Sep 23 2010

ALMONDS in the control of Diabetes and High Cholesterol

Category: Foods,UncategorizedJimR @ 7:26 pm

“Nature” provides many foods to combat disease

To name a few at random that could be added to the diabetic food list: Almonds, walnuts and other nuts, oatmeal, oatbran, fish and omega-3 fatty acids, olive oil, fruits and berries and the many other plant foods that provide vitamins, minerals, fiber and phytonutrients.

But here we will deal with almonds, for which there is plenty of reliable published information — and almonds, and other nuts, are a frequently recommended food supplement for several reasons, including their apparent affect on blood cholesterol.

People with diabetes are being urged to watch their cholesterol and blood pressure levels as well as their blood glucose levels

Results of a study from Denmark’s called the “Steno – 2” clinical trials, were published in 2008 and showed that, in addition to maintaining good blood-glucose control, it is also beneficial for diabetes sufferers to aggressively combat high blood pressure, high cholesterol, and high triglyceride levels. A report of this study from the Steno Diabetes Center can be found at:

Almonds and Walnuts significantly reduce blood cholesterol levels
That’s according to a 2008 Mayo Clinic news release that listed the top 5 foods that help to lower cholesterol numbers. When included in a cholesterol lowering diet, almonds and walnuts were found to have a “marked improvement within just four weeks, and they may reduce LDL cholesterol (the “bad” one) by as much as 12 percent”.

The Mayo Clinic comments do not specify the amount of almonds eaten daily but frequently suggested in other references is about one ounce, roughly 20 to 25 almonds and these I believe should be in the unsalted, raw uncooked, or dry roasted, state. For myself, I found that 20 or 25 is too many to eat at one time, a few at each of several times was better, and the motivation being the potential cholesterol lowering effects. Elsewhere I have seen a suggested amount of 2-1/2 ounces – that sounds a lot to me but the point is to have them available and to make a conscious effort to include them for snacks or whatever to gain the benefits they provide.

Soaking almonds for maximum beneficial nutrition
Something that I suspect most people do not know. Shelled almonds have a substance in their brown skins called phytate, an anti-enzyme that can sometimes be difficult to digest. There are recommendations that, to help digestion and to gain the most nutrition from almonds by allowing their nutrients to be released, they should be soaked in water for about 12 hours and then dried out completely, possibly with heat not to exceed much above 100 degrees Fahrenheit, after which they can be stored as required.

It should also be noted that all nuts are high in calories, for almonds about 170 calories per ounce (28 grams) and this is because they are rich in monounsaturated fats. But these are the healthier fats. At the same time, almonds are low in the unhealthy saturated fat and they do contain many other essential minerals and other nutrients, including calcium, magnesium, manganese, phosphorus, and vitamin E — in the form of alpha-tocopherol. All of those and compounds called phytochemicals, which, their advocates claim, may help protect against cardiovascular disease and possibly other disease conditions.

There have been many reliably conducted studies done that have reported convincingly that when almonds are included in a person’s diet they help lower cholesterol levels and also provide many other health benefits that should not be ignored. A reference to a few of these reports is added at the end of this piece. After reading some of the articles relating to almonds I have to conclude that these nuts are just too good not to be part of a daily diet even if you are not diabetic. The right course of action might be, as I have seen suggested “To lower your risk of cardiovascular and coronary disease, enjoy a handful of almonds at least four times a week”.

Brazil Nuts, Walnuts, and other nuts
Probably the benefits of other nuts, such as Brazil nuts and walnuts, should also be reviewed. I believe a few Brazil nuts provide a daily requirement of selenium, another mineral that apparently can be deficient in diabetics. Joseph Guliano, M.D., a diabetic himself, in his book The Diabetic Male’s Essential Guide to Living Well, has much to say about minerals and states his opinion that diabetics should supplement all the essential minerals such as selenium, zinc, copper, manganese.

Another comment of interest on nuts in general is posted on the WebMD website, for which the web address is given at the end of this piece, in which Frank Hu, MD, PhD, associate professor of nutrition and epidemiology at the Harvard School of Public Health, tells WebMD that “Our epidemiological studies have shown eating about one ounce of nuts every day will reduce the risk of heart disease in the long run by 30%.”

Caution regarding nut allergies
I do realize that some people are allergic to nuts, especially children and for that reason I raise a caution flag here. Some nut allergies can be life threatening and fatalities have occurred. I personally recall an incident of a child who had unknowingly eaten nut-containing substances when away from normal home-supervision when at a summer-camp, the situation ending in the tragic death of the unsuspecting child. Two of my own children are allergic to nuts and my wife and I were always watchful. Neither my wife or myself have nut allergies and neither does a younger child of ours.

Almonds, Magnesium and Manganese
Almonds are a very good source of magnesium and manganese, minerals in which diabetics tend to be deficient, according to many reports. That is the opinion expressed in a 2001 website article “How Diabetes Works” by Craig Freudenrich, PH.D.

Similarly those views are shared by Michael T. Murray, N.D., as mentioned in his book  Diabetes and Hypoglycemia. Dr. Murray suggests that, in addition to eating foods rich in magnesium, such as almonds, an additional magnesium supplement of 300 to 500 mg daily should be taken by diabetics, preferably in a highly absorbable form such as magnesium aspartate or citrate, together with 50 milligrams of vitamin B6. For manganese he recommends that a good daily dose for a diabetic is 30 milligrams.

[Another B vitamin that I have found helps with my feet problems is B-12, described in this article: Diabetic Neuropathy and B-12.]

Caution: Please note, anyone reading this article should obtain their own confirmations and opinions for themselves from healthcare professionals regarding the appropriateness of amounts and individual minerals and supplements mentioned here.

The United States DRI’s (Dietary Reference Intakes, published by the Food and Nutrition Board) recommends a magnesium intake of 420 mg per day for males aged 31 and older and 320 mg per day for females aged 31 and older. A quarter of a cup of almonds provides nearly 100 mg of magnesium, that’s almost a quarter of the recommended daily intake of magnesium for males and a little less than one third for females, but for me, I think that would be too many almonds in one day.

Magnesium is one of several important electrolytes, minerals in the human body that carry an electric charge and that have an essential role in maintaining balance in much of the body’s chemistry relating to muscles, nerves, heart function, fluid retention and other activities. Many doctors, often those who, as well as being medical practitioners, are also advocates of nutrition and complementary methods of treatment, claim that most adults, even non diabetics, do not obtain sufficient dietary magnesium for good health. Food sources of magnesium are leafy green vegetables, nuts, seeds, whole grains, beans, lentils, and peanuts.

Mineral amounts in 1oz. of raw unsalted almonds

Mineral Amount % RDI
Potassium 206 mg 0.059
Phosphorus 134 mg 0.134
Calcium 70 mg 0.070
Magnesium 77 mg 0.22
Selenium 1.2 mcg 0.034
Iron 1.2 mg 0.08
Zinc 0.95 mg 0.063
Manganese 0.7 mg 0.14

Values courtesy  Dr. R.D. Decuypere

I suspect that most doctors who treat diabetic patients are unlikely to be recommending food supplements such as almonds and minerals or vitamins and would probably not requisition blood tests that could indicate whether there are any deficiencies in some of those vitamin and mineral substances.

Regarding minerals, my own doctor usually tests only for potassium, and sometimes for sodium and chloride levels, all three of which are also electrolytes. Those tests are monitored together with the many standard diabetic tests for other things such as creatinine, eGFR, ALT, TSH, cholesterols, triglycerides.

Beyond those usual essential tests, I sometimes wonder whether it would make sense, at least perhaps annually, to test for a much wider range of vitamins, minerals and other nutrients in addition to the above standards that follow the conventional diabetic protocols.

NOTE: In July 2003, the FDA approved qualified heart health claim for almonds, hazelnuts, peanuts, pecans, some pine nuts, pistachios and walnuts, these nuts contain less than 4g of saturated fats per 50g. Packages of nut products that meet the FDA’s requirements will now be able to carry the following claim: “Scientific evidence suggests but does not prove that eating 1.5 ounces per day of most nuts, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease.”

For your further reference, many other individual food items, suitable for the diabetic menu, are discussed at out companion site Diabetic Food List. And more general diabetes topics can be found at Normal Blood Sugars and Diabetes.

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Jan 11 2010

The Glycemic Index and the Glycemic Load

Category: ExplanationJimR @ 9:21 pm


When considering various foods that you might wish to add to a diabetes food list, it can be helpful to know their Glycemic Index rating.

The Glycemic Index, or GI for short, is a list of carbohydrate containing foods that have been rated for their speed of conversion to glucose, and the release of that glucose into the bloodstream, compared to a standard reference value of 100 assigned to pure glucose. Pure glucose being very speedily released into the bloodstream since it does not require any further chemical breakdown by the digestive-system as would other food items.

The higher the numerical grading of a food the faster it is absorbed into the bloodstream compared to other foods of lower numerical value. Examples of this would be the breakfast cereals:

All-Bran with an established GI of 42,
Shredded Wheat with a GI of 67, and
Corn flakes with a GI of 84,

indicating that the carbohydrates in Corn flakes are converted much more quickly into glucose than the other two cereals with All-Bran taking the longest time. A faster release of glucose causes a faster and higher spike in blood sugar elevation, something to be avoided, or at least minimized if possible, leading to the conclusion that All-Bran is a better cereal choice than the others to include on the diabetic food list.

But not all high GI foods are bad and there are times, such as before, during, and after exercising, when they are beneficial. The body reacts to the higher blood glucose by releasing insulin, a hormone that assists the body in building muscle, although we must always keep in mind that the diabetic person’s body has an impaired ability to deal with insulin and higher blood glucose. These matters would be better discussed and commented on by the diabetic’s doctor or qualified health team members.

Many foods, such as proteins and fats, do not contain significant amounts of carbohydrate and are not listed on the glycemic Index.

The glycemic index is a useful tool to aid in choosing carbohydrate containing food items to include in a diabetic food list, enabling an emphasis on those with lower index values. But the inclusion of low GI foods in a diabetic food plan is only one of several considerations in determining an appropriate dietary regimen to follow over the long term.

GI range of values

Low GI values are 55 or less
Medium GI values are 56 to 69
High GI values are 70 and above.

The Glycemic Load
But what if the carbohydrate food we eat is only part of a larger meal that is otherwise devoid of carbohydrates, perhaps a meal of mostly protein and fat, of meat, vegetables, fruits, that have little or no carbohydrate content? In that case, measuring by weight in terms of grams, the carbohydrates would  be only part of the total grams in the meal and from this an adjusted GI value can be obtained by applying a simple formula..

To cover that situation, there is an extension and enhancement of the glycemic index known as the Glycemic Load. The glycemic load derives a set of values from those of the GI by taking into account the quantity, or quantities, of carbohydrates that are actually in the total meal of food item.

It becomes more practical to consider the GL of a food item when it is only a relatively small portion of the food being consumed, even if it is has a high GI rating,.

For a simplified example: when  knowing that one cup of the 84 GI cornflakes weighs about 30 grams, we can easily calculate the proportion of the cornflakes to the weight of the total meal. When being considered as part of a larger breakfast meal of 120 grams weight, it would be 25 percent of the total and that becomes the glycemic load value. 25 percent of the 84 GI is 21, the GL value of the cornflakes in the breakfast.

GL ranges of values
A GL value of 21 is still rather high, the substitution of a lower GI cereal such as Bran flakes or oatmeal porridge  would achieve a much lower GI rating. A GL value below 10 is considered to be low and above 20 is high in the opinion of most nutritionists.

An important decision regarding carbohydrate consumption
A major decision rests on what percentage of carbohydrates will be included in the overall diabetic food plan, whether to follow the American Diabetes Association’s recommendations of a high ratio of carbohydrates, or the opposite approach of lower carbohydrates, or somewhere in between. This is a controversial subject for many health care practitioners and needs careful consideration and discussion elsewhere. There are strong advocates whose differing views are worth hearing, even though a diabetic patient mainly depends on his or her personal physician to provide guidance, much of the management of the diabetic condition is in the hands of the individual diabetic.

The food lists available from this blog-site do provide the nutrient content and information for many common food items, indicating whether high or low on the GI and some food groups in general are summarized. For a very complete listing of GI values the following resources are suggested – although doing the research can get rather complicated and time consuming:

1.  The University of Sydney, Glycemic Index Web site.

2.  David Mendosa, blogger and medical writer.

3. There is also a very good article and explanation by staff of the Linus Pauling Institute at Oregon State University. That explanation references the GI to cardiovascular disease, a major complication of diabetes, and to obesity, to cancer, and to gallbladder disease. With its comments on several other topics of interest, it is worth a read and can be reached at Linus Pauling Institute.

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