For millions across South India, the day begins with the comforting
warmth of idlis, the crisp masala dosas, or the tangy lemon rice. These
dishes, steeped in tradition and flavour is almost the way of life. But
have you ever wondered what these foods do to your blood sugar levels?
However, for those managing diabetes or looking to make healthier
food choices, endocrinologists say understanding the Glycemic Index (GI)
and Glycemic Load (GL) of these dishes is crucial.
Dr V Mohan, renowned diabetologist and chairman for Dr Mohan’s
diabetes and research centre says, “High-GI foods, as demonstrated by
our study, are associated with type 2 diabetes, obesity, and heart
diseases. Our research also shows that diets high in glycemic index and
load are linked to increased mortality, with individuals consuming
high-GL foods tending to have shorter lifespans. Additionally, high
glycemic load has been connected to cancer, and it significantly impacts
lipid levels as well.”
What is Glycemic Index and Glycemic Load
Dr V Mohan, explaining to South First says, “GI
index of a food is the ability of the food to increase the blood sugar
levels,” and Glycemic Load (GL) is GI multiplied by the quantity of the
food consumed.
Dr Mohan elaborates, “obviously not all foods are equal and those
foods that contain carbohydrates particularly simple carbohydrates that
digest easily, have highest Glycemic index. On the other hand, foods
that are rich in protein and fat is said to have lower GI. The complex
carbohydrates or the unrefined carbohydrates like brown rice or whole
wheat or unpolished millets would have lower GI and better nutritional
properties.”
However, Dr Mohan warns that while the GI of the food is a useful
concept, one could choose a fruit with a lower GI as opposed to fruit
with a higher GI. We should also keep in mind that it is not the GI
alone that is important but also GL.
“For instance, a certain food has very high GI but someone has only a
small portion of it, then your glucose levels may not spike. On the
other hand, if the GI is slightly lower but you take a large portion of
that food, obviously your GL will be much higher. It is more important
to keep the glycemic load in mind rather than the glycemic index.
Although it is useful to keep in mind the glycemic index of the food,”
he says.
How is GI calculated?
To calculate GI, a group of healthy individuals consumes a portion of
the test food and their blood sugar levels are measured and compared to
the base line and comparing that with the gold standard, which is
Glucose or white bread. Both Glucose and white bread is considered to
have a glycemic load of 100. If the food fed has a GI of over 70, then
it is high GI, 55-69 is moderate and food that has below 55 are
considered as a low GI.
High GI foods: The risky favourites
A study conducted by the Department of Dietetics at the National
Institute of Nutrition, in collaboration with ICMR Telangana, published
in the Journal of Food Science and Technology, developed a database on the glycemic carbohydrates, glycemic index, and glycemic load of common South Indian breakfast foods.
23 varieties of commonly consumed foods were tested. Interestingly,
the GI was highest in onion dosa (79.69 percent) and lowest in vada
sambar (36.89 percent). The glycemic load of commonly consumed breakfast
foods tested were shown highest in plain dosa (39.69 percent) ad lowest
in vada sambar (18.44 percent). The GL load was found to be higher in
rice-based breakfast foods than that of legume-based breakfast foods.
Foods with a high GI can lead to rapid spikes in blood sugar,
increasing the risk of diabetes and obesity. According to the study:
MLA Upma pesarattu (GI: 72.85, GL: 36.42)
Open Dosa (GI 77.33, GL 39.34)
Lemon rice (GI: 79.30, GL: 39.65)
Onion dosa (GI: 79.69, GL: 39.84)
Plain dosa (GI: 79.39, GL: 39.69)
Vegetable biryani (GI: 74.53, GL: 37.26)
Tomato bath (68.57, GL 36.54)
Low GI foods: The better picks
Low-GI foods provide steady energy release, making them ideal for sustained energy levels.
Options include:
Vada sambar (GI: 36.89, GL: 18.44)
Pesarattu (GI: 60.69, GL: 33.70)
Chapati (GI: 62.43, GL: 28.37)
Parota (GI: 62.48, GL: 31.24)
“Adding legumes and whole grains to your breakfast can significantly
reduce the glycemic impact while improving overall nutritional value,”
suggests Reena Mohan, a dietitian based in Bengaluru.
Fruits with low GI–guava and apple
Fruits with high GI–watermelon and sapota, jackfruit and banana
The study emphasised that legume-based breakfasts like pesarrattu are
healthier than rice-based meals. The glycemic impact is directly linked
to the carbohydrate quality, with rice dishes often ranking higher on
the GI and Gl scales.
Healthier breakfast choices
Dr Mohan says, “One way of reducing the high glucose spikes in our
diets is to follow a certain order in eating. Even if you are eating
carbs, start the first meal with some veggies which are non starchy,
green leafy vegetables.”
It can also be started with a protein like an omelette before eating
the Idli. As this can form a protective mesh of fibre which traps the
glucose and doesn’t allow it to rise. This is one simple trick to reduce
their glucose spikes, he adds.
Suggestions by doctors to enjoy South Indian breakfast, without compromising health:
Choose millets: replace rice in dosa and idlis with millets for a lower glycemic load.
Add vegetables/protein: Fibre-rich vegetables and protein can lower the GI of upma, dosa and rice based dishes.
Embrace legumes: Options like pesarattu or adai (lentil dosa) are nutritious and filling.
Mind your portions: Smaller servings can prevent excessive glycemic spikes.
GI is flawed, say low carb diet advocates
Interestingly, low carb diet practitioners call GI as flawed and misleading. Speaking to South First,
Shashikant Iyengar, co-founder of dlife.in said, “GI measures the blood
sugar response to a fixed amount (50g) of carbohydrate in isolation,
but in real life, foods are rarely eaten alone or in these quantities.
This makes GI an incomplete metric, ignoring the carb content–the total
carbohydrate load of a meal and the individual’s metabolic condition.”
Citing Dr Richard Bernstein, a pioneer in diabetes management and
author of Diabetes Solution, Shashikant Iyengar says, “Dr Richard has
long argued that the GI is irrelevant for people with diabetes. He
explains that people with diabetes experience far greater glycemic
variability than non-diabetics due to their impaired insulin response.”
Even “low-GI” foods can cause significant sugar spikes in diabetes,
especially when eaten in large amounts. He adds that we see a lot of
Instagram influencers making videos on various foods impacting the blood
sugar as seen on a CGM. “Most of them are non diabetic and the response
will vary from those with diabetes. Such videos are misleading at the
best,” he says.
He explains that from a low-carb perspective, the goal is to reduce
overall carb intake to stabilise blood sugar and improve insulin
sensitivity, rendering GI largely irrelevant.
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