Glycemic Index for WLS 2

How To Use Food Choices & Glycemic Index for WLS Success

June 6, 2018

Have you ever noticed that some foods, meals, or snacks leave you feeling fuller longer, while others leave you feeling hungrier than before you ate the food?  You may be aware of some of the reasons for the difference in satiety, the size of the meal or snack, nutrient composition-protein versus fat versus carbohydrate; but digging a little deeper, you may find that foods with a higher Glycemic Index, may actually make you feel hungrier after eating them!

Different food choices affect how you feel in a number of different ways: some foods (those high in protein, fat, or higher in fiber) may leave you feeling fuller longer because they take longer to digest than other foods.  Sometimes your craving and your food choice just don’t “match up”, leaving you feeling less than satisfied.

For example, if you were craving something salty and you tried to satisfy that craving with something sweet, you may still have the desire to eat something salty. Other foods show up in your bloodstream as glucose faster, possibly causing a spike in insulin production and release and a subsequent lower blood sugar (crash!).  These foods that tend to show up in your bloodstream faster often have a high Glycemic Index.

What is the Glycemic Index?

The Glycemic Index (GI) is a number assigned to a food that defines how fast the carbohydrates from the food show up in your bloodstream as glucose in the time after you eat.

Foods are compared to a standard, which is a 50-gram dose (3 Tablespoons) of pure oral glucose. The standard has a rating of 100. The test food is rated based on the percent a 50-gram dose of the food raises blood sugar compared to the oral glucose. A food with a low Glycemic Index would have a number from 1 to 55, moderate GI would have a number from 56 to 69, and high GI would have a number from 70 and above. For example, brown rice raises blood sugar 55 percent as much as glucose, so the Glycemic Index for brown rice is 55.

What are the Limitations of the Glycemic Index?

The Glycemic Index of a food should not be the only factor to consider when choosing a food. Certain limitations in the way the Glycemic Index is calculated may encourage you to avoid foods that are healthy for you and have little to no effect on blood sugar even though the Glycemic Index is higher.

Factors that affect the absorption of a food, things like fiber, acidity, how much a food is processed or cooked, whether it is eaten with another food, and portion size required to deliver the 50-gram dose for the test, will all affect the Glycemic Index of a food.

Carrots, for example, have a high Glycemic Index, mostly because about a pound and a half of carrots are required to produce a 50-gram dose of carbohydrate. Carrots are rarely eaten in that large of an amount. The health benefits of carrots are undeniable, so avoiding them would not be beneficial to weight loss or good health.

The Glycemic Index gives useful information, but should not be the only standard by which a food is chosen.  Another system was developed that uses Glycemic Index, but takes into account the number of carbohydrates in a serving. This system is called Glycemic Load.  A low Glycemic Load is less than 10, moderate is 11 to 19, and high is 20 or above.

The Glycemic Load of carrots, to use a previous example, is low. Lists of foods and their Glycemic Index and Glycemic Load are readily available online and in print.

glycemic index

Can the Glycemic Index/Glycemic Load be Used for WLS?

Having an idea of how a food is going to make you feel after you eat it is a great way to make food choices that will be sure to keep you feeling healthy and satisfied all day. Limiting your intake of high Glycemic Index and especially Glycemic Load foods may help to keep your blood sugar and insulin levels in a more steady state.

Limiting these foods may help you to avoid those blood sugar highs and subsequent lows that come with eating high Glycemic Index foods (even if you do not have diabetes).

A good rule of thumb is to fill half of your plate with low Glycemic Load vegetables-foods like broccoli, cabbage, kale, green beans, and all leafy greens, one quarter of your plate with a good source of protein, and one quarter of your plate with a low Glycemic Index carbohydrate source foods like barley, quinoa, couscous, or even sweet potatoes!

Your weight loss surgery will help you to not feel as hungry and to feel full faster, so maximize those benefits by choosing foods that will not only improve your health but keep you feeling satisfied longer!

ABOUT THE AUTHOR

Nikhilesh Sekhar MD, FACS, FASMBS currently practices at New York Bariatric Group and has performed hundreds of bariatric procedures including Laparoscopic Gastric Bypass, Laparoscopic Sleeve Gastrectomy and Laparoscopic Adjustable Gastric Banding. He also has background performing laparoscopic Nissen for reflux, laparoscopic inguinal and ventral hernia repair, laparoscopic colectomy and laparoscopic lymphadenectomy.

Read more articles from Dr. Sekhar