Glycemic Index and Glycemic Load

Blood glucose (glycemic) response to “complex” carbohydrates has been found to vary considerably so a more accurate indicator of the relative glycemic response to dietary carbohydrates is the glycemic index.

Glycemic Index

In the past, carbohydrates were classified as simple or complex based on the number of simple sugars in the molecule. Carbohydrates composed of one or two simple sugars like fructose or sucrose (table sugar) were labeled simple, while starchy foods were labeled complex because starch is composed of long chains of the simple sugar, glucose. Advice to eat less simple and more complex carbohydrates was based on the assumption that consuming starchy foods would lead to smaller increases in blood glucose than sugary food. This assumption turned out to be too simplistic since the blood glucose (glycemic) response to “complex” carbohydrates has been found to vary considerably. A more accurate indicator of the relative glycemic response to dietary carbohydrates is the glycemic index.

Measuring the Glycemic Index of Foods

To determine the glycemic index of a food, volunteers are typically given a test food that provides 50 grams of carbohydrate and a control food (white bread or pure glucose) that provides the same amount of carbohydrate on different days. Blood samples for the determination of glucose are taken prior to eating and at regular intervals after eating over the next several hours. The changes in blood glucose over time are plotted as a curve. The glycemic index is calculated as the area under the glucose curve after the test food is eaten, divided by the corresponding area after the control food is eaten. The value is multiplied by 100 to represent a percentage of the control food. For example, a baked potato has a glycemic index of 76 relative to glucose and 108 relative to white bread, which means that the blood glucose response to the carbohydrate in a baked potato is 76% of the blood glucose response to the same amount of carbohydrate in pure glucose and 108% of the blood glucose response to the same amount of carbohydrate in white bread. In contrast, cooked brown rice has a glycemic index of 55 relative to glucose and 79 relative to white bread. In the traditional system of classifying carbohydrates, both brown rice and potato would be classified as complex carbohydrates despite the difference in their effects on blood glucose levels.

 Physiological Responses to High vs. Low Glycemic Index Foods

By definition, the consumption of high-glycemic index foods results in higher and more rapid increases in blood glucose levels than the consumption of low-glycemic index foods. Rapid increases in blood glucose are potent signals to the beta-cells of the pancreas to increase insulin secretion. Over the next few hours, the high insulin levels induced by consumption of high-glycemic index foods may cause a sharp decrease in blood glucose levels (hypoglycemia). In contrast, the consumption of low-glycemic index foods results in lower but more sustained increases in blood glucose and lower insulin demands on pancreatic beta-cells.

 Glycemic Load

The glycemic index compares the potential of foods containing the same amount of carbohydrate to raise blood glucose. However, the amount of carbohydrate consumed also affects blood glucose levels and insulin responses. The glycemic load of a food is calculated by multiplying the glycemic index by the amount of carbohydrate in grams provided by a food and dividing the total by 100. In essence, each unit of the glycemic load represents the equivalent blood glucose-raising effect of 1 gram of pure glucose or white bread. Dietary glycemic load is the sum of the glycemic loads for all foods consumed in the diet. The concept of glycemic load was developed by scientists to simultaneously describe the quality (glycemic index) and quantity of carbohydrate in a meal or diet.

Disease Prevention

Type 2 Diabetes Mellitus

After a high-glycemic load meal, blood glucose levels rise more rapidly and insulin demand is greater than after a low-glycemic load meal. High blood glucose levels and excessive insulin secretion are thought to contribute to the loss of the insulin-secreting function of the pancreatic beta-cells that leads to irreversible diabetes. High dietary glycemic loads have been associated with an increased risk of developing type 2 diabetes mellitus (DM) in several large prospective studies. In the Nurses’ Health Study (NHS), women with the highest dietary glycemic loads were 37% more likely to develop type 2 DM over the next 6 years than women with the lowest dietary glycemic loads. Additionally, women with high-glycemic load diets that were low in cereal fiber were more than twice as likely to develop type 2 DM than women with low-glycemic load diets that were high in cereal fiber. The results of the Health Professionals Follow-up Study (HPFS), which followed male health professionals over 6 years were similar. In the NHS II study, a prospective study of younger and middle-aged women, those who consumed foods with the highest glycemic index values and the least cereal fiber were also at significantly higher risk of developing type 2 DM over the next 8 years. The foods that were most consistently associated with increased risk of Type 2 DM in the NHS and HPFS cohorts were potatoes (cooked or French-fried), white rice, white bread and carbonated beverages.

 Cardiovascular Disease

Impaired glucose tolerance and insulin resistance are known to be risk factors for cardiovascular disease as well as type 2 DM. In addition to increased blood glucose and insulin concentrations, high dietary glycemic loads are associated with increased serum triglyceride concentrations and decreased HDL cholesterol concentrations, both cardiovascular disease risk factors. High dietary glycemic loads have also been associated with increased serum levels of C-reactive protein (CRP), a marker of systemic inflammation that is also a sensitive predictor of cardiovascular disease risk. In the NHS cohort, women with the highest dietary glycemic loads had a risk of developing coronary heart disease (CHD) over the next 10 years that was almost twice as high as those with the lowest dietary glycemic loads. The relationship between dietary glycemic load and CHD risk was more pronounced in overweight women, suggesting that people who are insulin resistant may be most susceptible to the adverse cardiovascular effects of high dietary glycemic loads.


In the first two hours after a meal, blood glucose and insulin levels rise higher after a high-glycemic load meal than they do after a low-glycemic load meal containing equal calories. However, in response to the excess insulin secretion, blood glucose levels drop lower over the next few hours after a high-glycemic load meal than they do after a low-glycemic load meal. This may explain why 15 out of 16 published studies found that the consumption of low-glycemic index foods delayed the return of hunger, decreased subsequent food intake, and increased satiety (feeling full) when compared to high-glycemic index foods. The results of several small short-term trials (1-4 months) suggest that low-glycemic load diets result in significantly more weight or fat loss than high-glycemic load diets. Although long-term randomized controlled trials of low-glycemic load diets in the treatment of obesity are lacking, the results of short-term studies on appetite regulation and weight loss suggest that low glycemic-load diets may be useful in promoting long-term weight loss and decreasing the prevalence of obesity.


Evidence that high overall dietary glycemic index or high dietary glycemic loads are related to cancer risk is somewhat inconsistent. Prospective cohort studies in the US and Denmark found no association between overall dietary glycemic index or dietary glycemic load and breast cancer risk. In contrast, a prospective cohort study in Canada found that postmenopausal but not premenopausal women with high overall dietary glycemic index values were at increased risk of breast cancer, particularly those who reported no vigorous physical activity, while a prospective study in the US found that premenopausal but not postmenopausal women with high overall dietary glycemic index values and low levels of physical activity were at increased risk of breast cancer. Higher dietary glycemic loads were associated with moderately increased risk of colorectal cancer in a prospective study of US men, but no association between dietary glycemic load and colorectal cancer risk was observed in a prospective study of US women. In contrast, another prospective cohort study of US women found that higher dietary glycemic loads were associated with increased risk of colorectal cancer. Although there is some evidence that hyperinsulinemia (elevated serum insulin levels) may promote the growth of some types of cancer, more research is needed to determine the effects of dietary glycemic load and/or glycemic index on cancer risk.

Disease Treatment

Diabetes Mellitus

Low-glycemic index diets appear to improve the overall blood glucose control in people with type 1 and type 2 diabetes mellitus (DM). A meta-analysis of 14 randomized controlled trials that included 356 diabetic patients found that low-glycemic index diets improved short-term and long-term control of blood glucose levels, reflected by clinically significant decreases in fructosamine and hemoglobin A1C levels. Episodes of serious hypoglycemia are a significant problem in people with type 1 DM. In a study of 63 men and women with type 1 DM, those randomized to a high-fiber, low-glycemic index diet had significantly fewer episodes of hypoglycemia than those on a low-fiber, high-glycemic index diet.

 Lowering Dietary Glycemic Load

Some strategies for lowering dietary glycemic load include:

• Increasing the consumption of whole grains, nuts, legumes, fruits and nonstarchy vegetables
• Decreasing the consumption of starchy high-glycemic index foods like potatoes, white rice and white bread
• Decreasing the consumption of sugary foods like cookies, cakes, candy and soft-drinks

Brooklyn Launches Sugar Watchers Course

Launch of Sugar Watchers Weight Loss Course. How to control the fat-storing hormones with food and supplements.

Today is the day I’ve been planning and prepping for: the launch of my Sugar Watchers Weight Loss Course. After months of writing, organizing and researching, I’m very happy to make this announcement.

You can read more about Sugar Watchers HERE or see video to the right, but briefly here’s some highlights of the course:

  • Detailed description of nutrients – as people learn about blood sugar levels, weight loss and how to control the fat-storing hormones with food alone, supplements are suggested with thorough instructions on their use.
  • Charts, graphs, and extensive instructions and food lists – I’ve collected so many useful documents and illustrations over 15 years that I provide here, to give my students a clear picture of the process.
  • Online support – This is the one I’m most excited about! The Sugar Watchers Secret Facebook Group, an environment of sharing and getting healthy with others. I think this is the most powerful tool.

I’m aware that this may look like just another weight loss program but it’s not – it’s MY weight loss program and I’m doing it with my students! That’s why the secret Facebook group is so exciting – I get to participate fully and set the tone for sharing success. This is definitely NOT just another diet – I’m fully persuaded that blood sugar control through food and supplements is the best way to lose weight.

So today’s the day! I’ve posted my before picture taken 5 months ago (I’m about the same weight now just no tan). I’ll be making videos too so you’ll see me soon enough – watch me shrink, tan or no tan!

Thanks for visiting ~ Catch ya later





Brooklyn Meets 3 Weight Loss Goals

Hi – I’m Val Robitai. I’m from Brooklyn and that’s what they call me!

I have been on an incredible health journey that I share here, for people who want to lose weight, and feel better, more youthful. I mean it, this is no scam weight-loss program that leaves you feeling alone or frustrated due to lack of information or support. This is for people who need guidance to make a big change. If that’s you, if all you need is some daily support then I created this blog “fa yu” (when I say something like “fa yu,” sound it out and you can be from Brooklyn too!) I have so much to tell you about weight loss that you need to know if you’re going to be successful at it.

My weight loss journey began way back. My mother and all my friends’ mothers were always on a diet. They were probably all on the same diet since I can remember seeing the same Pepperidge Farm puny white diet bread at everyone’s house. The programs and diets of the day in Brooklyn included Richard Simmons’ Deal-A-Meal, Mike Hebranko’s OPIN (Overweight People in Need), OA (Overeaters Anonymous), and of course Weight Watchers. Gosh, I go as far back as doing jumping jacks with Jack LaLanne on TV in the 1960s (of course I was a very, very, very young girl 🙂  I joined gyms like Lucille Roberts, and another one on Avenue U that I can’t remember the name of. There were a few.

Being Italian and growing up in Brooklyn, I ate like Italian Brooklynites eat…ALOT. Food was love, food was beautiful, food and family gatherings were the mainstays of my childhood. I have many fond memories of events where the emphasis was on food, but food can also be painful.

Probably like many people reading this, food, eating, feeling unpopular because of weight, clothes not fitting, yadayadaya….can be very devastating to the soul. You may have your own pain around weight so I won’t go into detail with my story. No, I will only share with you my solutions.

So let’s “ttawk,” I’ll go make “cawfee.”

I got rid of my food cravings (I know, amazing)…once, I lost 35 lbs (changed my lifestyle) and kept the weight off effortlessly for a few years. But I haven’t been paying attention and the weight is back! It’s been creeping back  for awhile now and I just didn’t catch on, or I was in denial, until I finally got on a scale.

I’m no spring chicken and I don’t feel like I have to look gorgeous and perfect anymore, but I do care about my health. Being close to 60 requires some definite action on my part to feel well, think clearly and look my best.

So a few weeks back I started digging for ways to get myself back on track. I started writing right after I weighed myself for the first time in years. My initial goal was to write a 100+ page comprehensive weight loss course, which I did, but I have to admit I did it for myself. I knew I needed to get organized. I needed to pay attention again to the lifestyle principles of weight loss that work and aren’t so hard. I motivated myself to write the course. It was very important to me to undertake and complete this.

My next goal was to have a support group for people who want to lose weight. When I look back at the successes in anything in my life, but especially in losing weight, I can say with certainty that group support is a powerful tool. So I created a secret Facebook page where people can share their weight loss experiences with each other, their food plans, have ongoing interaction and daily inspiration. It’s not a therapy group, it’s a place for people to post their meal plans and photos, snatch recipes, and hear each other’s victories. Sharing and identifying with others makes us strong and capable, and makes our weight loss journey easier.

Finally, I created this blog because remember, I’m from Brooklyn, I love to “ttawk” and I love food! Recipes that don’t send my blood sugar through the roof is my calling! How to control insulin and cortisol, the two sugar hungry hormones, is my forte! I’m a sugar watcher, that’s what I do. From now on when people ask me how I lose weight, just to keep it simple I’ll say: I watch sugar.

Here’s what “a day in the life of a sugar watcher” looks like, and below is a lovely recipe I made for breakfast that you can save: