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					HIGH CARBOHYDRATE                        VS        LOW CARBOHYDRATE: THE EFFECT                       OF CARBOHYDRATES ON
                                                   THE GLYCEMIC LEVEL OF PERSONS                      WITH TYPE 2 DIABETES

The reason for this study is to increase                             Student Researcher: Raul Castro, Martin High School
awareness of the effects of foods and knowl-             Mentor: Nora Martinez, MPH, City of Laredo Health Department,
edge of the glycemic index in the management
of type 2 diabetes. The glycemic index                                                                WIC, Laredo, Texas
measures the effect of a certain food on the
blood glucose level of a person.1 It is
hypothesized that not all carbohydrates have          BACKGROUND                                   METHODS
the same composition and checking postpran-
dial blood sugars is crucial in any diabetes
                                                          Carbohydrates are essential to our           The study was open to patients of
education program.
                                                      daily life; they provide the body with       the City of Laredo Health Department
Patients with type 2 diabetes were recruited          the energy needed to keep all body           (CLHD) La Familia Program with type
from the City of Laredo Health Department La          systems functional. After eating, car-       2 diabetes. The test compared the
Familia Program. They were served a lunch                                                          differences in glycemic control with
                                                      bohydrates are broken down by en-
meal prepared by nutritionists that consisted of
                                                      zymes into sugars and are absorbed           regular white rice (high carbohydrate)
3 oz. baked chicken breast, 1/3 cup white rice
and K cup broccoli. The recommended                   into the bloodstream. The sugars are         and brown rice (low carbohydrate). The
serving sizes for each food, according to the         absorbed in the blood so that the            volunteers came in one week for a
Complete Guide to Carb Counting by the                blood may transport it to cells where        healthy lunch consisting of: 3 oz
American Diabetes Association, were fol-              the energy is used. Some carbohy-            chicken breast, 1/3 cup white rice, 1/2
lowed. The patient’s blood glucose readings                                                        cup mixed vegetables, and a light
were taken prior to the meal and at 1 and
                                                      drates cause blood sugar level to rise
2 hours after the meal. The patients were             rapidly. Foods such as white rice, for       beverage. This food was cooked by the
asked to return in a week; the same meal was          example, are converted immediately           healthiest and easiest method possible.
prepared using brown rice, which, although            to blood sugar, causing the level to         The chicken was baked using only lime
has 2 more grams of carbohydrate, ranks lower         spike rapidly. On the other hand, due        juice and Mrs. Dash salt-free seasoning
in the glycemic index. The meals were exactly                                                      for taste. Before the volunteers ate, their
the same with exception of the type of rice
                                                      to the fiber content, brown rice is
                                                      digested more slowly, causing a slower       blood sugar levels were checked with an
served (whole grain vs. white.)
                                                      change in blood sugar level. Brown           Ascensia Contour glucometer and the
The nine volunteers’ blood glucose levels were        rice has a lower glycemic index              readings were recorded on a data sheet.
averaged and graphed. Overall, the results for        ranking than that of white rice. The         Blood sugar levels were also taken at 1
the brown rice showed a small increase in                                                          and 2 hours after the meal and were
                                                      glycemic index ranks foods according
blood sugar but then a much bigger decrease
                                                      to how they affect glucose in the            recorded. Averages of the first, second,
in blood sugar and ended up in 15 mg/dL
lower than the original results. These results        bloodstream. The glycemic index uses         and third readings were recorded and
show that carbohydrates are not the only factor       the amount of carbohydrates, the             compared.
that affect the blood sugar level and that other      fiber content, and serving size to               The volunteers returned again for a
factors, such as fiber content, the type of                                                        second meal a week later. The same
                                                      calculate the rise or fall of blood sugar
carbohydrate (simple or complex), and how
                                                      level when the food is consumed. One         meal was prepared with the only change
processed the food is can also affect the
glycemic index.                                       of the most important factors that           being the type of rice. The serving of
                                                      determine a food’s glycemic index is         brown rice contained more carbohy-
                                                      how highly processed its carbohy-            drates than the equally portioned white
                                                      drates are. Processing carbohydrate          rice. Blood sugar levels were taken prior
                                                      removes the fiber-rich outer bran            to the meal and at 1 and 2 hours after
                                                      and the vitamin and mineral rich             the meal for a total of 3 readings.
                                                      inner germ and leaves mostly the
                                                      starchy endosperm. Diets filled with
                                                      high glycemic index foods will cause         RESULTS
                                                      quick and strong increases in blood
                                                      sugar levels which are linked to                 Nine volunteers were recruited to
                                                      an increased risk of diabetes and            participate in the study. The blood
                                                      heart disease.2 On the other hand,           glucose levels for initial, 1 hour post-
                                                      lower glycemic index foods have              prandial and 2 hour postprandial were
                                                      been shown to help control type 2            averaged and evaluated. Overall, based
                                                      diabetes.3                                   on the results, white rice was found to

                                                     Ethnicity & Disease, Volume 18, Spring 2008                                        S1-67
Castro and Martinez

have the greatest impact on the blood        accordingly and look for trends based             LIMITATIONS
glucose level. At one hour postprandial,     on the foods they consume.
the average rise of blood glucose when                                                             Because this project was initiated by
white rice was consumed was 23 mg/dL                                                           students and was not an ongoing project of
above the original reading, or baseline,                                                       CLHD, there were a few limitations. First,
in comparison to when brown rice was         DISCUSSION                                        a timeline of six weeks was not sufficient to
consumed the average rise of blood                                                             recruit a larger sample population. In
glucose was 13 mg/dL above the base-             Carbohydrates do not always cause             addition, the project could have been more
line. During the second hour, the blood      an increase in glycemic levels and the            extensive had a component on medical
glucose level after consumption of white     consumption of carbohydrates does not             history (eg medications) been included as
rice fell to 9 mg/dL above the baseline      always disturb glycemic control. We               an initial screening. This project provided
vs 15 mg/dL below the baseline for           speculate that, due to the fiber content          insight for the CLHD La Familia Diabetic
brown rice.                                  of brown rice, the carbohydrates were             Program to place more emphasis on food
    Consumption of brown rice resulted       absorbed at a steadier rate than those of         intake and the effects it has on blood
in significantly lower blood glucose         white rice, thus causing a decrease of the        glucose level.
readings than that of white rice. This       glycemic level. The hypothesis was
was unexpected since brown rice is           proven. The results imply that not all            1. Wardlaw GM. Index Perspectives In Nutrition.
higher in carbohydrates than the white       carbohydrates are broken down similar-               4th ed. 1999;G-9.
rice (2 g more). As a result, it cannot be   ly. The process depends on several                2. Schulze MB, Liu S, Rimm EB, Manson JE,
assumed that similar foods, which differ     factors such as fiber content, type of               Willett WC, Hu FB. Glycemic index, glycemic
in carbohydrate levels, will affect blood    starch, physical form (coarsely ground               load, and dietary fiber intake and incidence of
                                                                                                  type 2 diabetes in younger and middle-aged
glucose in a manner relative to their        grain) and overall control of the indi-
                                                                                                  women. Am J Clin Nutr. 2004;80:348–356.
carbohydrate level. Thus, as these results   vidual’s diabetes. Other factors include          3. Liu S, Willett WC. Dietary glycemic load and
indicate patients with diabetes should       stress, physical activity, and general               atherothrombotic risk. J Womens Health
monitor their blood glucose levels           health.                                              (Larchmt). 2003;12:115–122.

S1-68                                            Ethnicity & Disease, Volume 18, Spring 2008

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Description: Carbohydrates are the body's basic energy supply of material, energy sports training provided mainly by glycogen, so we have to add enough glycogen. The most effective way is doing fitness training before breakfast before the game or when dietary intake of carbohydrates for energy to provide adequate training to prepare. Meanwhile, in order to get a good training effect, need to pay attention to the campaign before, during and after the added sugar drinks.