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You probably know what kinds of things make your blood sugar go skyrocketing — maybe it’s pasta, orange juice, cereal, or banana. But sometimes it’s less clear what pulls your glucose levels in the other direction. When you eat a higher-carb food, what have you found that softens the subsequent spike? What are some natural options for lowering blood sugar? Take this quiz and test your knowledge of the Spike Stoppers!
Reviewed by Constance Brown-Riggs, MSEd, RD, CDE, CDN 07/14.
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Question 1 of 10
Nuts are a healthy part of any diet, for everyone and those with diabetes. Nuts pack in protein, fiber, and nutrients in a small package. Including nuts in the daily diet has been shown to lower cholesterol levels, guard against heart disease, and even (at least in women) protect against diabetes. Which nuts offer blood sugar benefits?
Correct
The answer is d.
Many nut varieties are a healthy addition to the diet. With diabetes in mind, almonds, pistachios, and peanuts each have a lot to offer. Eating pistachios each day lowers cholesterol and other risk factors for heart disease in those with diabetes.
Source
Ros, E. “Nuts and CVD.” British Journal of Nutrition. July 7, 2015. https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/nuts-and-cvd/CEC8BE27FD7457BF545E08183A7AD181.
Del Gobo, L.C., Falk, M.C., Feldman, R., et al. “Effects of Tree Nuts on Blood Lipids, Apolipoproteins, and Blood Pressure: Systematic Review, Meta-Analysis, and Dose-Response of 61 Controlled Intervention Trials.” American Journal of Clinical Nutrition. September 23, 2015. http://ajcn.nutrition.org/content/102/6/1347.abstract.
Bullo, M., Juanola-Faigarona, M., Hernandez-Alonso, P., et al. “Nutrition Attributes and Health Effects of Pistachio Nuts.” British Journal of Nutrition. July 7, 2015. https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/nutrition-attributes-and-health-effects-of-pistachio-nuts/1C2AE1F4EACF37030525FAD73ABCFFA0.
Sauder, K.A., McCrea, C.E., Ulbrecht, J.S., et al. “Effects of Pistachios on the Lipid/Lipoprotein Profile, Glycemic Control, Inflammation, and Endothelial Function in Type 2 Diabetes: A Randomized Trial.” Metabolism. July 21, 2015. http://www.metabolismjournal.com/article/S0026-0495(15)00216-4/abstract.
Incorrect
The answer is d.
Many nut varieties are a healthy addition to the diet. With diabetes in mind, almonds, pistachios, and peanuts each have a lot to offer. Eating pistachios each day lowers cholesterol and other risk factors for heart disease in those with diabetes.
Source
Ros, E. “Nuts and CVD.” British Journal of Nutrition. July 7, 2015. https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/nuts-and-cvd/CEC8BE27FD7457BF545E08183A7AD181.
Del Gobo, L.C., Falk, M.C., Feldman, R., et al. “Effects of Tree Nuts on Blood Lipids, Apolipoproteins, and Blood Pressure: Systematic Review, Meta-Analysis, and Dose-Response of 61 Controlled Intervention Trials.” American Journal of Clinical Nutrition. September 23, 2015. http://ajcn.nutrition.org/content/102/6/1347.abstract.
Bullo, M., Juanola-Faigarona, M., Hernandez-Alonso, P., et al. “Nutrition Attributes and Health Effects of Pistachio Nuts.” British Journal of Nutrition. July 7, 2015. https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/nutrition-attributes-and-health-effects-of-pistachio-nuts/1C2AE1F4EACF37030525FAD73ABCFFA0.
Sauder, K.A., McCrea, C.E., Ulbrecht, J.S., et al. “Effects of Pistachios on the Lipid/Lipoprotein Profile, Glycemic Control, Inflammation, and Endothelial Function in Type 2 Diabetes: A Randomized Trial.” Metabolism. July 21, 2015. http://www.metabolismjournal.com/article/S0026-0495(15)00216-4/abstract.
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Question 2 of 10
Taking vinegar with a meal helps moderate blood glucose response, lessening the after-meal blood sugar spike.
Correct
The answer is true.
Highly acidic substances slow down stomach emptying, which moderates blood sugar spiking. Acetic acid in vinegar has been shown in research to reduce postprandial blood sugar. There is now modern research backing the traditional use of vinegar, particularly for keeping blood sugar levels under control, for people with or without diabetes.
Source
Lim, J., Henry, C.J., and Haldar, S. “Vinegar as a Functional Ingredient to Improve Postprandial Glycemic Control—Human Intervention Findings and Molecular Mechanisms.” U.S. National Library of Medicine and National Institutes of Health. June 27, 2016. https://www.ncbi.nlm.nih.gov/pubmed/27213723.
Johnston, C.S. “Examination of the Antiglycemic Properties of Vinegar in Healthy Adults.” U.S. National Library of Medicine and National Institutes of Health. https://www.ncbi.nlm.nih.gov/pubmed/20068289.
Mitrou, P., Petsiou, E., Papakonstantinou, E., Maratou, E., Lambadiari, V., Dimitriadis, P., Spanoudi, F., Raptis, S. A., and Dimitriadis, G. 2015. “The Role of Acetic Acid on Glucose Uptake and Blood Flow Rates in the Skeletal Muscle in Humans with Impaired Glucose Tolerance.” January 28, 2015. https://www.ncbi.nlm.nih.gov/pubmed/25626409
Mitrou, P., Petsiou, E., Papakonstantinou, E., Maratou, E., Lambadiari, V., Dimitriadis, P., Spanoudi, F., Raptis, S. A., and Dimitriadis, G. “Vinegar Consumption Increases Insulin-Stimulated Glucose Uptake by the Forearm Muscle in Humans with Type 2 Diabetes. Journal of Diabetes Research. April 7, 2015. http://doi.org/10.1155/2015/175204.
Incorrect
The answer is true.
Highly acidic substances slow down stomach emptying, which moderates blood sugar spiking. Acetic acid in vinegar has been shown in research to reduce postprandial blood sugar. There is now modern research backing the traditional use of vinegar, particularly for keeping blood sugar levels under control, for people with or without diabetes.
Source
Lim, J., Henry, C.J., and Haldar, S. “Vinegar as a Functional Ingredient to Improve Postprandial Glycemic Control—Human Intervention Findings and Molecular Mechanisms.” U.S. National Library of Medicine and National Institutes of Health. June 27, 2016. https://www.ncbi.nlm.nih.gov/pubmed/27213723.
Johnston, C.S. “Examination of the Antiglycemic Properties of Vinegar in Healthy Adults.” U.S. National Library of Medicine and National Institutes of Health. https://www.ncbi.nlm.nih.gov/pubmed/20068289.
Mitrou, P., Petsiou, E., Papakonstantinou, E., Maratou, E., Lambadiari, V., Dimitriadis, P., Spanoudi, F., Raptis, S. A., and Dimitriadis, G. 2015. “The Role of Acetic Acid on Glucose Uptake and Blood Flow Rates in the Skeletal Muscle in Humans with Impaired Glucose Tolerance.” January 28, 2015. https://www.ncbi.nlm.nih.gov/pubmed/25626409
Mitrou, P., Petsiou, E., Papakonstantinou, E., Maratou, E., Lambadiari, V., Dimitriadis, P., Spanoudi, F., Raptis, S. A., and Dimitriadis, G. “Vinegar Consumption Increases Insulin-Stimulated Glucose Uptake by the Forearm Muscle in Humans with Type 2 Diabetes. Journal of Diabetes Research. April 7, 2015. http://doi.org/10.1155/2015/175204.
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Question 3 of 10
Dietary fat slows the process that turns the carbs you eat into the glucose in your blood. But too much fat added to a high-carb meal can cause a delayed rise, and may have other negative effects, as well. In addition, the type of fat consumed can also affect blood sugar levels after a high-glycemic meal. Which of these has a positive effect on blood sugar levels after a high-glycemic meal?
Correct
The answer is c.
One study showed that, in people with type 1 diabetes, using olive oil in a meal with a high glycemic index significantly and beneficially affected after-meal blood sugar levels.
“Although saturated fat typically doesn’t cause problems on a low-carb diet,” says Franziska Spritzler, RD, CDE, “when consumed with a high-carb meal, it can promote insulin resistance, inflammation, and high blood glucose levels for several hours afterwards. So, olive oil would be a better choice if you’re going to be eating a lot of carbs.”
Source
Bozzetto, L., Alderisio, A., Giorgini, M., et al. “Extra-Virgin Olive Oil Reduces Glycemic Response to a High-Glycemic Index Meal in Patients with Type 1 Diabetes: A Randomized Controlled Trial.” Diabetes Care. February 2016. http://care.diabetesjournals.org/content/early/2016/01/29/dc15-2189.
Incorrect
The answer is c.
One study showed that, in people with type 1 diabetes, using olive oil in a meal with a high glycemic index significantly and beneficially affected after-meal blood sugar levels.
“Although saturated fat typically doesn’t cause problems on a low-carb diet,” says Franziska Spritzler, RD, CDE, “when consumed with a high-carb meal, it can promote insulin resistance, inflammation, and high blood glucose levels for several hours afterwards. So, olive oil would be a better choice if you’re going to be eating a lot of carbs.”
Source
Bozzetto, L., Alderisio, A., Giorgini, M., et al. “Extra-Virgin Olive Oil Reduces Glycemic Response to a High-Glycemic Index Meal in Patients with Type 1 Diabetes: A Randomized Controlled Trial.” Diabetes Care. February 2016. http://care.diabetesjournals.org/content/early/2016/01/29/dc15-2189.
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Question 4 of 10
Research has shown that low-glycemic-index (GI) eating is associated with lower postprandial (after-meal) blood sugar as well as the prevention of:
Correct
A body of evidence supports the case for the benefits of a low-GI diet in the prevention of obesity, diabetes, and cardiovascular disease. In addition, at an international meeting of carbohydrate experts, a consensus was reached, stating that “…diets low in [GI] were relevant to the prevention and management of diabetes and coronary heart disease, and probably obesity…[these diets] were considered particularly important in individuals with insulin resistance.” Given the high rate of diabetes and pre-diabetes worldwide, this expert panel noted an urgent need to communicate information on low-GI eating to the general public.
Source
Augustin, L.S., Kendall, C.W., Jenkins, D.J., et al. “Glycemic Index, Glycemic Load, and Glycemic Response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC).” U.S. National Library of Medicine and National Institutes of Health. September 2015. https://www.ncbi.nlm.nih.gov/pubmed/26160327.
Incorrect
A body of evidence supports the case for the benefits of a low-GI diet in the prevention of obesity, diabetes, and cardiovascular disease. In addition, at an international meeting of carbohydrate experts, a consensus was reached, stating that “…diets low in [GI] were relevant to the prevention and management of diabetes and coronary heart disease, and probably obesity…[these diets] were considered particularly important in individuals with insulin resistance.” Given the high rate of diabetes and pre-diabetes worldwide, this expert panel noted an urgent need to communicate information on low-GI eating to the general public.
Source
Augustin, L.S., Kendall, C.W., Jenkins, D.J., et al. “Glycemic Index, Glycemic Load, and Glycemic Response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC).” U.S. National Library of Medicine and National Institutes of Health. September 2015. https://www.ncbi.nlm.nih.gov/pubmed/26160327.
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Question 5 of 10
Blood sugar can go up with exercise.
Correct
The answer is true.
Exercise usually lowers blood sugar, because insulin is more effective during exercise. It can also raise blood sugar, because during exercise, your body may produce the hormone adrenaline, which releases sugar stored in your muscle and liver.
Source
University of California, San Francisco. “Exercise and Blood Sugar.” Diabetes Education Online. Accessed November 29, 2016. https://dtc.ucsf.edu/living-with-diabetes/activity-and-exercise/exercise-blood-sugar/.
Incorrect
The answer is true.
Exercise usually lowers blood sugar, because insulin is more effective during exercise. It can also raise blood sugar, because during exercise, your body may produce the hormone adrenaline, which releases sugar stored in your muscle and liver.
Source
University of California, San Francisco. “Exercise and Blood Sugar.” Diabetes Education Online. Accessed November 29, 2016. https://dtc.ucsf.edu/living-with-diabetes/activity-and-exercise/exercise-blood-sugar/.
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Question 6 of 10
The body of research has become increasingly clear that a certain type of diet fights inflammation and prevents harmful metabolic changes in those with diabetes. This diet is:
Correct
The correct answer is anti-inflammatory.
The highly-processed American diet leads to frequent blood sugar spikes, which trigger a complex stream of negative effects in the body, even in people without diabetes. Dietary improvements—switching to a “low-glycemic, anti-inflammatory” die— can bring about dramatic and immediate benefits in after-meal spiking.
A low-glycemic, anti-inflammatory diet is rich in minimally-processed, high-fiber, low-glycemic, plant-based foods, whole grains, legumes, and nuts.
Source
Gomes, J.M., Fabrini, S.P., and Alfenas, R.C. “Low Glycemic Index Diet Reduces Body Fat and Attenuates Inflammatory and Metabolic Responses in Patients with Type 2 Diabetes.” U.S. National Library of Medicine and National Institutes of Health. September 2016. https://www.ncbi.nlm.nih.gov/pubmed/27598983.
Incorrect
The correct answer is anti-inflammatory.
The highly-processed American diet leads to frequent blood sugar spikes, which trigger a complex stream of negative effects in the body, even in people without diabetes. Dietary improvements—switching to a “low-glycemic, anti-inflammatory” die— can bring about dramatic and immediate benefits in after-meal spiking.
A low-glycemic, anti-inflammatory diet is rich in minimally-processed, high-fiber, low-glycemic, plant-based foods, whole grains, legumes, and nuts.
Source
Gomes, J.M., Fabrini, S.P., and Alfenas, R.C. “Low Glycemic Index Diet Reduces Body Fat and Attenuates Inflammatory and Metabolic Responses in Patients with Type 2 Diabetes.” U.S. National Library of Medicine and National Institutes of Health. September 2016. https://www.ncbi.nlm.nih.gov/pubmed/27598983.
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Question 7 of 10
Dietary fiber can significantly slow the absorption of carbohydrates and the subsequent rise in blood sugar.
Correct
The answer is true.
Fiber is a component of plant foods that our bodies cannot digest. It’s a type of carbohydrate that has a minimal effect on blood glucose levels, and, in fact, can decrease glucose absorption into the bloodstream. Scientists don’t fully understand how fiber does this, but it appears that soluble fiber actually changes the structure and texture of food in the stomach, interfering with the breakdown of starches during digestion. What is clear is this: diets higher in soluble fiber offer multiple health benefits, including improved blood glucose control.
Source
Surampudi, P., Enkhmaa, B., Anuurad, E., et al. “Lipid Lowering with Soluble Dietary Fiber.” U.S. National Library of Medicine and National Institutes of Health. December 2016. https://www.ncbi.nlm.nih.gov/pubmed/27807734.
Incorrect
The answer is true.
Fiber is a component of plant foods that our bodies cannot digest. It’s a type of carbohydrate that has a minimal effect on blood glucose levels, and, in fact, can decrease glucose absorption into the bloodstream. Scientists don’t fully understand how fiber does this, but it appears that soluble fiber actually changes the structure and texture of food in the stomach, interfering with the breakdown of starches during digestion. What is clear is this: diets higher in soluble fiber offer multiple health benefits, including improved blood glucose control.
Source
Surampudi, P., Enkhmaa, B., Anuurad, E., et al. “Lipid Lowering with Soluble Dietary Fiber.” U.S. National Library of Medicine and National Institutes of Health. December 2016. https://www.ncbi.nlm.nih.gov/pubmed/27807734.
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Question 8 of 10
Momordica charantia is:
Correct
The answer is c—a bitter gourd native to the tropics.
Commonly known as bitter melon or bitter gourd, this vegetable has been shown to have “antidiabetic” properties, including the suppression of after-meal blood glucose spikes. It’s used widely in cooking in many cultures, and is also prepared as a traditional Chinese medicine and herbal supplement that can be found in health-food stores. Check with your doctor before taking any herbs or supplements.
Source
Raina, K., Kumar, D., Agarwal, R. “Promise of Bitter Melon (Momordica charantia) Bioactives in Cancer Prevention and Therapy.” U.S. National Library of Medicine and National Institutes of Health. October 2016. https://www.ncbi.nlm.nih.gov/pubmed/27452666.
Incorrect
The answer is c—a bitter gourd native to the tropics.
Commonly known as bitter melon or bitter gourd, this vegetable has been shown to have “antidiabetic” properties, including the suppression of after-meal blood glucose spikes. It’s used widely in cooking in many cultures, and is also prepared as a traditional Chinese medicine and herbal supplement that can be found in health-food stores. Check with your doctor before taking any herbs or supplements.
Source
Raina, K., Kumar, D., Agarwal, R. “Promise of Bitter Melon (Momordica charantia) Bioactives in Cancer Prevention and Therapy.” U.S. National Library of Medicine and National Institutes of Health. October 2016. https://www.ncbi.nlm.nih.gov/pubmed/27452666.
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Question 9 of 10
Sourdough bread is lower in carbs than other types of bread.
Correct
The answer is false.
Sourdough breads don’t have fewer carbs than plain old white bread. However, sourdough contains lactic acid and propionic acid, natural byproducts of the fermentation process. As we said earlier, acidic substances slow the emptying of the stomach, which could mean sourdough has less of a glycemic impact than regular bread. It’s worth a test, right?
Incorrect
The answer is false.
Sourdough breads don’t have fewer carbs than plain old white bread. However, sourdough contains lactic acid and propionic acid, natural byproducts of the fermentation process. As we said earlier, acidic substances slow the emptying of the stomach, which could mean sourdough has less of a glycemic impact than regular bread. It’s worth a test, right?
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Question 10 of 10
Eating prickly pear cactus with a high-carb meal can lower blood sugar response.
Correct
The answer is true.
When people with type 2 diabetes include prickly pear cactus in their diet, research shows that the post-meal blood sugar spikes are lessened. Prickly pear cactus can be found in any Mexican-food market, and increasingly, in supermarkets. The cactus pads, called nopales, are a popular ingredient in salads, soups, and casseroles in Mexico. Cactus is also used in traditional medicine in Mexico and in other cultures for everything from lowering cholesterol to soothing sunburn and protecting against alcohol-induced liver damage.
Source
López-Romero, P., Pichardo-Ontiveros, E., Avila-Nava, A., et al. “The Effect of Nopal (Opuntia ficus indica) on Postprandial Blood Glucose, Incretins, and Antioxidant Activity in Mexican Patients with Type 2 Diabetes After Consumption of Two Different Composition Breakfasts.” U.S. National Library of Medicine and National Institutes of Health. November 2014. https://www.ncbi.nlm.nih.gov/pubmed/25132122.
Updated by Victoria Dolby Toews, MPH, 9/16.
Incorrect
The answer is true.
When people with type 2 diabetes include prickly pear cactus in their diet, research shows that the post-meal blood sugar spikes are lessened. Prickly pear cactus can be found in any Mexican-food market, and increasingly, in supermarkets. The cactus pads, called nopales, are a popular ingredient in salads, soups, and casseroles in Mexico. Cactus is also used in traditional medicine in Mexico and in other cultures for everything from lowering cholesterol to soothing sunburn and protecting against alcohol-induced liver damage.
Source
López-Romero, P., Pichardo-Ontiveros, E., Avila-Nava, A., et al. “The Effect of Nopal (Opuntia ficus indica) on Postprandial Blood Glucose, Incretins, and Antioxidant Activity in Mexican Patients with Type 2 Diabetes After Consumption of Two Different Composition Breakfasts.” U.S. National Library of Medicine and National Institutes of Health. November 2014. https://www.ncbi.nlm.nih.gov/pubmed/25132122.
Updated by Victoria Dolby Toews, MPH, 9/16.
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