Eight key diabetes foods and low glycemic load recipes - Patrick Holford (2024)

1. Oats Rule

As we have seen, oats are a superb food choice for blood sugar control. You can eat them as oat flakes (cold) or soak and cook them to make porridge. Oatcakes are the best ‘bread’ choice, for example, with your scrambled or boiled egg, or as a snack during the day with a high-protein spread such as hummus. Nowadays you can also find oat bakes (so much better than crisps) and oat biscuits, but do check that they say low-GI or GL load on the box.

The Nairn’s brand is particularly GL conscious. The best oat choices are those highest in the soluble fibreFibre is an important part of a balanced diet. There are two type of fibre; soluble and insoluble. Insoluble fibre helps your bowel to pass… called beta-glucans. This is found in oat bran, the rougher outer layer of the grain. So, it’s best to choose ‘rough’ oatcakes rather than ‘fine’. You can lower the GL load of your breakfast further by adding a spoonful of oat bran. This simple act makes a big difference to the GL load of the meal. Since oat bran is highly absorbent, if you add it to cereal, it is best to leave the cereal to soak for a few minutes before eating, and put in more liquid than you normally would. You want to eat as much beta-glucans as you can to help balance your blood sugar.

Not only does the presence of beta-glucans in food slow-release the carbohydrates you eat but it also helps to lower cholesterol. An example of this is a study, conducted by Dr Allan Geliebterof the New York Obesity Research Center at St Luke’s-Roosevelt Hospital. [1] In that study, Dr Geliebter gave volunteers either an oatmeal breakfast, high in beta-glucans, or a sugared cornflakes breakfast, containing equal calories. Those who had the oat-based breakfast consumed 30 per cent fewer calories at lunch, compared with those who ate sugared cornflakes for breakfast. According to Dr Geliebter, ‘The effect may be due primarily to a delay in gastric emptying, the time it takes for oatmeal to leave the stomach and enter the blood as glucose and other nutrients.

The slower the stomach empties the longer food stays in the stomach and the longer people feel full and satisfied.’ The best foods for beta-glucans [2] are shown below, giving the percentage of beta-glucans per food:

• Celery 20% of dry weight
• Carrot 20% of dry weight
• Radish 20% of dry weight
• Oats up to 7.5% (e.g. Nairn’s rough oatcake, which is 88% oatmeal, would contain up to 6.6% beta-glucans)
• Pearl barley 4% (e.g. 1/4 cup pearl barley contains 2.5g beta-glucans soluble fibre)
• Soya bean 0.8% of dry weight
• Shiitake mushrooms 0.4% of dry weight

2. Rye or barley instead of wheat

The whole rye grain is also excellent in terms of GL. Rye bran, in one study, lowered glycemic load better than oat bran. [3]

In practical terms this means a wholegrain rye bread, in moderation, would be a good choice for breakfast or a snack, together with a protein-rich food. The best choice of all would be the slow-cooked German-style breads called pumpernickel, sonnenbrot or volkenbrot. Bear in mind that some use wheat as well, so it’s best to go for those breads that are wheat-free (they’re now widely available in supermarkets). You can also find whole rye sourdough bread, which is good. These breads will be more dense and heavier than regular wheat bread – this is a good sign, but make sure you have thinner slices. One thin slice will be 5GLs. Rye also changes genetic expression away from insulinInsulin is a hormone made by the pancreas. It is responsible for making the body’s cells absorb glucose (sugar) from the blood…. resistance, reversing the indicators of metabolic syndrome. [4] So, if you really want to go for it, stay away from wheat as much as possible, choosing oats and rye.

Barley is another good grain to use, better than wheat. A study conducted by Dr Joseph Keenan, MD, of the University of Minnesota Medical School in Minneapolis, showed that eating barley makes you feel less hungry. [5] Dr Keenan fed a group of overweight people who also had high cholesterol the same diet, but either with barley muffins, high in barley bran and beta-glucans, or wheat muffins. The groups who ate the barley muffins felt significantly fuller and more satisfied throughout the study than those who ate the wheat muffins. ‘We attribute the improvement in satiety almost entirely to the beta-glucan. Foods rich in beta-glucan stay in the stomach for a longer period of time compared to foods low in this fibre. That leads to a feeling of fullness, or satiety,’ said Dr Keenan. Those eating the barley muffins lost, on average, 225g (8oz) per week whereas those who ate the wheat gained 225g (8oz) per week. Also, those who consumed the beta-glucan-rich muffins had significantly reduced total cholesterol (11 per cent) and the ‘bad’ LDL cholesterolLDL is short for low density lipoprotein. It is the “bad cholesterol” which collects in the walls of blood vessels, causing blockages. High LDL levels… (12 per cent), while high density lipoprotein cholesterol levels remained unchanged. ‘This is a very significant result,’ said Dr Keenan. ‘Such reductions are estimated to produce a 20 per cent reduction in the risk of developing heart disease.’ You can buy wholegrain pearl barley, which boils like brown rice. It is also full of beta-glucans and soluble fibres and has a good flavour – quite chewy.

Chewing is good because it means you take a little longer to eat your meal. Pasta tends to be a lower GL Load than bread anyway but a variety of pastas is now available made from rye, quinoa and chickpeas. You’ll find these more often in health-food stores. These are a good choice, and you may also find Dreamfields pasta, which is especially low GL.

3. Eat more lentils and chickpeas

This food group, known as pulses, is a staple in countries with low diabetes incidence, but we just don’t eat enough of these highly nutritious foods in countries with a typical Western diet. Other than beans on toast, most people don’t eat enough pulses (beans on toast is not a bad choice if you pick sugar-free beans – Whole Earth, sweetened with apple juice, are the best tasting).

Pulses are all relatively high in proteinProteins are large molecules consisting of chains of amino acids. Proteins are essential nutrients for the human body – they are a building block of…, making them lower GL Load. If, for example, you chose a serving of beans or lentils as your 7GL carbohydrateCarbohydrates are the primary source of energy for the body as they can be broken down into glucose (sugar) more readily than either protein or… portion in a main meal, you’d be achieving your low-GL goals easily: 130g (43⁄4oz) of cooked chickpeas is 7GLs; 150g (51⁄2oz) of red kidney beans is 7GLs; 175g (6oz) of butter beans is 7GLs; 210g (71⁄4oz) of lentils is 7GLs 260g; (91⁄2oz) of borlotti beans is 7GLs.

Including a serving of lentils, or beans, for dinner actually has a knock on effect on breakfast, quite substantially reducing the blood sugar spikes of breakfast the next day. This was proven in a study that fed people different kinds of evening meals, then different kinds of breakfast, while measuring their blood sugar levels after the meals.

The lower the glycemic load of the evening meal, the flatter the increase in blood sugar was after breakfast the next day. A dinner containing roughly a 130g (4 3⁄4oz) serving of cooked lentils was the best.

4. Quinoa

Quinoa has been grown in South America for 5,000 years and has a long-standing reputation as a source of strength for those working at high altitudes. Called the ‘mother grain’ because of its sustaining properties, it contains protein of a better quality than that of meat. Although known as a grain, quinoa is technically a seed. Like other seeds, it is rich in essential fats, vitamins and minerals, providing almost four times as much calciumWhat it does: Promotes a healthy heart, clots blood, promotes healthy nerves, contracts muscles, improves skin, bone and dental health, relieves aching muscles and bones,… as wheat, plus extra ironWhat it does: As a component of red blood cells, iron transports oxygen and carbon dioxide to and from cells. Also vital for energy production…., B vitamins and vitamin EWhat it does: Acts as an antioxidant, protecting cells from damage, including against cancer. Helps body use oxygen, preventing blood clots, thrombosis, atherosclerosis. Improves wound…. Quinoa is also low in fatThere are many different types of fats; polyunsaturated, monounsaturated, hydrogenated, saturated and trans fat. The body requires good fats (polyunsaturated and monounsaturated) in order to…: the majority of its oil is polyunsaturated, providing essential fatty acidsEssential Fatty Acids (EFAs) are fats that must be taken in through the diet as they cannot be made by the body. Both omega-3 and…. Quinoa is also one of the highest protein sources in the vegetable kingdom, with 16 per cent of its calories as protein (soya has the most, at 38 per cent protein, and some other beans are also higher). As such, quinoa is about as close to a perfect food as you can get.

Quinoa can be found in many supermarkets these days, as well as health-food stores, and can be used as an alternative to rice. To cook it, rinse well, then add two parts water to one of quinoa and boil for 15 minutes. It is also gluten-free and is a much lower GL than rice. A 7GL serving of cooked quinoa is 130g (4 3⁄4oz). The GL load comes down even more if you serve it with protein, such as some fish or maybe tofu for a vegetarian option.

5. Chia seeds, walnuts and almonds

You might not have heard of chia seeds but I’ve been aware of them for some time as the richest source of omega-3 fats from the vegetable kingdom, and a staple food for thousands of years going back to the Aztecs and beyond. It’s just that you couldn’t get chia seeds in the UK and many other countries until recently. The first record of chia’s consumption by humans is in 3500 BC, and by 1500 BC it had become a cash crop in Mexico. Aztec rulers received chia seeds as an annual tribute from conquered nations, and the seeds were offered to the gods during religious ceremonies. But chia dropped out of the Meso-American diet and culture after it was banned by the Catholic Spanish conquistadores, because it had been worshipped by the locals. Instead, agriculture was forced towards growing foods that Europeans were accustomed to.

Now, chia is making something of a comeback – and rightly so. Along with the South American grain quinoa, chia is a highly nutritious food that should become a daily part of our diet, going a long way to restoring our essential fat intake back towards more omega-3 than omega-6. Like flax seeds (also called linseed), chia is very high in soluble fibres, as well as omega-3 fats and protein, all of which are good news as far as reversing metabolic syndrome and diabetes are concerned. Chia has more than double the soluble-fibre content of oats but, of course, you wouldn’t eat the same quantity. Added to oats, for example in porridge, it is a great way to greatly increase your soluble fibre intake. The three reasons I prefer chia to flax are, firstly, it is nutritionally superior; secondly, it tastes better; and thirdly, it stores and remains fresh for longer. This is because it’s naturally high in antioxidants.

In a study giving people with diabetes 37g (1 1⁄4oz) of chia a day, which is about two heaped tablespoons, versus wheat bran, which was used as a placebo, those eating chia had a decrease in their glycosylated haemoglobinHaemoglobin is the protein that is found in red blood cells. It contains iron and is responsible for carrying oxygen from the lungs to the… and their blood pressure. [6] Like flax, chia is a very good source of protein – about 20 per cent, which is much higher than grains, including even quinoa. Rice is only 7 per cent protein, while oats are pretty much the best grain with 17 per cent protein. Chia, however, is richer in antioxidants and soluble fibre than flax – and it is also nutritionally superior in the following ways:

• Chia oil is 64 per cent alpha linolenic acid (omega-3) and 19 per cent linoleic acid (omega-6), compared to flax, which is 58 per cent omega-3 and 15 per cent omega-6.
• Chia provides 631mg of calcium and 466mg of magnesiumWhat it does: Strengthens bones and teeth, promotes healthy muscles by helping them to relax, also important for PMS, important for heart muscles and nervous… per 100g (3 1⁄2oz), whereas flax contains 199mg of calcium and 362mg of magnesium.
• Chia is also very low in sodium – 19mg versus 34mg per 100g (3 1/2oz) in flax. I have a 15g (1⁄2oz) serving every day (a tablespoon), which gives me 100mg of calcium and 70mg of magnesium, a really decent amount for maintaining good health and also ideal if you have diabetes mellitus.

A 15g (1⁄2oz) serving also has an antioxidantAntioxidants are substances that protect cells within the body from damage caused by free radicals. They help to strengthen the body’s ability to fight infection… rating of 1,335 ORAC points. This represents more than a fifth of your daily target of 6,000 ORAC points. Having a quarter of a cup of berries is another 1,000, as is four walnuts or pecan nuts. So, all three with breakfast is more than half your ideal daily antioxidant intake. Taste-wise, chia has a much nicer, slightly nuttier flavour than flax and tastes good on its own, added to cereal, bread or cakes and in salads or soups. Many health-food stores stock it. (Available from Totally Nourish.) Chia seeds are tiny, like sesame, so need grinding before consuming to release all the goodness, or they can be soaked for ten minutes. You can also buy ground chia seeds. Much like oat bran, they absorb a lot of water, so if you add them to cereals, shakes or soups they will bulk up, much like the oats in porridge. This makes you feel fuller.

Flax seeds are also a great source of omega-3, soluble fibres and protein. Much like chia they are best either ground or soaked for ten minutes. Aim for a tablespoon of these seeds once a day. The next best seeds are pumpkin seeds. These are 21 per cent protein, and reasonably high in omega-3. An advantage of pumpkin seeds is that they are very high in magnesium, which you’ll see is also vital for blood sugar control. Pumpkin seeds are large enough and soft enough to be eaten whole, either on cereal, or as a snack, perhaps with a piece of fruit. If you are ‘on the road’ it’s a good idea to have a supply so that when your blood sugar dips you can have a carbohydrate food, plus some pumpkin seeds. Aim for a tablespoonful.

Other good nuts for helping to reverse metabolic syndrome and reduce cardiovascular risk are walnuts and almonds. Walnuts have been shown to improve circulation in those with diabetes, [7] and generally to help reduce indicators of cardiovascular risk. Whether you choose chia, flax or pumpkin seeds, or nuts, you really want to be having a tablespoon of seeds, or a small handful of nuts, every day, either in your food, for example on breakfast, or as part of a low-GL snack. You can get almond butter and pumpkin-seed butter, which are better for you than regular butter or margarine. Peanuts and peanut butter (sugar-free) are also an excellent source of protein but won’t provide the other benefits of omega-3 fats and soluble fibres.

6. Squashes, including zucchini or courgettes

I’m not talking about squash drinks here, but the vegetable family, which includes courgettes, marrows, pumpkin, butternut squashes and many other varieties of winter squash. These are a very low GL Load vegetable so a great choice for your 7GL carbohydrate portion for a main meal. Recent research reveals that an extract from pumpkin promotes the regeneration of damaged pancreatic cells in type-1 diabetic rats, boosting levels of insulin-producing beta cells and insulin in the blood. [8]

A group, led by Tao Xia of the East China Normal University, found that diabetic rats fed the extract had lower insulin levels and less destruction of insulin-producing cells. Xia says: ‘pumpkin extract is potentially a very good product for pre-diabetic persons, as well as those who have already developed diabetes’. He adds that although insulin injections will probably always be necessary for these patients, pumpkin extract could drastically reduce the amount of insulin they need to take. The protective effect of pumpkin is thought to be due to both antioxidants and D-chiro-inositol, a molecule that affects insulin activity. It’s a bit early to say the same effects will occur in people with diabetes but, given that squashes have a very low GL as well, I encourage you to make them a regular part of your diet.

7. Berries, cherries and plums

The principal sugar in most berries, cherries and plums is xylose, making these fruits especially slow-releasing. The bluer the berries the better, so blackcurrants, blackberries, blueberries and cooked black elderberry are all superfoods.

In a recent study, blueberries were put to the test on a group of overweight, insulin-resistant volunteers deemed at high risk of diabetes. They were given a blueberry smoothie every day for six weeks, or an identical-looking and tasting fake smoothie. Those getting the real thing had a 22 per cent increase in their insulin sensitivity. [9] The Montmorency cherry is exceptionally high in antioxidants and Montmorency cherry extract (called Cherry Active), as a cordial, is the only fruit drink I recommend. Since the predominant sugar in cherries is xylose, this drink is relatively low in GL (even so, be careful not to have more than a shot a day), whereas grape juice contains pure glucose. Plums, when in season, are a great fruit snack, together with some protein such as a few almonds or pumpkin seeds.

Prunes are dried plums and three or four on cereal is an alternative fruit, but make sure they haven’t been soaked in sugar. The next best fruits are apples and pears, but the kind of apple or pear you choose makes a difference. The harder and less sweet conference pears, for example, have the lowest GL.

8. Cinnamon

A spoonful of cinnamon a day really does help keep diabetes mellitus at bay. Cinnamon is a safe and inexpensive aromatic spice, which has been used for many years in traditional herbal medicine for the treatment of type-2 diabetes. The active ingredient in cinnamon, MCHP, mimics the action of the hormone insulin, which removes excess sugar from the bloodstream. Cinnamon also appears to reduce blood cholesterol and fat levels [10] and decrease blood pressure. [11] I certainly recommend you make a daily teaspoon of cinnamon part of your reverse-diabetes programme. While we no doubt have much to learn about cinnamon, animal studies have found that there is a positive effect on blood sugar levels when treated with cinnamon.

A study in 2005 found that following a high-sugar meal, cinnamon reduced blood sugar and increased insulin levels for up to 30 minutes. [12] Another animal study found that after just two weeks of cinnamon administration, there were positive effects on fat levels and blood sugar levels, and after six weeks insulin levels and ‘good’ HDL cholesterolHDL is short for high density lipoprotein. It is the “good cholesterol” responsible for removing harmful cholesterol from the bloodstream. High HDL levels reduce the… had also increased. [13] There have also been positive findings in human studies. A research group found that when people who are in the early stages of diabetes mellitus development rather than just at higher risk were given a cinnamon extract called Cinnulin for 12 weeks, there were improvements in several features of metabolic syndrome (blood sugar levels, blood pressure and body fat percentage). [14]

A follow-on study found that the cinnamon extract also improves antioxidant status, thus potentially giving protection from arterial damage caused by oxidants. [15] Another recent study in people with diabetes found similar results. Thirty-nine patients were given cinnamon extract for four months and showed a substantial reduction in post-meal blood sugar levels and a 10 per cent reduction in fasting blood sugar levels. Interestingly, people with diabetes with the poorest blood glucose control showed the biggest improvements with cinnamon. [16]

How much cinnamon do you need?

Once again, studies are showing us the most effective levels of cinnamon to take. In one study, in 2003, researchers gave three groups of people with diabetes 1g, 3g or 6g (a heaped teaspoon) of cinnamon per day. All responded to the cinnamon within weeks, with blood sugar levels 20 per cent lower on average than those of a control group. Some of the volunteers taking cinnamon even achieved normal blood sugar levels. Tellingly, blood sugar started creeping up again after they stopped taking cinnamon. The biggest improvements were seen with the highest dosage.

A more recent Scandinavian study in which volunteers were given rice pudding, with or without cinnamon, found that those given 3g of cinnamon produce less insulin after the meal. In an earlier study the researchers also found that cinnamon may slow down gastric emptying. This would have the effect of slow-releasing the carbohydrates in a meal. This effect was seen with 6g of cinnamon, not 3g. A teaspoon is roughly 3g. A heaped teaspoon is closer to 6g. I recommend you take 1 teaspoon (3g) per day.

Summary

To obtain blood sugar control, regulate your appetite and improve your general health:

• Eat your oats (and shiitake mushrooms and barley) for their betaglucans.
• Vary your grains – don’t always eat wheat, but opt for rye or barley.
• Eat pulses (beans, lentils and chickpeas) regularly.
• Make the super-grain quinoa a regular part of your diet.
• Snack on a small handful of chia seeds, walnuts or almonds every other day to help improve your cardiovascular health.
• Include squashes and pumpkins for their pancreas-promoting power.
• Pick deep-coloured blueberries, blackberries, blackcurrants, cherries and plums, or apples and pears, which are all naturally lower in sugar.
• Sprinkle a spoonful of cinnamon onto your cereal each morning or add to your soups and bakes to subtly spice them up.