereal I eat is the Co-op's own "CVM Champ" cereal found in their bulk section. It is a multi-grain cereal. The cereal particles are about the same size as steel cut oats, so not surprisingly, it is low glycemic. I would guess that other multi-grain hot cereals with similar textures would be low glycemic as well.

Grains and Breads:

Related to cereals are whole grains. Brown rice is a difficult one to make a generalization on. Different types of rice will produce different glycemic responses. But generally speaking, short grain rice will have a higher response than long grain rice. What I have been eating is medium grain brown rice, again from the Co-op's bulk section. And it has a low response.

But something that surprised me was amaranth. It gave a very high response. This could be because the kernels are very small. I say this as buckwheat groats and spelt groats both produced a low response, and their kernels are rather large. Quinoa also gave a low response, and its kernels are only slightly smaller than the buckwheat and spelt groats. So as with hot cereals, the size of a grain's kernels could be a determining factor in its glycemic response.

In regards to breads, I generally consume Ezekiel sprouted grain products, including bread, buns, English muffins, pita bread, and tortilla shells. All of these have a low response. This is no surprise as wrappers for the bread are sometimes marked as being low glycemic. But Alvarado sprouted grain buns tend to spike my blood sugar. I'm not sure why the difference.

Buckwheat pancakes made from Arrowhead Mills' pancake mix gave an interesting response. Both times I tested them, my blood sugar went up to 100 after half an hour, but it only dropped a few points after an hour the first time and actually rose a few points the second time. This is different from the significant drop after an hour that I normally get. But still, all the readings are within the normal range.

Corn tacos and corn tortilla chips are also low glycemic, as long as they are eaten with meat, cheese, and veggies.

Also producing a low response was egg noodles, as part of a beef-vegetable-noodle soup. This was no surprise as noodles have a low glycemic rating, and the beef and veggies would further ensure the meal had a low response.

Similarly, lasagna produces a low response. This was true for both homemade lasagna made with ground meat and for store-bought frozen vegetable lasagna. Again, this is not surprising as any kind of pasta noodles are rated as being low glycemic.

Snacks:

I recommend dark chocolate in my book due to its high antioxidant levels. But when I ate half of a 3.5 ounce bar, it caused a large blood glucose spike then crash. But that was eaten alone as a snack. In my book I actually recommend eating only - 1 ounce a day, and eating that much after a meal as a small desert was not problematic.

I also recommend yogurt in my book, and it is listed as being very low glycemic. A specific way of eating it that I recommend is to thaw out some frozen berries in a bowl, and then to add the yogurt to give you the taste of store-bought fruit yogurts without all of the added sugar. I also will add stevia or sucralose to sweeten it, and maybe some nuts. The combination of yogurt, berries, and nuts is very low glycemic, despite being rather high in carbs.

Another snack I recommend is nuts and fruit. And again, that is low glycemic. I mention in my book that dried apricots are probably the healthiest dried fruit. And a combination of nuts and dried apricots is also low glycemic. However, raisins or dates cause a very high glycemic response.

Another snack I tried was whole wheat graham crackers and peanut butter. I ate three "sandwiches" (six 2" squares), and the glycemic response was moderate.

Ice Cream:

In my book, I do not speak too kindly about ice cream. This is because it is high in saturated fat, sugar, and often contains artificial ingredients (p.142). But then in the section on cheating, I state it would be acceptable to consume a "cheat food" once or twice a week, and I use ice cream as an example (pp. 237-238).

But I wish I had added that if you do eat ice cram, you should at least make it a little less unhealthy by using a "natural" brand that does not contain artificial ingredients, like Breyer's All Natural Ice Cream. This brand is also somewhat lower in saturated fat and sugar than some other brands, but it tastes great. So on the rare occasions I eat ice cream, I make it Breyer's.

That said, I tested the ice cream by eating a full cup of vanilla flavor, and it produced a moderate response, raising my blood sugar to 108 and then dripping to 88. This was not surprising since ice cram has a moderate glycemic rating.

Snack Bars:

In my book, I do not recommend snack bars. The reason I don't is because such bars generally contain artificial ingredients and lots of sugar, and soy is often the main or even only protein, which I also don't recommend for reason that are beyond this article.

In any case, I decided to try a few such bars for the purposes of this article. The first was a Balance Gold bar, "Chocolate/ Peanut Butter" flavor. The wrapper says it's a "Nutrition Energy Bar/ High Protein." It also claims it is "Low GI." And it truly was low glycemic. The same went for its "Caramel Nut Blast" flavor. This brand of bars also uses more casein and whey proteins than soy protein and natural rather than artificial flavorings, so they are a little better than most. But it should be noted the regular Balance bars have mostly soy. So be sure to get the "gold" variety.

Another bar was a Pay Day Pro: "High Protein Energy Bar." Somewhat surprising, its glycemic response was higher than the Balance bar. I say surprisingly as the main carb source is fructose, and fructose is low glycemic. But this is not to say that fructose is a healthy type of sugar. I detail in my book the problems with fructose, so I will not be getting this bar again. That's kind of sad as Pay Day bars were my favorite candy bars when I was a kid.

Another bar I tested was Kind Fruit + Nut: "Nut Delight." It is mostly mixed nuts with honey. And it gave a moderate response. The honey probably kept it form being a low response.

Another snack I tried was Kashi's "TLC bars." These are basically granola bars, with two bars in a pouch. I ate one pouch of the "Roasted Almond Crunch" flavor, and they gave a high glycemic response. This was surprising given that granola has a moderate response. But whatever the reason, granola bars are probably not a good thing for hypoglycemics and diabetics to eat.

Foods and Meals Effects on Blood Glucose. Copyright 2008 by Gary F. Zeolla.

This article is concluded at: Foods and Meals Effects on Blood Glucose - Part Two.

The above article first appeared in the free FitTips for One and All newsletter.
It was posted on this Web site July 1, 2008.

  Dealing with Health Difficulties

  Hypoglycemia, Diabetes, and the Glycemic Index

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