Sigh. The
headlines last week were filled with talk of how the latest study showed that eating low glycemic index (GI) foods, which don’t raise blood sugar levels quickly, rather than high glycemic foods, had no effect on health. A critical look at the way the study was conceived, planned and analyzed is necessary here.
Since When is Pasta Low Glycemic?
The biggest problem with this
study is that grains and potatoes were used in both the low GI and high GI groups. Why bother using non-starchy vegetables in the low glycemic group when you include high glycemic grains, rice, pasta and potatoes in that group? Or high fiber in all groups? The degree of processing of whole grains also makes a huge difference on the glycemic index. Most whole wheat breads these days are made from flours ground so fine that they
affect the blood sugar levels, sometimes more than a candy bar. The GI of a whole grain product today cannot just be gleaned from a chart in an old text book, which is what the researchers used. Gut microbes and pre-biotics were not even discussed at all.
Wheat also is the food MSG was first isolated from because it is high in the amino acid glutamate, which directly
tells the pancreas to release insulin. Type I diabetics often have antibodies to the enzyme GAD that gets rid of excess glutamate. So there may be other reasons to exclude wheat in at least one group when studying sugar, glycemic load, glycemic index, insulin, obesity and health.
A Distinction Without a Difference
This latest study seemed designed to find the outcome desired. In the introduction, what is considered “healthful” is spelled out up front: “a healthful diet rich in
whole grains, vegetables, and fruits“ which biases the study from the very beginning. The study researchers also only used diets their associates already came up with, like the DASH diet and did not even consider the typical American diet. The differences in glycemic load were so slight or incremental as to be hardly noticeable, which is what was reported. It reminded me of studies comparing a dose of one drug against a slightly higher dose of that same drug. Or two similar drugs against each other, but never against a totally different therapy that might call into question the expensive drug du jour. The difference in the diets regarding GI was so small as to be barely noticeable although they claimed it was a ”large contrast". The foods they chose to call low GI, which included white rice, pasta or potatoes were laughable. The study headlines don’t reflect the actual data when it comes to the low carb diets, which did have a definite impact on health and showed in the results despite the fact that a real low carb diet contains from 10% to 30% of calories, not 40%, which was used in the study. The media chose to focus only on GI and not the low carb results, which were significant. Also, the differences between fructose and glucose which impact the body differently were not considered.
Low Carb Diets
Even though I was trained in nutrition and food science, if I didn’t try a true low carbohydrate diet under the care of a health counselor associated with my local hospital, I might be tempted to dismiss claims of low carbohydrate effects on health, but I did. I was told since I was 18 I had to watch my cardiovascular health, I even lost a kidney a few years back and the diets doctors always told me to try were low salt, low fat. But never, never did they say, carbohydrates were a problem. That could be due to the fact that Ansel Keyes, who terrified everyone about butter, did not disclose while he was on his anti-fat crusade, that his laboratory had been
funded by the sugar industry as far back as 1944. The establishment researchers who carried out this study may simply have been trying to protect the advice they have been giving out for years.
Why “More” Whole Grains?
Decades of low fat, low sodium advice from misguided health policy and scant science resulted in a diet after surgery for me that called for 7, yes,
seven servings of carbohydrates a day. That’s what happens when you limit protein and fat. That’s what’s left for kidney patients. “More whole grains”. What always gets me riled is the impulse of health news journalists to throw the word “more” in front of an admonition to eat whole grains. We are eating quite enough, thank you. The truth is we need more artichokes and asparagus, not more bread.
The Real Mediterranean Diet
If you look at a true Mediterranean diet, it has more vegetables and more meat, and much of the cheese is full fat. An Italian will wax absolutely rhapsodic about artichokes, broccoli rabe, and escarole, or capicola (“Gabagool” if you’ve seen the Sopranos) and prosciutto. Low fat? Have you seen sopressata? Or Burrata, which is basically mozzarella drowning in cream? In Italy, mozzarella comes from water buffalo, and is full fat.
Before the Pasta
Anti-pasto is just as important as pasta. More so. It is often our favorite course. Italians eat meat, provolone, mozzarella and non-starchy vegetables like red roasted peppers, pepperoncini, pickled cauliflower, celery, mushrooms, artichokes and olives
before they eat pasta. Protein and fiber first will cause you to eat less simple carbs. That is why they call it
anti-pasto. The order in which you eat your meal matters. A soup course, which was always on the menu every night for my grandfather from Perugia, also cuts pasta intake. An Italian who eats antipasto which includes vegetables and meat as well as soup before their pasta will eat less pasta than an American who sits down to an enormous bowl of pasta with jarred, sugar-laden tomato sauce or a deep dish pizza with breadsticks on the side. Italians know how to pace their meals for good reason and eat moderate amounts because they eat a very wide variety of foods. If you gorge yourself on the first course you will run out of room by the third and there are still two more to go. My husband learned the hard way at his first holiday dinner with my family, small amounts of many things gets you to dessert, which is usually only served at holidays. If you do it right, and you’re lucky, you might have room for a mini cannoli and an espresso. I think that’s why Italian pastries are so tiny.
