Determination of how the body metabolizes foods allow scientists to gain insights to the varying effect different foods have on an individual. Insulin elevated by a food is calculated by a clinical rating system called the Glycemic Index.

In the diabetic, it is important to know the insulin response of a food in order to predict blood sugar response. In the average person, consistent ingestion of foods holding a high glycemic index causes an increase in fat storage and adipose tissue, and increases the risk of Type II diabetes. Foods and drinks that carry a high glycemic index trigger an undesirable insulin response. This reaction results in an excess of insulin in the blood stream. Controlling the glycemic index of foods and drinks allows for control over food-driven insulin stimulation and reactive hypoglycemia.

All foods, both prepared and natural, all drinks and nutraceuticals can be assigned a numerical value which is actually a guage of insulin response. In general food that elicit a low glycemic response are preferable for use by diabetics and foods that ar high glycemic are less preferable for diabetics. In reality, the occasional transgression of consuming a high glycemic food is inevitable. No one can or does eat a perfect diet. But the point in identifying high glycemic from low glycemic foods is to be able to choose the insulin response you desire. Any diabetic can tell you that they cannot possibly control their insulin levels if they do not know what foods and drinks raise insulin. If the glycemic response of foods and and drinks is taken into account, the diabetic can select foods which will not overly exacerbate insulin respsonse. Controlling insulin response is important in the long-term as well as the short-term. Long-term control over insulin response allows for reduction and or/stabilization of parenteral administration of insulin.

INSULIN & GLYCEMIC IMPACT OF FOOD
Foods that adversely affect blood sugar by elevating insulin levels are "high glycemic" and foods that do not elevate insulin levels are "low glycemic." The glycemic index can be utilized in helping control circulating insulin levels in diabetics. Excess insulin levels cause retardation in the rate or wound healing, decreased life span, lethargy, and lipogenesis.

Conversely, well-modulated insulin levels result in:

1. Reduced excess adipose tissue (body fat)
2. Increased and sustained energy
3. Increased mental alertness
4. Reduced serum cholesterol levels
5. Reduced incidence of high blood pressure
6. Increased cardiavascular fitness
7. Reduced risk of Type II diabetes
8. Reduced incidence of hypoglycemic 9. Reduced prostaglandin E2 levels

Additional risk factors for increased insulin in the diabetic and non-diabetic include prostaglandin E2 levels. After age 40, for every ten years a person ages, prostaglandin E2 levels increase by 24%. Prostaglandin E2 increases insulin production, which may explain why the risk of diabetes increases as we age. Prostaglandin E2 levels increase risk of cancer and are associated with arthritis, cardiovascular disease, allergies, inflammatory conditions, and diabetes. Prostaglandin E2 (PE2) levels may be reduced in humans by excercise in the form of 30 minutes of jogging or 60 minutes of walking per day. Excess weight also increases PE2, and heavier persons are more likely to develop PE2. High protein diets exacerbate PE 2 levels. Reducing saturated fat and meat consumption in the diet can reduce PE2 and PE2 series production. *

FUNCTIONAL FOODS: BIOENGINEERING LOW GLYCEMIC FOODS
Since most fast foods and prepared foods are very high glycemic, re-engineering these foods would be extremely beneficial to the diabetic as well as those who carry excess adipose tissue (body fat). Pasta, for example, may be bioengineered to produce either a high glycemic response or a low glycemic response. A high glycemic response would only be desirable in the case of extreme low body fat or prior to certain athletic events in which an insulin surge is desirable. A correctly bioengineered functional food can effectively modulate blood sugar levels with great precision.

Modulation of blood sugar levels also allows for the regulation of Lipoprotein Lipase (LPL), the gatekeeper for fat storage in the fat cell. LPL, the "Fat Enzyme", is produced by various tissues and is similar to plasminogen. LPL is an important regulator of lipid and lipoprotein metabolism. Adipose tissue LPL allows for the uptake of plasma triglycerides as fat-cell-fuel. Adipose tissue LPL is directly tied to increases in body fat. Insulin is the key regulator of LPL, so insulin increases adipose (fat) tissue LPL activity. Diet induced adipose tissue LPL activity exacerbates plasma triglyceride depostion into adipose tissue. In simple terms, high glycemic foods stimule fat-storage.

The benefit of bioengineering food, particularly fast-foods and snack foods, is to transform high glycemic, fattening foods into low glycemic, healthier foods. Caloric-control is old science.

Glycemic control is future science.. Caloric-control is antiquated because all calories are not created equal. For example, equal calories of bread and pasta have unequal reaction in the human body. Though pasta and bread are composed of the same raw materials, the do not metabolize equally in the body.

Many food manufacturers are currently researching and introducing Functional Foods. These foods typically contain added nutrients, and phytochemicals, vitamins, minerals and/or herbs. Unfortunately, most foods, drinks and nutraceuticals do not reveal their glycemic index on the label. In fact, most manufacturers don't even know the glycemic impact of their product. This can make it difficult for the diabetic and hypoglycemic to figure out the glycemic response of the product.

METABOLIC PATHWAYS
To understand the chemical impact on the body of a food, we need to track the path of the food from ingestion to excretion and analyze the body's reaction as it moves through the system.

• Reactive hypoglycemia (caused by ingesting high glycemic foods or drinks
• Insuffecient food intake at prior meal
• Fasting hypoglycemia (intervals of feeding are insufficient)
• Fasting hypoglycemia (the more serious type caused by pancreatic tumors or liver disorders)
• Inherited hypoglycemia (usually from a diabetic blood relative)

Symptoms of low blood sugar can occur both post-meals and between-meals. Typical symptoms include lethargy and sleepiness following a meal and irritation and jitteriness between meals. If you do not eat frequently enough, mild shaking and weakness of the limbs can occur. Symptoms can be mild or severe, depending on the individual. Blood sugar in some persons can drop well below 50 mg/dl without symptoms while others can drop to 50-55 mg/dl with severe symptoms.

It is obvious that individual biochemistry plays a role in the development of blood-sugar-related symptoms. Diabetics can experience hypoglycemia when insulin administration is inadequate or incorrectly timed. Following ingestion of food, liquids or alcohol (which restricts the liver-sugar relationship), excess sugar in the blood of a diabetic can be downloaded too rapidly which causes hypoglycemia.

LOW BLOOD SUGAR AND EXCESS BODY FAT
Low blood sugar can also cause rampant and uncontrollable eating binges. That is one reason hypoglycemia typically causes weight and fat gains. The other reason is stimulation of Lypoprotein Lipase (LPL), the fat enzyme. Adipose (fat) tissue LPL plays a major role in the fat accumulation. Adipose tissue LPL allows the uptake of plasma triglycerides as storage in fat cells. LPL activity inadipose tissue is associated with insulin. Diabetics with lower plasma insulin levels have normal plasma LPL levels. The combination of sucrose (table sugar) and dietary fat is a particularly fattening duo. The mechanism by which sucrose and dietary fat turn to added body fat can be explained through their interaction with LPL.

Sucrose + Dietary Fat > Stimulation of LPL

Stimulation of LPL > Secretion of chylomicron triglycerides into the blood in large quantities.

Avoiding the combination of high fat, high sugar foods will greatly reduce excess body fat stores, both in the diabetic and non-diabetic, but those very foods to be avoided are the same foods humans are biochemically programmed to crave. When the body is in a low blood sugar state, it's main focus is to get you to eat foods that raise blood sugar - fast. Your body will chemically force you to eat foods that are high glycemic, extremely fattening, and that stimulate appetite: namely sweets, chocolate, potato chips, french fries, pizza, sugar-laden soft drinks and crunchy snacks. These foods almost always fit the high-fat and high-sucrose profile. It is no coincidence. High glycemic (insulinogenic), high fat foods are the foods craved during low blood sugar stated.

High glycemic foods and drinks stimulate LPL which causes enlargement of fat cell: not more fat cell, just fatter fat cells. Following the three main aging-related fat cell cycles, body fat is additionally stimulated by pregnancy, heredity, lack of exercise and diet. Reducing consumption of high fat foods and high glycemic foods results in reduction of body fat. Diabetics and hypoglycemics can help avoid blood sugar swings that trigger cravings for insulinogenic foods by:

1) Eating every 3-4 hours
2) Making sure each meal or snack contains protein, carbohydrates, fiber and nutrients
3) Avoiding high glycemic foods, drinks and nutrients

Counteracting a low blood sugar episode before it begins will allow you to control food-cravings for high glycemic foods. Understanding the glycemic impact of foods is vital to the diabetic. Until all foods and drinks voluntarily display, or are forced by the FDA to display, the glycemic response of the product on the label, diabetics will have to calculate the probable glycemic response of the product themselves. This takes a little effort, but is well worth time in preventing insulin-stress to the body.

* Colon Cancer, Physical Activity and Prostaglandin E2, Nutrition Week, June 11 1999:29 (22):7
Nationa Cancer Institute, June 2, 1999;91 (11): 950-953