Foods that spike a patient’s blood glucose are not what you think (2024)

When providing nutrition advice to patients with prediabetes, the foods that can increase blood-glucose levels are often not what you think. Identifying those foods are key to helping patients take the right step toward healthier eating.

The AMA Ed Hub™ offers online learning from the AMA and other trusted sources, all in one place. That includes “Nutrition Science for Health and Longevity: What Every Physician Needs to Know,” a condensed CME course that equips busy physicians with the nutrition science and skills that enable them to improve patient care. The four-hour, self-paced course, updated every year, is developed and hosted by theGaples Institute,an educational nonprofit focused on enhancing the role of nutrition and lifestyle in health care, and is distributed in collaboration with the AMA Ed Hub.

Most people know that eating sugar-filled pastries or candies cancausebloodglucoselevelsto rise, whichposes a special concern for the nearly 50% of U.S. adults with prediabetes or diabetes. However,foods don’thave to taste sweetto spike blood sugar levels.

“It’swell understood that if you eatsomething sweet, like abrownie your bloodglucosewillbump, so no one is surprisedwhen that happens,”saidStephen Devries, MD, a preventive cardiologist and executive director of theGaplesInstitute. “But many patients are unaware that starchy foods, many without a trace of sweetness, can bump bloodglucoselevels even more.”

Doughnuts are filled with added sugar and fat—no one mistakes them for a healthy food choice.But sometimes, well-meaning replacement foods can have unintended consequences.

“Patients with reason to be concerned about their blood sugarusuallyunderstand that sugary foods like doughnuts are poor choices,” said Dr. Devries.“In an effort to lower their sugar, they may swap a breakfast doughnut for something less sweet, like a bagel. But many patients don’t realize that starchy foodscancauseblood sugartosoar even higher than sweetones.”

Theexplanation is that starch ismetabolized by the body intoglucose. Because the bagel has a greater mass of carbohydrate than the doughnut, it leads to a higher release of glucose into the blood stream, referred to as the “glycemic load.”

However, the conclusion isdefinitely notto encourage patients to eat more doughnuts.Instead, “the importance of comparing glycemic loads is to demonstrate that patients need to take care to limit not only sugary foods like doughnuts, butto alsoreduce their intakeof starchy foods that can also spike sugar levels,” said Dr. Devries.

“Skip the doughnuts and bagels for breakfast—better to opt for oatmeal and fruit for breakfast,”he added.

“Potatoes are a vegetable,but the health value of all vegetablesarenot interchangeable. White potatoesin particular havea very high glycemic load. As a result, a baked white potatocan also raise blood sugar even more than aglazed doughnut.”

Interestingly, potatoes chilled when eaten have a lower glycemic load than when served warm.A good alternative to potatoes as a side dish are beans or cauliflower rice, a popular culinary newcomer. The glycemic load is much lower,and cauliflower includes several key nutrients.

Even though it is not sweet, sticky white rice is anotherfood that can deceptively bump blood sugar. Devoid of thefibrous outer bran and nutrient filled germ layers, white rice is mostly starchwith a correspondingly high glycemic load.

A better choice is brown rice, a whole grainwith more fiber than white rice and a lower glycemic load. Otherwhole grain alternatives to white ricearebarleyandfarro.

“Whole grains areabsolutelypreferred overrefined,butshouldn’t be consumed in unlimited quantitiessaid Dr. Devries.“Largeamountsofeven whole grains, including brownrice,canstillspike blood glucose levels.”

As described in theGaplesInstitute nutrition course, dietary fiber, especially the soluble type, reduces the amount of sugar absorbedfromthe digestive tract. Goodsources ofdietarysolublefiber include oats, beans,apples, citrus fruits, and nuts.

AMA members are eligible for a 20% discount on theGaples Institute's nutrition CME course. Contact the Unified Service Center for the discount code at (800) 262-3211 or[emailprotected].This course is approved for 4.0 AMA PRA Category 1 Credit(s)™ and ABIM MOC medical knowledge points.