Women's Bodies, Women's Wisdom (152 page)

H
IGH- AND
L
OW-GLYCEMIC
-I
NDEX
F
OODS

The following foods are generally regarded as high-glycemic-index (high GI) or low-glycemic-index (low GI) foods, but be aware that these are just general guidelines. How a food is prepared makes a big difference. For instance, sweet potatoes are low GI, but candied sweet potatoes are certainly not! And while pasta is low GI because it’s harder to digest than most flour products, overcooked pasta has a much higher GI than aldente pasta. Also, adding lemon juice, lime juice, or vinegar lowers the GI of a dish, giving potato salad a lower GI than a baked potato.

There’s variation among categories, too. Most breads (including the more processed whole-wheat breads) are high GI, for example. But sourdough and pumpernickel breads (because of their acidity) and whole-wheat breads with a dense and grainy texture are low GI. There can even be variation among the foods in a more specific category, such as bran cereal. All-Bran, for instance, is low GI, while the same manufacturer’s bran flakes are high GI.

Jennie Brand-Miller, Ph.D., of the University of Sydney, one of the world’s leading authorities on the glycemic index, says you don’t have to avoid high-glycemic-index foods altogether; instead, plan around them. It’s fine to have a high GI food on your dinner menu, for example, as long as the other foods you serve are low GI. The net effect will be a low-glycemic-index meal.

For more information on the glycemic index (including a database of foods and their GI values), visit
www.glycemicindex.com
, a website maintained by the GI Group of the University of Sydney in Australia. Also see any of the numerous books written or cowritten by Dr. Brand-Miller, including
The New Glucose Revolution: The
Authoritative Guide to the Glycemic Index
(Marlowe, 2007),
The
New Glucose Revolution: Low GI Eating Made Easy
(Marlowe, 2005), and
The Low GI Diet Cookbook
(Marlowe, 2005), to name just a few.

Stages of Insulin Resistance
1. Glycemic stress.
Eating too many foods with a high glycemic load leads to blood vessel inflammation. Many individuals at this stage actually experience hypoglycemia, in which their blood sugar be comes too low after a high-GI meal. This is particularly likely after eating a high-GI meal combined with caffeine (the standard American breakfast of a doughnut or bagel and cup of coffee).

SIGNS OF INSULIN ABUSE AND EARLY GLYCEMIC STRESS

Carbohydrate cravings and uncontrollable hunger (the munchies)

Emotional eating

Nighttime eating

Slowly expanding waistline

Increasing resistance to weight loss

Fatigue and possibly shaky weakness following a meal

2. Beginning of insulin resistance.
Beta cells of the pancreas are stimulated to produce more insulin to get it across the thickened blood vessel walls and into the cells to store the excess sugar. High insulin levels result in high triglycerides, abnormal estrogen metabolism, low HDL cholesterol, high blood sugar, cardio vascular disease, and increased risk of diabetes. Once insulin levels are raised, a chain reaction is triggered that results in so many metabolic changes, it can’t be stopped without significant lifestyle changes. (When I was a macrobiotic vegetarian—and also eating too much bread—my HDL cholesterol was a dangerous 35. I was only thirty-two years old. Now it is at a healthy 70!) Muscles are the first place to become insulin resistant. Once they do, blood sugar gets redirected to your fat cells, primarily in your abdomen. That means that when you eat a high-GI meal, it goes right to your tummy and seems to bypass your muscles entirely! (Over time, skeletal muscles also become marbled with fat.) This is the stage at which you and your doctor should be looking for signs of insulin resistance (high triglycerides and low HDL are often the first signs of glycemic stress and early insulin resistance). The sooner you change your diet, the better. You’ll then be able to reverse and prevent all kinds of problems, and also reach your normal weight.

SIGNS OF EARLY INSULIN RESISTANCE

Nighttime eating

Central weight gain (expanding waistline)

Slow weight gain without change in diet

Low HDL cholesterol

Increased triglycerides

Heartburn

Increased fatigue following a high-GI meal or snack

Menstrual irregularities

Hypoglycemia

Craving sugar and high-GI carbohydrates

Insomnia

3. Full-blown metabolic syndrome.
Inexorably, if diet and lifestyle aren’t changed, insulin resistance leads to full-blown metabolic syn drome in which high blood pressure, high cholesterol, obesity, in creased fibrinogen in the blood (a clotting factor), and a whole host of other problems results.

CONDITIONS RELATED TO INSULIN RESISTANCE
(SYNDROME X OR METABOLIC SYNDROME):

Type 2 diabetes

Increased levels of fibrinogen (increased blood clotting)

Central obesity (apple-shaped figure)

High blood pressure

Abnormal cholesterol levels

Sleep apnea

Cardiovascular disease, including stroke

Heavy menstrual periods

Most forms of polycystic ovary disease

Anovulation and fertility problems

Hirsutism

Male pattern baldness

Breast, colon, and other cancers

Depression

Dementia

Given the high prevalence of insulin abuse and glycemic stress, I can guarantee you that there’s no way you can learn to trust your body’s instincts around food until you go on a program that stabilizes your blood sugar and resets your metabolism. You simply have to eliminate all refined carbohydrates, eat low-glycemic-index carbs, and eat the right amount of protein, healthy fats, and micronutrients. This requires a significant reeducation for most people. Though there are many ways to do this (e.g., the South Beach Diet, Adele Puhn’s
Midlife Miracle Diet,
Dr. Mercola’s
No-Grain Diet,
Diana Schwarzbein’s
The Schwarzbein Principle,
etc.), I have personally found that the USANA five-day Reset program (see
www.usana.com
, and from the products menu, click on Diet & Energy, then on Diet, and then on Reset) is the easiest and most effective way for most women (not all) to decrease food cravings and reset their metabolism. The Reset program of pre-prepared shakes, pharmaceutical-grade vitamins and minerals, and nutrition bars supplemented with fruits and vegetables has been clinically proven to stabilize blood sugar and insulin levels, lower cholesterol, increase energy, decrease cravings, and promote weight loss (the average person usually loses about five pounds in five days—which results from a combination of fat and fluid loss so common when too-high insulin levels are reduced). Because the Reset program has been scientifically formulated to reset the body’s metabolism quickly and easily, it’s a very convenient and practical way for most people to experience what it feels like to have a normal metabolism with stable blood sugar. What is particularly remarkable is that the first fat to go is that which is around the abdomen, typically the most “stubborn” fat to get rid of. The reason for this, notes Dr. Strand, is that when you begin to reverse insulin resistance and glycemic stress, the body automatically starts to release its stored fat, particularly the fat around the abdomen that is so metabolically active and difficult to lose on conventional low-calorie and low-fat diets.

Once you’ve finished this five-day program, you’ll know what it feels like to be free of physical cravings and have stable blood sugar. (You may still desire the taste of chocolate, but you’ll be able to stop eating it after a few bites!) You may also notice that you sleep better and have a lot more energy. A wide variety of health problems improve considerably when you get your blood sugar and insulin under control. Resetting your metabolism puts you in a much better po sition to continue eating for health.

What to Eat

Your diet should consist of 80 percent low-glycemic-index fruits, vegetables and other foods and high-quality fats (see below and also box). Food should be sustainably or organically grown whenever possible. Some people can tolerate grains and other can’t. Eliminating ALL grains from the diet for one month or so can work wonders. Then add a few back and see how you do. Try to do something similar with other high-glycemic foods. Eliminate them entirely, then bring them back in small amounts and assess how you feel. Depending on your recovery from sugar addiction, you may or may not be able to tolerate some dessert now and then. I have personally found that I do best following a very low sugar diet, and that includes even sugar in fruits and vegetables.

G
LUTEN
I
NTOLERANCE

Approximately one in three people suffer from an intolerance to gluten, a protein found in grains, including oats, wheat, kamut, rye, and barley. Gluten, a staple of the American diet, is also found in wraps, breads, pasta, pizza, and rolls. About one in a hundred individuals have full-blown celiac disease (an autoimmune disorder of the small intestine characterized by an inability to digest gluten), which is conventionally diagnosed with an intestinal biopsy (for years, the only way to positively diagnose celiac disease and gluten intolerance). The vast majority of people with gluten intolerance don’t even know they have it.

Yet, a recent large study found that people with diagnosed, un- diagnosed, and “latent” celiac disease or gluten sensitivity have a higher risk of death, mostly from heart disease and cancer.
¹⁴
This study, which followed 30,000 patients from 1969 to 2008, found that there was a 39 percent increased risk of death in those with celiac disease, a 72 percent increased risk of death in those with gut inflammation related to gluten, and a 35 percent increased risk of death even in those who were sensitive to gluten but did not have a positive intestinal biopsy indicating celiac disease.

Gluten sensitivity masquerades as a host of other disorders including osteoporosis, constipation, inflammatory bowel disease, anemia, cancer, fatigue, canker sores, rheumatoid arthritis and most other autoimmune disorders, migraines, and even anxiety and depression.
¹⁵
According to functional medicine authority Mark Hyman, M.D., one the reasons gluten intolerance is more common now than ever before is that American strains of wheat have a much higher gluten content that those traditionally found in Europe because high-gluten wheats are needed to make the fluffy white bread and giant bagels that are so popular here.
¹⁶

The best way to test for gluten sensitivity is to eliminate all gluten from your diet for two to four weeks and then reintroduce it. But since it’s hidden in soups, salad dressings, sauces, and many other foods, you have to be knowledgeable about what foods contain it. (For a complete list of gluten-containing foods, go to
www.celiac.com
.)

Gluten sensitivity can also be diagnosed by a blood test that looks for specific anti-gluten antibodies. Such tests are available through Quest Diagnostics (see
www.questdiagnostics.com
) or Lab-Corp (see
www.labcorp.com
). Quite frankly, it’s far more practical to simply eliminate gluten from your diet and see how you feel. I also recommend the book
The No-Grain Diet
(Dutton, 2003) by Joseph Mercola, D.O.