“Health is not about the weight you lose, but about the life that you gain” – Dr Axe
Unless you have been living under a rock for the last decade, you have probably been exposed to some level of Raw food hype, detox marketing or Juice cleansing advocates and read lots of conflicting advice, especially with regards to juice cleansing.
For short-term interventions, I believe that a raw vegan diet or a well-structured juice cleanse can offer miraculous benefits, especially when shifting from a standard Westernized diet but it is not for everyone and the program needs to be adapted, structured and supported extremely carefully for participants with certain health complications.
I think everyone can agree that any nutritional plan that encourages more “Real Whole Foods’ and a reduction of sugar and processed and packaged foods is something that everyone can benefit from. However, the quantity of fruits, dried fruits, natural sweeteners, syrups and starches used in the plan is something that can vary for each individual.
A teaspoon of raw manuka honey used as part of a dressing poured over a nutritious bed of high fibre vegetables or healthy salad is very different to a raw dessert that contains two cups of raw honey and half a cup of dates.
High verses Low Glycemic Load
If you have Diabetes or have been diagnosed with Candida overgrowth, Adrenal Issues, Thyroid Problems or Insulin Resistance, you probably know you need to carefully monitor your carbohydrate intake as advised by your nutritionist or health care provider.
Different types of carbohydrates and carbohydrate-containing foods affect blood sugar differently, and these effects can be quantified by measures known as the Glycemic Index and the Glycemic Load.
What is Glycemic Index (GI) and Glycemic Load (GL)?
The Glycemic Index (GI) assigns a numeric score (0-100) to a carbohydrate based on how drastically it makes your blood sugar rise. Pure Glucose is 100 on the scale and the lower a food’s Glycemic Index, the slower blood sugar rises after eating that food. As a general rule of thumb, the more refined, cooked or processed a food is, the higher its GI, and the more natural, whole, high fibre or fat in the food, the lower its GI.
Unfortunately, Glycemic Index (GI) alone doesn’t give us the full picture and can at times be misleading. A more accurate scale is the Glycemic Load (GL) because it helps us to understand how quickly it makes glucose enter the bloodstream and how much glucose it can deliver dependant on the total grams of carbohydrates in the food.
The Glycemic Load (GL) is determined by multiplying the grams of a carbohydrate in a serving by the Glycemic Index, then dividing by 100. A Glycemic Load of 10 or below is considered low; 10-20 is moderate, and 20 or above is considered high.
Watermelon has a high Glycemic Index (80), which might appear to be something that should be avoided. However, a serving of watermelon is majority water and has very little carbohydrate (6 grams), therefore its Glycemic Load is only 5, which makes it lower Glycemic overall.
Unfortunately, due to the popularity of the Glycemic Index (GI), many people started to avoid fruits fearing the high sugar content. In the majority of modern day diets, it is refined carbohydrates, processed foods and Sugar that are the real enemies. If someone is suffering with Insulin resistance or severe Candida Overgrowth, sometimes it can be beneficial to refrain from fruits for a short period of time but It is important to remind ourselves that fruit contains vitamins, minerals, antioxidants, phytonutrients, enzymes, fibre and water and the first thought regarding food should be it’s nutritional profile.
Low Glycemic Load (GL) fruits (Reference Harvard Medical School article: Measuring Carbohydrate effects can help Glucose management) include: Limes (GL-1), Strawberry (GL-1), Kiwi – (GL-2), Grapefruit (GL-3), Watermelon (GL-5), Blueberry – (GL-5), Apple – (GL-5), Pineapple – (GL-6), Oranges – (GL-5), Mango – (GL-8).
In addition to this, adding additional fibre or fat (e.g. freshly ground flax and chia seeds are jammed packed with fibre and healthy fats) alongside the fruit can bind up excess sugars, slow down absorption and further decrease the raise in blood sugar levels.
A better way to check your blood sugar response
Although Glycemic Load can be a useful marker for general guidelines, everyone is unique and the best way to check your individual blood sugar spike caused by any particular food is to purchase a simple glucometer and measure your blood sugar levels after eating. By doing this, you can personally check your own response to each individual food and hopefully be able to continue to consume nutritious low glycemic load fruits as part of your diet.
A glucometer is a very affordable device that measures blood sugar, they’re commonly used by diabetics. You simply prick your finger with a sterilized lancet, and then you apply the drop of blood to a “test strip” that has been inserted into the glucometer, and it measures your blood sugar.
Testing Blood Sugar
Test your fasting blood sugar first thing in the morning after fasting for at least 12 hours. Retest again before lunchtime. Eat your lunch. Do not eat anything for the next three hours afterwards but track your blood sugar one, two and three hours after eating.
A target would be to have fasting blood glucose < 86mg/dL and after one hour < 140mg/dL, after two hours < 120mg/dL and after three hours, it should have returned to your baseline. (Reference: Dr Chris Kresser – Functional Medicine Pioneer)
To convert mmol/L to mg/dL simply multiply by 18.0182.
This is a personalised approach which will allow you to identify what trigger foods are not currently compatible with you.
Include more Resistant Starch (The Glycemic Anomaly)
Resistant starch is a type of starch that resists digestion, reaching the colon intact. Thus, we do not see the same spikes in either blood glucose or insulin after eating Resistant Starch, and why we do not obtain significant calories from Resistant Starch.
One simple way to add resistant starch to your diet is by cooking and cooling potatoes as this causes some of their starch to convert into resistant starch taking them from a high glycemic to a lower glycemic food choice. Consuming a potato in a cold potato salad for example would help to reduce the carbohydrate load, reduce the glucose response, and improve your insulin sensitivity.
Studies indicate that Resistant starch can be beneficial for the good bacteria in the gut, when consumed in quantities around 15 to 30 grams daily (equivalent to two to four tablespoons of potato starch). If resistant starch causes GI symptoms then it is a good idea to get tested for Microbial Dysbiosis and/or SIBO (small intestinal bacterial overgrowth).
It is not just about Glycemic Control
People who feel worse when they start including more real foods back into their diet could potentially be FODMAP sensitive. Fermentable Oligosaccharides, Disaccharides, Monosaccharide’s and Polyols (FODMAPS) are specific types of carbohydrates that are not absorbed well in the intestinal tract and can easily be fermented by gut bacteria causing problems, such as IBS, Diarrhea, Constipation, Bloating, Indigestion, Stomach Cramps, Nausea and Gas.
The categories of FODMAPS are listed below:
Lactose: Milk, yogurt, soft unripened cheeses, ice cream, custard, and dairy based desserts
Galactans: Legumes (kidney beans, soybeans, lentils, chickpeas, baked beans)
Fructose: Apples, honey, mango, watermelon, pears, HFCS, dried fruits, agave syrup, fruit juices
Fructans: Asparagus, artichokes, beetroot, brussel sprouts, broccoli, cabbage, egg plant, fennel, okra, chicory, garlic, leek, onion, lettuce, wheat, rye, pistachio, inulin, fructo-oligosaccharides
Polyps: Avocado, Apples, Apricot, Blackberry, Cherries, Lychee, Nectarines, Pears, Plums, Prunes, Mushrooms, Sorbitol, Mannitol, Xylitol, Maltitol and Isomalt.
As you can see there are a variety of raw fruits and vegetables that are FODMAP foods and could potentially cause more symptoms in an individual who is FODMAP sensitive. FODMAPS intolerance is a threshold response, so a reduction in any of the foods should show great improvements.
Not everyone is sensitive to all of the Foods in each category so an elimination diet can be done with each category for a period of 30 days to determine trigger foods and identify improvements in symptoms.
Usually after removing the problematic FODMAPS foods for 3-6 months will show great improvements and they can be gradually increased back into the diet but if not, it’s a good idea to test for small intestinal bacterial overgrowth (SIBO).