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Eat carbs last to aid blood glucose control.

Controlling blood glucose levels is a prime concern for people with diabetes, since chronically elevated blood glucose can do permanent damage to your eyes, vascular system, kidneys, and other organs. Foods high in carbohydrates can cause blood glucose to rise rapidly, so limiting carb consumption is standard advice for people with diabetes.

However, research conducted at Weill Cornell Medical College suggests that you may be able to keep glucose levels lower simply by eating foods in a certain order.

"What we found is that, if you eat carbs last, it disturbs your blood glucose level less," says Louis Aronne, MD, director of the Center for Weight Management and Metabolic Clinical Research and an author of the study.

Lower, slower rise in blood glucose. In the study, people with diabetes were given meals on two separate days, one week apart. Each meal included bread, orange juice, grilled chicken, broccoli, and a green salad. The only difference between meals was the order in which the foods were eaten. In the "carbs first" portion of the study, the bread and orange juice were eaten first, followed 15 minutes later by the salad, chicken, and broccoli; in the "carbs last" portion, the bread and orange juice were eaten at the end of the meal. The participants' blood glucose levels were measured at 30,60, and 120 minutes after the meal, and insulin levels were measured at 60 and 120 minutes.

"Eating carbs last reduced the rise in blood glucose by 37 percent," explains Dr. Aronne. "It also significantly reduced insulin levels; when insulin levels are lower, there's less strain on your pancreas."

He points out that the rate of change in blood glucose is also important: "It's better to have a gradual increase in blood glucose after eating, rather than a sharp rise and then a steep drop; following the 'carbs last' meal, the increase was gradual."

A practical strategy. Although these study results are encouraging, the study was small and consisted of only two meals. "We will be doing another study with a longer duration and a larger group of people," says Dr. Aronne. "But, if the results are reproduced, this simple dietary intervention may help prevent diabetes, and it may mean that people with diabetes can take fewer medications and/or lower dosages."

Meanwhile, you can apply this simple switch in food order to your meals, especially when you are dining out for dinner: If you go to a restaurant that serves bread first, skip it, eat your vegetables and protein, and then eat the bread or other high-carb foods, such as pasta or potatoes.

Dr. Aronne noted that one participant in the study continued to eat carbs last after the study was completed, and he has lost 25 pounds and is taking less medication for his diabetes.

"There are no special diets, no special cooking methods, no restaurants you can and can't go to--just a basic, simple change. It is a way that people with diabetes can eat carbs without having a massive impact on their blood glucose," says Dr. Aronne.


Uncontrolled diabetes can result in:

* Retinopathy, which can cause impaired vision and blindness

* Neuropathy, which can cause pain and tingling in the legs and feet and can result in amputation due to decreased blood flow

* Kidney damage and kidney disease, which can require dialysis
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Publication:Women's Nutrition Connection
Date:Oct 1, 2015
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