Adapt a healthy diet for your child using the glycemic index of foods
by Kate Marsh
BSc, M Nutr Diet, Grad Cert Diab Edn & Mgt
Accredited Practising Dietitian & Credentialed Diabetes Educator
Glycemic Index (GI) is the scientifically proven way of describing how the carbohydrates in foods affect our blood glucose levels.
• High GI foods are those in which the carbohydrates break down quickly during digestion, releasing glucose quickly into the bloodstream
• Low GI foods are those in which the carbohydrates break down slowly, releasing glucose into the bloodstream gradually.
Research has now shown that eating more low GI foods may have many benefits for health and weight management.
Low GI foods
• are more filling and satisfying, thereby reducing appetite
• result in lower insulin levels which make fat easier to burn and less likely to be stored
• help to lower blood fats
• help people with diabetes manage their blood glucose levels
• help to sustain endurance exercise for longer.
Low GI diets have also been shown to be associated with a reduced risk of developing diabetes and heart disease.
While much of the research into GI to date has been in adults, the last few years has seen a number of studies published showing the possible benefits of low GI diets for children.
Low GI diets have been shown to improve satiety in both overweight and normal weight children. In one study, when children were given either a low GI or high GI breakfast, their hunger ratings before lunch were significantly greater after the high GI breakfast compared with the low GI breakfast (Warren et al, 2003). This led to an increase in food intake at lunch, with the children eating around 150kcal more after the high GI breakfast than the low GI breakfast. A second study in obese adolescents found that while there was no difference in the amount of food consumed after a low GI or high GI breakfast, those eating a high GI breakfast requested more food to eat sooner than those who had the lower GI breakfast, indicating an increase in satiety with lower GI foods. Over a longer period of time, this could obviously lead to a lower energy intake, thereby helping with weight management.
Low GI diets have also shown benefits in terms of insulin levels. Insulin is a hormone which helps to control blood glucose levels and which promotes the storage of fat. One study in obese adolescents found that a reduced glycemic load (GL) diet resulted in a greater reduction in BMI and body fat and a smaller increase in insulin resistance after 12 months than a conventional low fat diet (Ebbeling et al, 2003), while a second study, also in obese adolescents, found a significantly lower glucose and insulin response to low GI meals compared to those with a high GI (Ball et al, 2003). And a study of healthy 8 year old children found that those with a lower overall dietary GI had lower insulin levels than those with a higher GI diet (Scagolini). Together these studies suggest that a low GI diet may play an important role in the management of obesity and the prevention of type 2 diabetes.
Finally, a study in children aged 11-25 years found that children whose diets had a lower glycemic load had higher levels of the "good" HDL cholesterol (Slyper et al, 2005). This has also been shown in adults and may have important implications for long term heart health. Glycemic Load (GL) takes into account the total glycemic response of a food or meal by multiplying the GI of the food by the amount of carbohydrate in the food.
With the possible benefits of low GI diets in overweight children, researchers from the Department of Pediatrics at the University of Utah School of Medicine conducted a pilot study to determine whether parents of overweight children aged 5-12 years can lower the glycemic index (GI) of low GI diets in overweight children, researchers from the Department of Pediatrics at the University of Utah School of Medicine conducted a pilot study to determine whether parents of overweight children aged 5-12 years can lower the glycemic index (GI) of their child's diet after receiving brief instructions and a handout from their pediatrician (Young et al, 2004). All of the parents in the study described the diet as easy to understand and two-thirds of them reported that their child was generally able to follow the diet. Eighty percent of the children also reduced their BMI after following the low GI diet.
One area in which low GI diets have been more widely used is in the management of diabetes and an Australia study of children with type 1 diabetes found that a low GI diet resulted in better blood glucose control without an increased risk of hypoglycemia (low blood glucose reaction) or weight gain when compared to traditional carbohydrate counting (Gilbertson et al, 2001). The children and their parents in the low GI group also preferred the low GI diet, finding it easier to follow.
How do I make the change to a Low GI Diet?
Changing to a low GI diet is not difficult. You don’t need to cut out any foods or food groups, just make better choices. This often just means swapping one food for another, as shown in the table below.
Substituting low GI for high GI foods
High GI Food
Low GI Alternative
Bread – white or wholemeal
Bread containing lots of grains
Processed breakfast cereals
Unrefined cereals such as rolled oats or natural muesli
Plain biscuits or crackers
Biscuits made with dried fruit, oats and wholegrains
Cakes and Muffins
Cakes made with fruit, oats and wholegrains
Potato
Substitute with yam, sweet potatoes and corn
Rice – most types of rice have a high GI
Try Basmati or Koshikari or try pearled barley, pasta or noodles instead.
Legumes , such as split peas, mung beans and soy beans all have a low GI due to their high content of soluble fibre, which slows down digestion.
Dairy products , such as milk, yoghurt and custard have a low GI as the main type of sugar in these products, lactose, is quite slowly digested. These foods also provide protein and calcium for growing children so should be included regularly in meals or snacks, for example milk on cereal, yoghurt as a snack and custard with fruit for dessert. Soya milks also have a low GI.
Fruits contain fructose, which is also slowly digested, so most fruits have a low or moderate GI. Some tropical fruits have a higher GI due to a higher proportion of glucose but all types of fruit are a healthy choice for your child. Fruits with the lowest GI values include apples, pears, berries, oranges, peaches and plums.
You can start by focusing on the carbohydrate foods that make up a regular part of your child’s diet, and switching these to lower GI choices. For example, if you child eats rice and cereal most days you could try serving more noodles in place of rice and change their processed breakfast cereal to oats. Or if your child eats a lot of potato, you could try serving more sweet potato, yam or corn instead. Not all food choices need to be low GI – switching just half of the carbohydrate foods your child eats in a day from high to low GI choices or including one low GI food at each meal is of benefit.
You can also lower the GI of a meal containing a high GI food by combining this with a lower GI food. For example, having a glass of milk (which has a low GI) along with a piece of white bread (which has a high GI) will give the overall meal a medium GI.
One thing to keep in mind is that GI should not be used in isolation when making healthy food choices. Some low-GI foods are high in saturated fat (e.g. chocolates, pizza, and potato chips), while some high-GI foods may still be good choices because they are nutritious and relatively low in energy and carbohydrate (e.g. watermelon and pumpkin).
So, when using GI, it should be should be used to supplement other healthy eating guidelines. These include:
1. Eating a variety of foods
2. Eating plenty fruits, vegetables and wholegrain breads and cereals
3. Limiting intake of saturated fats from foods such as fatty and processed meats, butter, cream, cakes, biscuits, pastries, chocolate and fried takeaway foods.
4. Limiting intake of foods and fluids high in added sugar
5. Limiting intake of salt and foods high in salt
For more information, on the GI content of foods please visit www.glycemicindex.com or get a copy of The New Glucose Revolution: Healthy Kids, written by the University of Sydney’s Jennie Brand-Miller along with dietitians Kaye Foster-Powell and Heather Gilbertson. This book offers invaluable information on how to use the GI to improve and maintain your child's overall health and nutrition. It clearly explains which types of carbohydrate are best for children of every age - from infants to teens - as well as meal plans, a low-GI food finder, and GI values for hundreds of foods and beverages.
References
Ball SD , Keller KR, Moyer-Mileur LJ, Ding YW, Donaldson D, Jackson WD.Prolongation of satiety after low versus moderately high glycemic index meals in obese adolescents. Pediatrics. 2003 Mar;111(3):488-94.
Ebbeling CB, Leidig MM, Sinclair KB, Hangen JP, Ludwig DS.A reduced-glycemic load diet in the treatment of adolescent obesity. Arch Pediatr Adolesc Med. 2003 Aug;157(8):773-9.
Gilbertson HR, Brand-Miller JC, Thorburn AW, Evans S, Chondros P, Werther GA (2001). The effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes. Diabetes Care 24:1137-43.
Silvia Scaglioni, Giorgio Stival and Marcello Giovannini. Dietary glyce mic load, overall glycemic index, and serum insulin concentrations in healthy schoolchildren. Am J Clin Nutr. 2004 Feb;79(2):339-40.
Slyper A, Jurva J, Pleuss J, Hoffmann R, Gutterman D. Influence of glycemic load on HDL cholesterol in youth. Am J Clin Nutr. 2005 Feb;81(2):376-9.
Warren JM, Henry CJ, Simonite V. Low glycemic index breakfasts and reduced food intake in preadolescent children. Pediatrics. 2003 Nov;112(5):e414.
Young PC, West SA, Ortiz K, Carlson J.A pilot study to determine the feasibility of the low glycemic index diet as a treatment for overweight children in primary care practice. Ambul Pediatr. 2004 Jan-Feb;4(1):28-33.
Sample Meal Plan For A Young Child (average age of 5 years)
Foods that are highlighted have low GI
Breakfast
8 am 1 slice of bread
1 slice of cheese
1 small banana
1 glass milk
Mid-Morning Snack
10.30 am Peanut butter sandwich
1 glass milk
Lunch
12.30 pm 1 bowl rice porridge
2 tablespoons fish
2 tablespoons of sweet potato
½ cup of green leafy vegetable
1 medium piece beancurd
Afternoon Snack
3.30 pm 1 tub plain yoghurt
Dinner
6.00 pm 1 plate spaghetti
2 tablespoons minced chicken
2 tablespoons tomato sauce
½ cup of spinach
1 small plum
Bedtime
8.30 pm 1 glass milk
To read up on some recipes that have a low GI please click below;
• Healthy Oat Bran Apple Cake
• Creamy Sweet Potato Soup
• Quick Quails Eggs and Spinach Noodle Soup
• Chicken & Macaroni Combo
• Thai Vermicelli Salad
• Spaghetti in Chicken and Tomato Sauce
• Sushi-liscious snacks
• Barley Banana Medley