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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa

The Insulin Index Is Better for Managing Your Blood Sugar

August 15th, 2015 · 21 Comments

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The Insulin Index is better for managing your blood sugar that the Glycemic Index. It is more recent than the Glycemic Index, which dates from the publication of  “Glycemic index of foods” in 1981. The first publication of the Insulin Index came in 1997 with “The insulin index of foods.”

The insulin index is broader than the Glycemic Index, which shows only the effect of carbohydrates on our blood sugar. The Insulin Index takes into account not just carbohydrate but also of all the dietary factors and their interactions that influence insulin demand.

Most of the current research on the Glycemic Index and essentially all of it on the Insulin Index comes from Dr. Jennie Brand-Miller and her laboratories in Australia. Among her other titles, she is a professor of molecular biosciences and director of the Sydney University Glycemic Index Research Service. I’ve known her for more than 20 years, and we wrote my first book, What Makes My Blood Glucose Go Up…and Down? together.

jennie.jpg

Dr. Brand-Miller and Me

International Diabetes Federation Convention, Busan, Korea

The original article that I published back in 2003 on the Insulin Index included only 38 foods that Dr. Brand-Miller and her colleagues studied then. Yet few of my older articles generated more interest than this limited study.

The most interesting finding of that early study, published in a 1997 issue of The American Journal of Clinical Nutrition, was that foods rich in protein and baked foods rich in fat and refined carbohydrates elicited “insulin responses that were disproportionately higher than their glycemic responses.”

Now 18 years later, the Insulin Index includes 120 foods in 1000 kJ servings. This study confirms that the Insulin Index of these foods eaten alone and in mixed meals better predicts the insulin demand than either the Glycemic Index or the Glycemic Load (which is measures the effect of the glycemic index of a food multiplied by its available carbohydrate content in grams in a standard serving).

You Can See the Entire List Here

This greatly expanded list of foods tested for their Insulin Index is freely available online. The Glycemic Index, the Glycemic Load, and the Insulin Index for these 120 foods are in Table 1. I found it to be too difficult to read online, but printed it out and studied it on paper.

The five foods highest in their Insulin Index are these:

  • Jellybeans, 117
  • The Aunt Jemima Original Pancake & Waffle Mix, 110
  • Honeydew melon, 93
  • Boiled russet potatoes, 88
  • Baked beans, 88

No big surprises, except for the baked beans, which has an Insulin Index exactly twice as high as its Glycemic Index. But all of these foods are high in carbohydrates.

Foods that Are Much Higher in Their Insulin Index

Several foods in addition to baked beans have an Insulin Index that is at least twice as high as their Glycemic Index. I exclude here a few foods that have quite low indexes):

  • Low-fat strawberry yogurt, Insulin Index 84, Glycemic Index 31
  • Skim milk, 60, 29
  • Kraft low-fat processed cheese, 42, 10
  • Low-fat cottage cheese, 52, 10
  • Reduced fat cottage cheese, 40, 10
  • 93% fat-free cheddar cheese, 20, 0

Each of these foods are high in protein. Previously we have known that protein has a moderate influence on the glycemic index, while fat has no influence.

Dairy is the Difference

The conclusion that I draw from the expanded Insulin Index reinforces  part of the findings from the original 1997 study: we need to take into account the protein in dairy products.

Cheese, milk, and yogurt stimulate a rise in our blood sugar that is considerably more than predicted by the glycemic index alone.

This article is based on an earlier version of my article published by HealthCentral.

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21 responses so far ↓

  • 1 ana // Aug 15, 2015 at 10:49 am

    fascinating. Does the II also get affected when food is eaten as a meal with other foods, similar to the GI? In some ways, this could help lower glucose in diabetics because of the insulin response (for those still making insulin on their own). But..those trying to stay in ketosis on low carb, opens a whole new can-o-worms.

  • 2 David Mendosa // Aug 15, 2015 at 3:20 pm

    Good question, Ana. I don’t know, but I would guess that it does.

  • 3 Renae // Aug 16, 2015 at 2:12 pm

    Should the protein and chicken/beef/salmon in our diet be reduced?
    It’s easy to measure my blood sugar –but is there a device to measure insulin in a similar fashion?

    Thank you.

  • 4 David Mendosa // Aug 16, 2015 at 5:51 pm

    I have eliminated chicken/beef/salmon from my diet, Renae, but that’s because I follow a vegetarian diet for ethical reasons. I really don’t know if it it necessary for health reasons. And the only tool we have to measure our blood sugar at a point in time remains a blood glucose meter.

  • 5 peturbed // Aug 31, 2015 at 6:53 pm

    It seems to me that we cannot ignore the insulin index. Even if these foods high on II do not lead to high blood sugar, that could be due to the stimulation of insulin; that is not problematic for normals perhaps, but for DMers it seems that any stress on insulin is bad, even if phase 2 response, and exogenous insulin, “cover” it. Would like to hear what Dr. B. would say.

  • 6 Kathleen // Sep 1, 2015 at 8:44 am

    I am a little confused by this; the GI and GL are based on blood sugar readings after eating these items, correct? If the blood glucose readings are generally good…..???

  • 7 David Mendosa // Sep 1, 2015 at 9:19 am

    What a great question, Kathleen! It deserves careful consideration, but my immediate thought it that some of the GI/GL numbers are based on testing of people who don’t have diabetes. Some, but I really don’t know what proportion. Does the testing on people who don’t have diabetes make a big difference? I just can’t say. I do hope that others will add their insights here.

  • 8 Nomi // Sep 1, 2015 at 1:59 pm

    No surprises here. Dr Bernstein makes a very strong argunent against low fst dairy snd processed cheeses. They are high in lactise which is a sugar. Full fat dairy including butter and cream dont raise bg.

  • 9 Steve // Sep 1, 2015 at 7:21 pm

    I believe you erred in stating the FII of cream cheese. When I looked at the table, I saw 18, not 52.

  • 10 David Mendosa // Sep 1, 2015 at 8:49 pm

    You’re right, Steve. Thank you for checking and for letting me know. I was looking at the wrong line and will correct it.

  • 11 Frankie // Sep 2, 2015 at 12:23 pm

    I was under the impression lowcarb was mostly meat with some non starch veg. If you are low carb how do you stay vegetarian? Or maybe you are on the same type 2 diet as me “the salad diet”. Salad cures everything. :)

  • 12 David Mendosa // Sep 2, 2015 at 2:43 pm

    I do eat a lot of salad, Frankie! A big salad at lunch is my main meal. My breakfast is a protein shake and I often have a bowl of yogurt or something like that for dinner.

  • 13 Barbara R. // Sep 7, 2015 at 6:40 pm

    Perhaps it’s the lack of fat in these foods that cause them to be more insulinogenic; do the full-fat versions have this effect as well? By the way, Dr. Jason Fung is doing great blog posts about insulin and diabetes.

  • 14 David Mendosa // Sep 7, 2015 at 7:17 pm

    It’s actually the protein as well as the carbs that makes a food insulinogenic, Barbara. Protein has some effect; less than that of carbs, but still some.

    Yes, I read and respect Dr. Fung.

  • 15 Kim Clinton // Nov 1, 2015 at 7:57 am

    What do you eat to get enough protein, David? You mentioned yogurt but it seems that dairy has a high insulin index number. I figure you maybe eat soy but I am wary of eating too much of it. I would like to eat vegetarian but there seems to be very few choices except for dairy and eggs and I do experience a blood sugar spike with those foods.

  • 16 David Mendosa // Nov 1, 2015 at 8:09 am

    The big change in my diet was in my breakfast, Kim. I used to start the day with smoked salmon, both for taste and protein. I switched to a protein powder, as I wrote at http://www.mendosa.com/blog/?p=3414 but I now use the Garden of Life brand. Like you, I want to avoid a lot of soy, but I do usually eat some tofu in my salad and occasionally have tempeh for dinner. But please note that we really don’t need as much protein as we normally get and I do make sure to get as much as the Institute of Medicine recommends, the amount of which I have referred to in several of my articles.

  • 17 Kim Clinton // Nov 1, 2015 at 2:25 pm

    For a long time my meat and cheese heavy diet has not been working to control my diabetes and I couldn’t figure out why. Then I dropped red meat and dairy because I figured lowering inflammation might be helpful and my numbers plummeted. This index may explain that change and maybe why salmon did not seem to lower my blood sugar as much as chicken. I think that becoming a vegetarian will be the next step now that I see some legumes can be eaten. But tell me, David, does the insulin index exonerate certain forms of pasta? I find it a little confusing that pasta and eggs are so similar on this index.

  • 18 evie // Nov 1, 2015 at 3:11 pm

    Greatly expanded list of foods tested for their Insulin Index is freely available online.
    The above is a quote from your latest article.

    This “online” link does not offer the said expanded list of foods tested for their insulin Index.

  • 19 David Mendosa // Nov 1, 2015 at 3:33 pm

    It is there, Evie, but as I said in my article, it is hard to find. It is in Table 1. It’s the last column (which may be hidden when you load the table) in the column headed FII (food insulin index)>

  • 20 David Mendosa // Nov 1, 2015 at 3:35 pm

    Good question, Kim. But here we have to consider the basic glycemic index. Pasta, being high carb, can’t be exonerated by the insulin index.

  • 21 Tara // Jun 7, 2016 at 1:09 pm

    I’m hoping you can help me understand something. How is it that cheese and yoghurt have really high insulin scores, but milk (dairy farmers) scores only 23 and 1% milk scores only 34? Those aren’t so bad… ?

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