According to the International Diabetes Federation, diabetes now affects more than 230 million people world-wide and is expected to affect 350 million by 2025. In the United States alone, over 20 million children and adults have diabetes, representing 7 percent of the population. Of those, it is estimated that more than 6 million people are undiagnosed and at risk of suffering diabetic complications, such as eye, kidney and blood vessel diseases, and premature death.
Experts agree the main reason for the rising prevalence of diabetes is the coexisting epidemic of obesity. Thus, approaches that can aid in both blood glucose control and support weight loss are of particular interest. This article will discuss two such approaches shown to be beneficial: following a low glycemic diet and the use of the dietary supplement ingredient Phase 2 Carb Controller™.
The Glycemic Index: A New View on Carbohydrates
Proper nutrition is of critical importance in managing diabetes. The main focus in the nutritional management of diabetes is to improve glycemic control by balancing food intake with insulin levels.
Although currently not endorsed by the American Diabetes Association, the glycemic index (GI) is advocated by most diabetes and health organizations world-wide, including the World Health Organization (WHO), the Diabetes Nutrition Study Group of the European Association for the Study of Diabetes, and the Canadian Diabetes Association.
The term “glycemic index” was first coined by professors David Jenkins and Tom Wolever, University of Toronto; their 1981 study, “Glycemic Index of Foods: A Physiological Basis for Carbohydrate Exchange,” published in the American Journal of Clinical Nutrition, revolutionized the way we understood carbohydrates. At that time, carbohydrates were classified as either simple (sugars) or complex (starches and vegetables). It was believed all simple carbohydrates caused a rapid rise in blood glucose levels and all complex carbohydrates released glucose more slowly into the body. Consequently, diabetics were advised to limit intake of simple carbohydrates and to eat more complex carbohydrates to manage their blood sugar.
These results showed the glycemic (blood glucose) response of carbohydrates was not black and white; in fact, blood glucose responses varied considerably among complex carbohydrates. The biggest surprise was that certain starchy foods (such as white bread) were digested and absorbed more quickly than certain sugary foods. These results fueled a dramatic increase in curiosity, debate and clinical research on this topic.
Carbohydrates, such as breads, rice, legumes, fruits and vegetables, are ranked on a scale of 0 to 100, based on how they affect blood glucose levels and, consequently, insulin levels. If a carbohydrate is digested quickly and causes a rapid rise in blood sugar levels, it is considered to be “high GI.” Foods made with refined starches, such as white bread, bagels and processed breakfast cereals, are examples of high GI foods. If a carbohydrate is more slowly digested and causes a slower and lower rise in blood sugar levels, it is considered “low GI.” Low GI foods include most vegetables, non-tropical fruits and unprocessed grains. Factors that impact the GI of a food include the type of starch and sugar it contains; the type and extent of processing/cooking; and the acid and fiber content of the food. Also, combining fats and proteins with carbohydrates will lower the overall glycemic response of the meal.
GI values reflect the average glucose response when a portion of food providing 50 grams of carbohydrate is eaten. To measure the impact of a particular serving of a food, researchers developed the glycemic load (GL), which is calculated by multiplying the GI by the number of grams of carbohydrate in a serving, then dividing by 100.
GI, Weight Loss and Diabetes
Numerous studies have linked high GI diets to obesity, increased belly fat, insulin resistance, type 2 diabetes and increased risk factors for heart disease, such as high cholesterol. Choosing low GI carbs can help facilitate weight loss, improve blood sugar control and lipid levels, and reduce the risk of diabetes.
Recently, a review of six clinical trials involving GI and lasting between five weeks to six months was conducted by the Cochrane Collaboration. These studies compared weight loss in people eating low GI foods to weight loss in people on higher GI diets or other types of weight loss plans. Dieters who focused on eating low GI foods dropped significantly more weight, about 2.2 pounds more than participants on other diets. Low GI dieters also experienced greater decreases in body fat measurements and body mass index (BMI). None of the studies reported adverse effects associated with consuming a low GI diet.
In large prospective epidemiologic studies, high-GI or -GL diets have been associated with a greater risk of type 2 diabetes, while low GI diets have consistently been associated with lower diabetes risk. In diabetic patients, studies suggest replacing high GI carbs with low GI forms will improve glycemic control and, among persons treated with insulin, reduce hypoglycemic episodes.
The Role of Phase 2 Carb Controller™
Phase 2 is a standardized extract of the white kidney bean. It promotes weight loss and improves glycemic control by reducing starch digestion. Phase 2 works in the intestine by temporarily inhibiting the activity of alpha amylase, the enzyme that breaks down starch into smaller glucose molecules. As a result, less starch is absorbed from a meal. Foods high in starch tend to be moderate- to high-GI. In clinical studies, Phase 2 has been shown to lower after-meal blood sugar levels and promote loss of body fat. In two of the initial studies on Phase 2, participants were given a standardized meal containing 60 g of starch (four slices of white bread) and either a placebo or 1,500 mg of Phase 2 in a margarine spread. After the meal, participants who were given Phase 2 had an average 66-percent reduction in after-meal blood sugar levels compared to the placebo group. Participants given Phase 2 reported no adverse side effects in either study.
An independent study conducted in Italy found supplementing with Phase 2 resulted in weight loss. This double blind, placebo-controlled study involved 60 overweight individuals aged 25 to 45. Participants ate starchy foods during one of their primary meals and took either a Phase 2 supplement or placebo at that time. Researchers measured body weight, body fat percentage and hip, waist and thigh circumference. By the end of the 30-day period, participants who took the Phase 2 supplement lost an average of 6.5 pounds and 10.5 percent fat mass and had significant reductions in all body measurements compared to those in the placebo group, who lost little or no weight.
A study conducted at Northridge Hospital Medical Center, UCLA, and published in Alternative Medicine Review, found participants given Phase 2 lost an average of 4.0 pounds in eight weeks, had an average 26-point reduction in triglycerides and had greater energy. In comparison, those participants given a placebo lost only 1.6 pounds. Other weight-loss studies with Phase 2 have been conducted in Mexico, Japan and the United States, yielding positive results. Most recently Phase 2 was found to lower the GI of white bread.
The clinical evidence on Phase 2 is so significant that FDA allows it to be sold with a claim for weight control and for reducing starch digestion.
Phase 2 is safe, well-tolerated and not known to interact with any drugs or supplements. The recommended dosage for Phase 2 is 1,000 to 1,500 mg before starchy meals. Phase 2 is available in a variety of forms, including tablets, capsules, and soft chews. It is also being incorporated into baked goods under the name Starchlite™.
Sherry Torkos is a practicing pharmacist and author of ten books including “The Glycemic Index Made Simple” (Wiley 2007). For more information visit: www.sherrytorkos.com.
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