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Eating carbs last helps control glucose

- — Eve Glazier, M.D., MBA; and Elizabeth Ko, M.D. Send questions to askthedoct­ors@mednet. ucla.edu

Can you please talk about the idea that the order in which you eat your food has an effect on your blood sugar? I have a friend who never eats sweets unless she can also have some vegetables and protein. Does this really matter?

Dear Reader: Your friend has tapped into a fascinatin­g area of research that has found that the order in which food groups are consumed during a meal can indeed have an effect on the degree to which blood sugar fluctuates. This discovery is important because repeated and sizeable swings in blood sugar are linked to an increased risk of developing insulin resistance. If unchecked, it often escalates to Type 2 diabetes, a disease that affects an estimated 39 million people in the United States.

Several studies have found that eating vegetables and protein before consuming simple carbohydra­tes had a beneficial effect on post-meal blood sugar. Researcher­s in Japan are among those who have explored the idea. In that study, participan­ts were asked to repeatedly eat the same meal, which consisted of protein, vegetables and white rice. The difference was that they consumed the food groups in a different order each time. The food was eaten on three days, with an overnight fast between each day. After each meal, changes to insulin levels and blood glucose concentrat­ion were measured over the course of the next two hours.

When participan­ts began by eating a simple carbohydra­te — in this case, white rice — their post-meal blood glucose and insulin levels were measurably higher than those who had eaten the white rice last. Conversely, when those same participan­ts began by eating protein and vegetables, which are complex carbs, and saved the rice for last, their post-meal insulin and glucose levels were measurably lower.

The speed at which food is consumed also appears to play a role in blood sugar control. Studies show that when people race through a meal, they have higher levels of blood glucose and insulin than when the same foods are eaten at a leisurely pace.

As for why this may be, it’s all about the compositio­n of the foods involved. Complex carbohydra­tes are high in fiber. As they are digested, this category of food creates a kind of gel matrix that slows absorption in the small intestine. Fats and protein help to moderate the pace at which food moves through the digestive system, which also puts the brakes on absorption. When eaten last, simple carbs enter a digestive landscape that discourage­s fast absorption. This results in a healthful reduction of postmeal blood glucose levels and decreased demands on insulin.

It is still important to limit consumptio­n of simple carbs. That includes snack foods, highly processed foods and those with added sugars. Consider beginning a meal with a salad or fresh vegetables, save the simple carbs for last and remember to eat slowly.

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