A Tool Box of Strategies to Prevent Blood Sugar Spikes When Eating High Glycemic Index Foods

This article aims to provide the reader with a set of tools (knowledge) that can be applied to achieve a blood sugar of less than 154.8 mg/dL (8.6 mmol/L) after one hour of eating.

That’s because a blood sugar of more than 155 (rounded off) is associated with many common and deadly diseases. I wrote about it below.

A High One-hour After-Meal Blood Sugar Test can Lead to Several Deadly Conditions

And if you miss the one-hour, the two-hour should be less than 140 mg/dL (7.8 mmol/L)

After-meal high blood sugar predicts Atherosclerosis better than Fasting blood sugar and HbA1c.

Studies have shown that a blood sugar of more than 154.8 mg/dL or 8.6 mmol/L one hour after a meal or 140 mg/dL or 7.8 mmol/L after two hours can predict the development of atherosclerosis and cardiovascular diseases for diabetics and non-diabetics.

The reason is that high blood sugar can change the immune response to cause inflammation. High blood sugar causes Metabolic Memory.

The changes in the immune system are permanent. That is why once you develop diabetes, chronic renal failure is a certainty. Blood sugar control can only delay the progression.

We need to know some concepts before developing strategies to lower blood sugar.

Glycemic Index and Glycemic Response

The Glycemic Index (GI) ranks how much blood sugar can rise after eating certain foods.

For example, cornflakes (GI-81), white rice (GI-73), and boiled potatoes (GI-78) have a higher glycemic index than chickpeas (GI-28).[2]

On the other hand, Glycemic Response (GR) is how the body reacts to foods depending on how they are cooked, combined with other foods, the sequence of how they are eaten, and how they are stored.

Area Under the Curve

In this article, the referenced studies use the Area Under the Curve (AUC) to measure how long it takes your body to use or store glucose after a set period following a meal. The AUC represents the blood sugar levels measured several times after the meal into one number.

A higher AUC means the sugar levels are higher for several hours than a lower AUC.

Knowing the information here could help the reader enjoy the foods they like and still get the desirable after-meal blood sugar levels.

With that in mind, let us go straight to the strategies.

1. Complement meals rich in carbohydrates with foods rich in fiber.

Carbohydrates are broken down into simple sugars like glucose before absorption. The inner lining of the stomach and the small intestines do the absorption. The large intestines are mainly for water.

If someone eats table sugar, which is also found in pop, soda, or soft drinks, the sugar is absorbed rapidly.

Rice, pasta, and other carbohydrates require digestion, but they are absorbed rapidly, especially if eaten alone.

Dietary fiber slows the transit time of food from the stomach to the small intestines and delays their absorption of the digested sugars.

Adding fruits, vegetables, whole grains, legumes, and nuts provides additional surface area for the ingested carbohydrates to stick to as they pass through the stomach.

For example, eating whole fruit instead of drinking its fruit juice results in a lower glucose AUC.

Another example is mixing white rice with fiber-rich foods like vegetables or chickpeas, which results in lower AUC than consuming rice alone.

2. Combine Carb rich foods with Healthy fats

Healthy monounsaturated fats from extra virgin olive oil, oily fish, nuts, and seeds stimulate insulin release like proteins.

Fat in the diet also slows stomach emptying and carbohydrate absorption. In the Liljeberg study, adding tomato sauce with olive oil or pesto decreased the AUC of plain rice and pasta.

Another study showed that adding cheddar cheese (120 g with 42 g of fat) to three high-GI foods (pasta, potato, and toast) resulted in a 58% reduction in the AUC of pasta, 56% when combined with potato, and 30% when combined with toast compared to eating them alone.

Henry C et al. found that adding cheddar cheese to high-glycemic-index foods like potato, pasta, and toast reduced the glycemic index of the three to a value considered low GI.

3. Complement meals rich in carbohydrates with foods rich in protein

Animal and vegetable proteins stimulate the release of incretins. Incretins are hormones that stimulate insulin release and lower blood sugar.

Proteins also slow stomach emptying and interact with the starch in the food to slow the enzyme alpha-amylase) that digest carbohydrates. The result is slower digestion and delayed sugar absorption.

A high-protein breakfast (30 g protein) has been shown to lower blood sugar 180 minutes after eating compared to a low protein (10 to 20 g).

Additionally, a high-protein breakfast results in lower blood sugars throughout the rest of the day. You can read about that study in,

A High-Protein Breakfast Can Lower Blood Sugar the Whole Day

What kind of protein lowers sugar the most?

A study from Singapore showed that soya beancurd was the protein source that significantly reduced Glycemic Response, followed by chicken, fish, and egg.

Henry C et al. also showed that tuna decreases the Glycemic response to potato and pasta by 18 and 54%, respectively.

4. Add vinegar or pickled foods to meals rich in carbohydrates with a high glycemic index.

Acidity slows gastric emptying time when combined with foods with a high Glycemic Index.

Studies have shown that high-GI foods combined with vinegar resulted in lower AUC than those without vinegar.

Ostman et al. found a 35% decrease in GI when 20 g of vinegar (1.39 Tablespoon) was combined with high-GI foods, such as white bread.

The website to convert the weight of vinegar to quantity is at this LINK.

Leeman M et al. showed that cold storage of potatoes (8 degrees C or 46.4F for 24 hours) increased the resistant starch, which is slower to digest.

Additionally, adding vinaigrette sauce (8 g olive oil and 28 g white vinegar (about 2 Tablespoons) lowered the GI and insulin response by 43% and 31%, respectively.

Pickles also lower the Glycemic Index of foods.

Santos et al. hypothesized the three mechanisms of how vinegar (about two to six tablespoons) lowers the glycemic index.

First, vinegar delays the action of amylase, which digests carbohydrates. Second, vinegar promotes blood sugar entry into the skeletal muscle for future fuel use and into the liver to be stored as glycogen.

The third is vinegar, which causes the body to produce specific proteins that improve the storage of blood sugar in the liver and muscles. During exercise, the ingestion of vinegar and sugar enhances the uptake of glucose into the muscles.

Learn more about vinegar and glycemic index at The Blood Sugar Lowering and Metabolic Effects of Vinegar

5. Consider Unripe fruits

When climacteric fruits like bananas, apples, pears, kiwis, peaches, melons, plums, or figs ripen, ethylene is given off, the fibers degrade, and sugars are released.

Underripe versions of the mentioned fruits have higher starch contents, are more resistant to digestive enzymes, and have a lower glycemic response.

As an aside, over-ripe bananas have high tyramine levels for those who have migraines and can precipitate a migraine headache. — Foods High in Tyramine

6. Consume foods that are in their original form

Steel-cut oats have a lower GI than instant oatmeal. That Quaker Instant Oatmeal, which is supposed to be “heart-healthy,” has a high glycemic index and increases cardiovascular disease risk.

A Tey et al. study showed that the GI of a whole guava’s GI (29 ± 4) is lower than guava puree (47 ± 4).

The same is true with whole papaya (38 ± 2) versus papaya puree (42.5 ± 5), Showing that pureed versions can increase blood sugar more.

Crummett and Grosso had different results. They found that those who consumed whole fruits (gala apples and blackberries) had higher blood sugar than those with blended apples and blackberries.

They hypothesized that the results might be associated with the release of dietary fiber and nutritional components from ground blackberry seeds.

Studies may have conflicting results. That is why blood sugar testing in response to foods is essential.

7. Cook pasta, rice, or other starchy foods al dente.

Cooking starch makes the glucose chains in carbohydrates easier to digest and faster to absorb. The longer the cooking time increases the glycemic response.

Cooking pasta al dente lowers the blood sugar response.

Kaur et al. found that a 2:1 water-rice ratio significantly increases resistant starch in white rice, resulting in a lower blood sugar level than a 3:1 or 4:1 ratio.

For Filipino readers, this means that arroz caldo, a porridge dish made of rice and chicken, and goto (porridge made with rice and beef tripe) have a high GI.

8. Prioritize microwave cooking over other cooking techniques like boiling, steaming, sautéing, and frying.

Tian Y et al. observed that microwave cooking of rice noodles resulted in the highest content of resistant starch (0.99 g/100 g) than sautéed noodles (0.59 g/100 g), steamed noodles (0.44 g/100 g), and boiled noodles (0.43 g/100 g).

9. Store cooked pasta, rice, and legumes in the fridge for one day and consume them cold or reheated (<130°C) to allow for the formation of resistant starch.

Hsin Yang et al. found that rice stored at 0°C (32°F) for five days has a lower AUC (1,806 ± 182 mg/d°) than those samples stored for 1 and 3 days (2,032 ± 191 mg/dl, 1,881 ± 184 mg/dl, respectively)

I discussed a similar method for white bread in — Ways to Lower After-Meal Blood Sugar when Eating White Bread

10. Eat Vegetables, Protein, Fat, and Starchy Foods in Sequence

Eating protein, fat, and fiber from vegetables before consuming starchy foods reduces post-prandial blood glucose by up to 73% and circulating insulin levels by 48% compared to consuming along, with, or after eating starchy foods.

Veggies Meat Carbohydrate Sequence Prevents After Meal Sugar Spike

11. Add viscous foods like okra, natto, and Japanese yam to lower post-prandial blood sugar

Slippery or slimy foods, like natto, okra, and Japanese yams, slow food movement from the stomach to the small intestine and can lower after-meal blood sugar.[3]

The polyglutamic acid chains make natto slimy and slow the gastric transit of the other foods taken with it.

I wrote a bunch of natto and nattokinase-related health articles, which are listed below.

12. Add nuts to high Glycemic Foods

Kendall CWC et al. found that nuts progressively reduce blood sugar dose-dependently when taken with 50 gms of white bread.

Pistachios can also help lower post-prandial blood sugar. — Pistachios decrease after-meal blood sugar

Pistachios improve insulin resistance and inflammatory markers.

13. A 15 to 20-minute Physical Activity can Lower Blood Sugar

Muscle contraction uses glucose for fuel. As walking continues, the glucose used inside the muscles is replenished by the absorbed sugar in the bloodstream.

Walk After Meals to Prevent Sky High Blood Sugars

Other exercises like pull-ups, rowing, or stationary cycling can also be done. I exercised without weight bearing when injured by doing Blood Flow Restriction Therapy.

Passing and Failing the One-Hour After-Meal Blood Sugar

Read more about KAATSU or Blood Flow Restriction Therapy at:

14. Eat a High Protein Breakfast

Skipping breakfast increases blood sugar throughout the day due to the prolonged effects of epinephrine and cortisol while fasting.

Eating rather than skipping breakfast results in lower blood sugars the whole day

Studies recommend that to make breakfast more effective in lowering blood sugar, it should be high in protein. I discussed them in A High-Protein Breakfast Can Lower Blood Sugar the Whole Day.

I still recommend intermittent fasting, but now I start fasting mid-afternoon until the day until the next day.

15. Add Dried Fruits to Meals

A study by Zhu et al. found that eating dried fruits, including dried apples, dried jujubes, dried apricots, and raisins, in addition to almonds, does not result in an excess rise in blood glucose concentrations when consumed as a substitute for high GI carbohydrate-based food.[4]

Summary

The image below summarizes some strategies to lower the after-meal blood sugar when enjoying high Glycemic Index foods.

Source: Culinary strategies to manage glycemic response in people with type 2 diabetes: A narrative review. Front Nutr. 2022 Nov 10;9:1025993

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Related:

Articles about After-meal blood sugar

Nattokinase/ Natto related

References:

Murillo S, Mallol A, Adot A, Juárez F, Coll A, Gastaldo I, Roura E. Culinary strategies to manage glycemic response in people with type 2 diabetes: A narrative review. Front Nutr. 2022 Nov 10;9:1025993. doi: 10.3389/fnut.2022.1025993. PMID: 36438742; PMCID: PMC9684673.
Very Well health. What Is the Glycemic Index?
Taniguchi A, Yamanaka-Okumura H, Nishida Y, Yamamoto H, Taketani Y, Takeda E. Natto and viscous vegetables in a Japanese style meal suppress post-prandial glucose and insulin responses. Asia Pac J Clin Nutr. 2008;17(4):663-8. PMID: 19114406.
Zhu R, Fan Z, Dong Y, Liu M, Wang L, Pan H. Postprandial Glycaemic Responses of Dried Fruit-Containing Meals in Healthy Adults: Results from a Randomised Trial. Nutrients. 2018 May 30;10(6):694. doi: 10.3390/nu10060694. PMID: 29848962; PMCID: PMC6024783.

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