Glycemic Index vs. Glycemic Load: Understanding Carbohydrate Impact on Blood Sugar and Low-Carb Strategies

This podcast episode, hosted by Dr. Ekberg, aims to clarify the often-confused concepts of Glycemic Index (GI) and Glycemic Load (GL) and their relevance to overall health, particularly from a low-carbohydrate perspective. The discussion begins by defining GI as a measure of how quickly a food is digested and converted into blood sugar, with a scale relative to pure glucose (100). Official guidelines classify high GI as above 70, medium as 56-70, and low as below 56. Dr. Ekberg highlights surprising examples, such as wheat bread having a faster blood sugar impact than pure table sugar, challenging common perceptions about "complex carbohydrates."

The episode then introduces Glycemic Load, which addresses a key limitation of GI. GL accounts for both the speed of digestion and the total amount of carbohydrates in a typical serving, providing a more comprehensive measure of a food's overall impact on blood sugar. Official GL guidelines classify high GL per serving as over 20, medium as 11-20, and low as less than 11. The podcast notes that, by these metrics, glucose and table sugar might appear to have a low GL due to small typical serving sizes, while wheat bread could be high. The official recommendation for total daily GL is less than 120, which Dr. Ekberg strongly critiques as "crazy" and likely stemming from the same flawed thinking behind the food pyramid's high grain recommendations.

Dr. Ekberg argues that the official guidelines for both GI and GL, as well as the recommended carbohydrate intake (e.g., 300 grams on a 2000-calorie diet), are excessively high and contribute significantly to conditions like diabetes. He contrasts these with real-world numbers relevant to low-carb, Paleo, and Keto diets. Foods like meat, eggs, and cheese are highlighted as having virtually zero carbohydrates and thus zero GI/GL. Non-starchy vegetables, full-fat dairy, and certain berries (raspberries, strawberries, blueberries) are presented as low-carb, low-GI, and low-GL options, typically yielding 1-10 grams of carbs and 1-2 GL per serving.

For practical application, Dr. Ekberg provides specific carbohydrate and glycemic load targets based on health goals. For maintaining health, he suggests consuming around 70 grams of carbs per day or less, with a total daily GL below 20. For individuals dealing with insulin resistance, inflammatory problems, or degenerative conditions, he recommends a stricter intake of 20-50 grams of carbs per day and a total daily GL between 4-10 to facilitate recovery. Ultimately, he simplifies the approach by advising listeners to "just count net carbs" (total carbs minus fiber), asserting that this method is less complicated and more effective than navigating the often-misleading official GI and GL guidelines.

"glycemic index is a measurement of how quickly something that you eat gets digested and turned into blood sugar"

"a high glycemic index is above 70 a medium glycemic index is 56 to 70 and a low glycemic index is lower than 56"

"wheat bread is absorbed faster it turns into sugar in your body faster than pure table sugar"

"glycemic index isn't such a good measurement because it doesn't tell you it doesn't give you the impact it doesn't give you an idea of how much total impact or volume it has to raise your blood sugar"

"glycemic load... is a measurement of how much not just how quickly with a certain amount enter your bloodstream but how much of an impact does it have on your overall blood sugar"

"in my mind this is just crazy and I don't know where they get these numbers but I suspect that these are the same people that also think that the food pyramid is a good idea"

"if we eat the recommended 60% of calories from carbs on a 2,000 calorie diet that comes out to 300 grams of carbs and that in my mind is what's going to cause or contribute to diabetes very quickly"

"you should probably consume somewhere around 70 grams of carbs per day or less and if you are insulin resistant or you have an inflammatory problem or some kind of degenerative condition that you're trying to reverse you should probably try to keep it between 20 and 50"

"I would recommend that you just count carbs you count net carbs you take the total carbs you subtract the fiber that gives you the net carbs and you're trying to keep those in a low range"