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Endocrine

Question
3 out of 28
 

Which of the following is the food of highest glycemic index? (AIPG 09)

 

 
A Corn flake
B Ice cream

 

C Rice
D Bread

 

 

Ans. A

Corn flake

Treatment of diabetes mellitus (Ref. Hari-18th ed. Pg-2990)

1). Patient Education : For any obese type II diabetic patient initial therapy is diet therapy and exercise.

a). (Reduce weight to maintain normal BMI)

BMI = body weight (kg) / height in meters2Q

BMI > 25 overweight

> 30 obese

b). Avoid food of high glycemic index (i.e. any food like sugar, glucose powder etc. which are absorbed immediately in GIT and raised blood sugar very fast).

 

TABLE - Daily Caloric Requirement*
 

Body Build

Activity Level

Sedentary

Moderately active

Very active

Obese

20 - 25

30

35

Normal

30

35

40

Underweight

35

40

45 - 50

*Calories (kcal) required per kilogram of ideal body weight per day.

 

Recent Advances: Yo-yo dieting (weight cycling). (Not Given in 18th ed. of Harrison)

In this process, the dieter is initially successful in weight loss but is unsuccessful in maintaining the loss long-term and begins to over eat again to gain the weight back. The dieter then again seeks to lose the regained weight and the cycle begins again. !!!

 

c). In Obesity down regulation of insulin receptors occurs.

 

Extra Edge : Downregulation & upregulation of insulin receptor.

Downregulation is the process by which a cell decreases the quantity of a cellular component, such as RNA or protein, in response to an external variable. An increase of a cellular component is called upregulation.

Mechanism: The Insulin Receptor

The process of down regulation occurs when there are elevated levels of the hormone insulin in the blood.

 

At high plasma insulin levels, the number of surface receptors for insulin is gradually reduced by the accelerated rate of receptor internalization and degradation brought about by increased hormonal binding.

 

Reversal

The process of downregulation can be counteracted by weight loss. Which leads to increase insulin receptors.

 

Glycemic index of various foods. (Ref. Park , 20th edition, Pg. 561)

 

100%

Glucose

80 – 90%

Corn Flakes, carrots, potatoes (mashed), maltose, honey, idli.

70-79%

Bread (whole meal), millets, rice (white), broad beans, potato (new), uppama

60 –69%

Bread (white), paratha (Wheat), rice (brown, unhusked), shredded wheat, beetroot, banana, raisins, sprouted green gram, sucrose.

50-59%

Buck wheat, noodles (white), peas (frozen), pongal sweet corn, potato chips.

40-49%

Nodles (whole mal), porridge oats (dahlia), beans, potato (sweet), oranges (juice), peas (dried), bengal gram, black gram.

30-39%

Black-eyed peas, apple, skimmed milk, curd/yogurt, tomato soup, ice cream

20-29%

Kidney beans, lentils (all daals), fructose, rajmaah

10-19%

Soyabeans, groundnuts

 

NB: Cornflake is a food of very high glycemic index. Q

 

Note: This table is given in 22nd edition of Park Pg. 568 in different style. But above given table given in 20th Edition is much better hence I have not changed it. …..Dr. Bhatia

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