Fiber Lecture 2021

For 1st Year Msc nutrition Students
By :- Melese.S(Chem,B.Pharm,Msc , Ass.professor )
Jimma University
Institute of Health
Faculty of Public Health, Nutrition & Dietetics Department
March 26,2019
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Mediterranean Diet
•A Delicious, Satisfying Way to Eat
© 2016 Oldways / Mediterranean Foods Alliance. May be reproduced for educational purposes.
10/23/2023 Visit www.oldwayspt.org for more information
Melese.Son the Mediterranean Diet. 2
The Mediterranean Lifestyle
It’s a healthy way to
eat and live for the rest
of your life.
Not at all like

those fad diets
you’ve tried.
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The Mediterranean Diet...
... is based on traditional foods
from countries
that surround the Mediterranean
Sea.
But you can enjoy it with

delicious, fresh, affordable foods
from your local supermarket.
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8 Simple Steps for Good Health
Eat lots of
1
vegetables.
Can you fill half your plate with

them at lunch and dinner?
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Change the way

2
you think about
meat.
Enjoy small amounts

as a garnish for flavor.
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Enjoy some dairy

3
products.
Greek or regular yogurt and a variety of

traditional cheeses are great.
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Eat seafood
4
twice a week.
For brain and heart health, enjoy tuna,

herring, salmon, shellfish and other fish.
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Cook a vegetarian
5 meal once a week.
When one night feels comfortable, try

two.
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6 Use good fats.
Think extra-virgin olive oil, nuts, seeds,

peanuts, avocados and more.
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7 Switch to
whole grains.
The fuller, nuttier taste of whole

grains and their extra fiber can help
keep you full for hours.
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For dessert,
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eat fresh fruit.
Save sweets for a rare treat or special

occasion.
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Mediterranean Diet Pyramid
Meats & Sweets
Less often
Wine
in moderation Poultry, Eggs, Cheese and Yogurt
Moderate portions, daily to weekly
Fish and Seafood

Often, at least twice a week
Drink water
Fruits, Vegetables,
Grains (mostly whole),
Olive oil, Beans, Nuts,
Legumes, Seeds, Herbs
and Spices
Base every meal
on these foods
Be physically active;
Enjoy meals with others
© 2009 Oldways Preservation and Exchange Trust • www.oldwayspt.org

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Vegetables
Be creative! Eat a variety of fresh,

frozen, and canned vegetables every
day.
These are just a few examples.

All vegetables are good!
©2009 Oldways Preservation and Exchange Trust • www.oldwayspt.org
 Spinach  Potatoes  Artichokes

 Red & green peppers  Mushrooms  Onions
 Carrots  Squash  Zucchini
 Eggplant  Broccoli
 Tomatoes - canned, fresh, sun-dried
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Grains
mostly whole
Choose whole grain options whenever

possible. The benefits are huge!
Enjoy plenty of intact grains and pasta

especially.
 Bread  Pasta, any shape /size

 Pita bread  Polenta from whole cornmeal
 Rolled oats  Rice – try brown, black red
 Bulgur  Farro, spelt and other grains
 Couscous
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Olive Oil
Olive oil is the principal fat of the

Mediterranean Diet.
Look for other healthy fats and oils,

too, like these below.
Healthy oils
Other healthy fats  Extra-virgin olive oil
 Avocados  Canola oil
 Olives  Walnut oil
 Nuts  Avocado oil
 Fish  Flax oil
 Grapeseed oil
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Beans,
Seeds, Nuts
Try as many varieties of beans, seeds

and nuts as possible!
Beans
 Hummus
 Green beans
Seeds Nuts  Canned & dried beans
 Sunflower  Almonds, Walnuts • Cannellini, Pinto
 Flax  Pecans, Pinenuts • Chickpeas, Black
 Chia  Peanuts, Pistachios • Lentils, Soybeans
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Fruit
Fresh, frozen, canned or dried –

choose a variety of fruits every day,
from the examples here or other
favorites.
Tip: Choose whole fruit instead of

juice!
 Apples  Blueberries  Grapes

 Oranges  Strawberries  Mangos
 Bananas  Raspberries  Kiwis
 Lemons  Pomegranates  Cherries
 Limes  Avocados  Peaches
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Fish &
Seafood
Omega-3 oils in fish contribute to

brain and heart health, among other
benefits.
 Salmon  Oysters  Calamari

 Tuna  Clams  Cod
 Sardines  Mussels  Swordfish
 Anchovies  Scallops  Shrimp
 Crabs  Tilapia
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Dairy
Dairy is enjoyed in the form of yogurt

and cheese – fermented dairy
products that contribute to good gut
health.
Choose any cheese! We’ve list just a few.

 Yogurt  Feta  Halloumi
• Greek  Mozzarella  Asiago
• Plain  Ricotta  Gorgonzola
 Low-fat milk  Pecorino  Parmigiano-Reggiano
 Manchego  Provolone
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Eggs &
Poultry
Eggs are considered the “ideal protein” –

and have a long history in the
Mediterranean Diet.
 Eggs provide protein; vitamins A, D,

and E; and minerals
 Poultry is a lean protein source.
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Once-in-a-
while foods
Greater health benefits are linked to

eating less of these “once-in-a-while”
foods.
 Sweets. Save sweets for  Red meat. Eat in small amounts as a

special occasions; enjoy garnish to dishes. Choose lean protein
fruit for dessert most days. sources such as beans, seafood, eggs
and poultry instead.
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Water
Make water your normal go-to drink at

most meals and throughout the day.
 An overall healthy diet  Tea, herb tea, and coffee (in moderate
provides added fluids from amounts) can also be good beverage
the fruits and vegetables choices.
you eat.  Add a squeeze of fruit juice to your
water for extra flavor.
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Wine
Studies show health benefits from

moderate wine consumption, for those
who drink.
 100% grape juice offers  Up to 1 glass a day for women (5 oz.

some of the same benefits total)
for those who don’t drink.  Up to 2 glasses a day for men (10 oz.
total)
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Many Health Benefits
Scientific evidence shows the Med Diet helps:
• Reach weight loss or management goals
• Lower your risk of heart disease and
high blood pressure
• Fight certain cancers and chronic diseases
• Reduce asthma
• Avoid diabetes; manage blood sugar
• Resist depression
• Nurture healthier babies
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Mediterranean Diet Swaps
Instead of.... Choose....

Mayonnaise on your sandwich Hummus
Butter on your toast Olive oil or nut butter
Meat in pasta sauce More vegetables!
Chocolate cake Baked pear & yogurt sauce
A bagel with jam Oatmeal with berries or
Greek yogurt with granola
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The Dietary Guidelines
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1. Eat Nutrient Dense Foods
Caloric Breakdown
Carbohydrates: 55-60%
Fat: No more than 30%
Protein: 10-15 %
Average American eats too much fat,

sugar, calories & sodium
Average American doesn’t eat enough
fiber.
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2. Balance calories to manage
weight
Monitor food and beverage intake, physical
activity and body weight.
Reduce portion sizes
When eating out, make better choices
Limit screen time (increase your activity)
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3. Reduce sodium, fats, added
sugars, refined grains & alcohol
What can too much salt/sodium
do to your body?
Can cause high blood
pressure and heart disease.
Where does it hide?

In prepared foods (frozen,
canned, etc.)
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4. Increase vegetables, fruits, whole grains, milk,
seafood and use oil instead of fat
It’s recommended that we eat 8 oz of

seafood per week
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5. Build healthy eating patterns that meet nutritional needs
over time at an appropriate calorie level.
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6. Include physical exercise as
part of healthy eating patterns
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Soluble Fiber
• examples include gums, pectins, mucilages,
some hemicelluloses
• functions:
– delay gastric emptying
– slow transit through the digestive system
– delay glucose absorption
– bind to bile, help decrease cholesterol
• food sources: fruits
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Insoluble Fiber
• examples include cellulose, hemicellulose
• functions:
– speed transit through the digestive tract
– delay glucose absorption
– increase fecal weight and soften stool to ease passage
– reduces risk of hemorrhoids, diverticulitis and appendicitis
• food sources: cereal grains, legumes, vegetables,
nuts
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Nutrient Sources
Water insoluble dietary fibers
β-glucans (a few of which are water soluble)
Cellulose cereals, fruit, vegetables (in all plants in general)
Chitin in fungi, exoskeleton of insects and crustaceans

Hemicellulose cereals, bran, timber, legume
Hexosane wheat, barley
Pentosane rye, oat
stones of fruits, vegetables (filaments of the garden bean),
Lignin
cereals
Xanthan production with Xanthomonas-bacteria from sugar substrates
water soluble dietary fibers

replace or complement in some plant taxa the starch as
Fructans
storage carbohydrate
Inulin in diverse plants, e.g. topinambour, chicory, etc.
Polyuronide
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Pectin in the fruit skin (mainly apples, quinces), vegetables
Soluble or Viscous Fiber
Goal Soluble Fiber grams
Barley, ½ cup cooked 1
Increase to 10-25 Oatmeal, 1 cup cooked 2
grams per day Psyllium seeds, ground 1T 5
Apple, banana, peach 1
Orange, grapefruit, pear 2
Beans, cooked, 1 cup 4-
6
Broccoli, ½ cup cooked 1
Brussels Sprouts, ½ cup ckd 3
Carrots, ½ cup cooked 1
Source: ATP 3 TLC Guidelines
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Practical Steps To
Increase Your Intake
of High-Fiber Foods
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Dietary Fiber-Eat More Fruit
Fruit is a good source
1 of fiber; low in fat and Fruits fiber, g
calories, and Apple, 1 medium 3.3
cholesterol-free. Applesauce, canned 1/2 C 1.5
Apricots, 3 medium 3.8
Two or more cups of Banana, 1 medium 3.1
fruit per day are Blackberries, fresh, 1 C 7.6
recommended. Blueberries, frozen, 1 C 4.2
Cantaloupe, 1 C pieces 1.4
Kiwi, 1 medium 2.6
Orange, 1 medium 3.1
Peach, 1 medium 1.5
Pear, 1 small 4.6
Prunes, 1/2 C cooked 4.7
Strawberries, raw, 1 C 3.1
USDA National
10/23/2023 Nutrient Database Melese .S 42
Dietary Fiber-Eat More Vegetables
Vegetables are low in fat Vegetables fiber g
2 and calories and high in Asparagus, ½ C cooked 1.8
Broccoli, ½ C cooked 2.6
fiber, vitamins, and
Brussels sprouts, ½ C ckd 2.0
minerals.
Carrot, ½ C cooked 2.3
Three to five or more Coleslaw, ½ C 0.9
servings of vegetables per Green beans, ½ C cooked 2.0
day are recommended. Green peas, ½ C cooked 4.4
Greens, ½ C cooked 2.1
Potato, baked, 1 medium 3.8
Summer squash, ½ C ckd 1.3
Winter squash, ½ C baked 2.9
Sweet potato, 1 med. Baked 3.8
Tomato, fresh, 1 medium 1.5
10/23/2023USDA National Nutrient DatabaseMelese .S 43

Eat MoreMore
Dietary Fiber-Eat Whole Grains
Whole Grains
Whole grains are a good Grains fiber-g

3 source of fiber. They are
Bran Flakes cereal, 3/4 C 5.3
Grape-Nuts, 1/4 C 2.5
usually low in fat, and they
Oatmeal, 3/4 C, cooked 3.0
tend to fill you up.
Pancakes, three 4” cakes 1.5
Three or more servings of Pasta, 1C, cooked 2.5
whole grains per day are Rice, brown, 1C cooked 3.5
recommended. Rice, white, 1C cooked 1.4
Shredded wheat, 1 C 5.0
Tortilla, 1, whole corn 1.5
Wheaties, 1 C 3.0
White bread, 1 slice 0.6
Whole-wheat bread, 1 slice 1.7
USDA National
Dietary Fiber-Eat More Legumes
Legumes are the foods Legumes fiber g
4 highest in fiber. They are Black beans, ½ C cooked 7.0
also good sources of Burrito, bean & cheese, 1 15.0
protein. Chickpeas, ½ C cooked 5.3
Eat three or more servings Hummus spread, ¼ C 3.8
per week. Daily intake is Lentils, ½ C cooked 7.8
ideal. Lima beans, baby, ½ C 7.0
Pinto beans, 1 C cooked 15.4
Tofu, raw, firm, ¼ block 1.9
Tofu, raw, regular, ¼ block 0.3
USDA National Nutrient Database

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Dietary Fiber-Choose Fruit/Veg Juice
Juice fiber g
Pure fruit and vegetable
5 juices contribute some
Apricot nectar, 6 oz 1.1
Grape juice, 1 C 0.3
fiber and are good sources Grapefruit juice, ½ C 0.1
of vitamins. Orange juice, 1 C 0.5
Look for juices without Pineapple juice, ½ C 0.5
added sugar. Tomato juice, 1C 1.0
V-8 juice, 1C 1.9
Soft drink*, 1 can 0.0
* Soft drinks are loaded with sugar
and calories but not nutrients.
USDA National
Dietary Fiber-Eat Nuts and Seeds
Nuts fiber
Nuts are good sources of
6 fiber, protein, and
g
Almonds (23), 1 oz. 3.3
unsaturated fats. Cashews (18), 1 oz. 0.9
Nuts have been found to Filberts (21), 1 oz. 2.7
reduce the risk of heart Mixed nuts, 1 oz. deluxe 1.6
disease. Peanut butter, 2 T 2.6
Peanuts, 1 oz. 2.3
Pecans (15 halves), 1 oz. 2.7
Pistachios (49), 1 oz. 2.9
Sunflower seeds, 1 oz. 2.6
Pumpkin seeds (142), 1 oz. 1.1
Walnut halves, 1 oz. 1.9

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Dietary Fiber-Eat Less Refined Foods
Much of the fiber is Sample Foods fiber g

7 removed in refined and Apple, 1 med. 3.3
processed foods. Applesauce, canned 1/2 C 1.5
Apple juice, 1 cup 0.2
Choose more unrefined,
Soft drink, 1 can 0.0
natural foods.
Whole-wheat bread, 1 slice 1.7
White bread, 1 slice 0.6
Twinkie, 1 0.1
Soft drinks, ice cream, candy

sugar, butter, margarine 0.0

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Dietary Fiber – Read Food Labels
Nutrition Facts
• When buying
8 foods, check the
Serving Size 2.5 oz. (71g)
Servings per container 4
Amount Per Serving
label for fiber Calories
130
content. Calories from fat 25
• You will soon Total Fat 3g

% Daily Value
5%
learn which foods Saturated fat 1 g
5%
are higher in Polyunsaturated fat 0.5g
Monounsaturated fat 1.5g
dietary fiber. Cholesterol 10 mg
4%
Sodium 290 mg
12%
Total Carbohydrate 18g 6%
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Dietary fiber 5g 49
20%
Effect of dietary fiber on breast Cancer
Systematic review
Sourec: Annals of Oncology, Jnaury, 2012

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Insoluble fibre has more effect on weight
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Fiber and Colorectal Cancer: review of evidence
10/23/2023 Source
Melese: .S 52
Whole Grains & Risk of Mortality
• ARIC study, 15,792
1.00
people 45-64, 11 yrs
Mortality, any cause (RR)

1.00
• Those eating the most 0.75

0.84
whole-grains had a 48%

0.66
decrease in mortality. 0.63
0.50 0.52
• After adjusting for BMI,
exercise, cholesterol, 0.25
etc. they still had a 23%
lower risk of dying from 0.00
any cause. 0.1 0.5 1 1.5 3
Whole Grains, Servings/Day

(Quintiles)
Amer Jour Clin Nutr 78: 383-390

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Glycemic index
• The glycemic index of a carbohydrate represents how
quickly its consumption increases blood sugar levels.
Values range from 1 (the slowest) to 100 (the fastest, the
index of pure glucose).
• However, how quickly the level actually increases also
depends on what other foods are ingested at the same
time and other factors.
• The glycemic index tends to be lower for complex
carbohydrates than for simple carbohydrates, but there
are exceptions.
• For example, fructose (the sugar in fruits) has little effect
on blood sugar.
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Glycemic Index: Definition
• Glycemic index (GI) measures how fast a carbohydrate is

digested and raises blood sugar and insulin levels
• Measure of relative glycemic response to dietary carbohydrates
• Rate and degree of blood sugar elevation following
consumption.
• Reference food:
– White bread or Glucose = 100
– Higher index  faster and greater rise of postprandial
glucose and/or insulin
• Glycemic index debate
-low glycemic index supposedly helpful in reducing glucose load
via reduced insulin response required
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What Is the Glycemic Index?
• System of ranking foods according to how much they raise blood glucose
relative to a reference food
– Developed by Jenkins DJ, et al. Am J Clin Nutr. 1981;34(3):362-366.
• Rapidly digested or absorbed carbohydrates = high GI
• Slowly digested or absorbed carbohydrates = low GI
• References on GI
– Brand-Miller J, et al. The New Glucose
Revolution. 3rd ed. New York, NY:
Marlowe & Co.; 2006
• Written by experts on GI
– Atkinson, et al. Diabetes Care.
2008;31(12):2281-2283
• Most comprehensive table of the
GI of foods that has
been assembled to date
Abbreviations: GI, glycemic index.

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Figure from http://www.glycemicindex.com/aboutGI.htm. Melese .S 56
Blood Glucose and Insulin Curves
High energy
storage
zone
After eating:
• White bread (solid line) Hunger Zone
and then
• Spaghetti (dotted line) High insulin response
leads to obesity,
(each food was eaten on insulin resistance and
exhaustion
different days)
JAMA, May 8, 287:2415

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The Glycemic Index
• a measure of the extent to which a food raises
blood glucose concentration & elicits an insulin
response compared to pure glucose
Low Moderate High

pasta banana white bread
baked beans orange juice cornflakes
bran cereals ice cream potatoes
apples jelly beans
milk watermelon
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The Glycemic Index
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The Glycemic Index cont.
Glucose 100
Baked potato 85
Jelly bean 78
Honey 73
Bagel 72
Sucrose 65
Boiled new potato 62
Brown rice 55
Chocolate 49
Boiled carrots 47
Orange 44
Spaghetti 42
Apple 38
Skim milk 32
Lentils 29
Fructose 23
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Glycemic Index (contd)
• Use of Glycemic Index
– Lower GI foods digest & Fastest Glucose
Dextrose
convert to glucose more slowly
Starch (branched-chain)
– High-fiber slower than low
Sucrose/Corn Syrup
– High-fat slower than low Fructose
– Solids slower than liquids Starch (straight-chain)
– Cold foods slower than hot Lactose
– Type of sugar/starch affects GI Galactose
Slowest Sugar Alcohols
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Glycemic Index (GI)
The GI reflects the rate of digestion and absorption of

CHO
Blood glucose area after test food

GI = X 100
Blood glucose area after reference food
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What Does the Glycemic Index Value Mean?
• The glycemic index (GI) is expressed as a ratio comparing the blood glucose increase caused
by a test food to that of a reference food (usually glucose [G], historically white bread [WB])
for 2 hours following ingestion:
Area Under the Curve for Test Food

× 100 = GI
Area Under the Curve for Reference Food
• Conversion for different reference foods: GIG × 1.4 = GIWB
– The GIG for carrots (mean of 4 studies) = 47
– The GIWB for carrots (mean of 4 studies) = 68
• How about a ½ cup of carrots? GI of 47% and it contains about 6 g carbohydrate
GL + 47 x 6/100= 3g
• Let’s take a medium apple. It has a GI of 40% and it contains 15 grams of carbohydrate
GL = 40 x 15/100 = 6 g
• What about a small baked potato? Its GI is 80% and it contains 15 g of carbohydrate
GL = 80 x 15/100 = 12 g
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Atkinson FS, et al. Diabetes Care. 2008;31(12):2281-2283. Melese .S 63
GI rating for some common carbohydrates
• A Glycaemic Index of
 less than 55 is considered Low,
 56 to 69 Medium and
 Greater than 70 is High.
• Values will vary depending on brand, variety,
ripeness, preparation etc. The below table
contains the GI for a selection of foods
(Hamilton 2005)
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Glycemic Index (GI): Protocol
1. 25 or 50 grams carbohydrate of test food.

2. Blood samples taken:
1st hour: every 15 minutes
2nd hour: every 30 minutes
3rd hour: every 30 minutes*
3. Values plotted; AUC calculated.
4. Test food response compared to reference food
response.
5. Average GI of 8-10 volunteers = GI of test
food.
* DM volunteers only.
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Glycemic Index (GI): Sample Graphs
Adapted from Good Carbs Bad Carbs Reprinted courtesy of Marlowe & Company.
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Factors Influencing GI Ranking
• Type of starch
• Physical entrapment
• Viscosity of fiber
• Sugar content
• Fat and protein
• content
Acid content
• Food processing
• Cooking
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Type of Starch
Amylose Amylopectin
• Absorbs less water • Absorbs more water
• Molecules form tight • Molecules are more open
clumps • Faster rate of digestion
• Slower rate of digestion
Lower GI Higher GI
Kidney beans (28) Russet potato (85)

Uncle Ben’s converted LG rice (50) Glutinous rice (98)
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Physical Entrapment
Bran acts as a physical barrier that

Bran slows down enzymatic activity on
the internal starch layer.
Endosperm
Lower GI All Bran (38)
Pumpernickel bread (50)
Germ
Higher GI Bagel (72)

Corn Flakes (92)
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Viscosity of Fiber
Viscous, soluble fibers transform intestinal
contents into gel-like matter that slows
down enzymatic activity on starch.
Lower GI Higher GI
Apple (40) Whole wheat bread (73)

Rolled oats (51) Cheerios (74)
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Sugar Content
sugar sucrose glucose + fructose
(GI 60) (GI 100) (GI 19)
starch maltose glucose + glucose

(GI 105) (GI 100) (GI 100)
Lower GI Higher GI
Frosted Flakes (55) Golden Grahams (71)

Raisin Bran (61) Rice Krispies (82)
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Fat & Protein Content

Fat and protein slow down gastric
emptying, and thus, slows down digestion
of starch.
Lower GI Higher GI
Peanut M&M’s (33) Jelly beans (78)

Potato chips (54) Baked potato (85)
Special K (69) Corn Flakes (92)
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Acid Content
Acid slows down gastric emptying, and
thus, slows down the digestion of starch.
Lower GI Higher GI
Sourdough wheat bread (54) Wonder white bread (73)
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Food Processing
Highly processed foods require less
digestive processing.
Lower GI Higher GI
Old fashioned, rolled oats (51) Quick, 1-minute oats (66)
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Cooking
Cooking swells starch molecules and
softens foods, which speeds up the rate of
digestion.
Lower GI Higher GI
Al dente spaghetti – boiled Over-cooked spaghetti –

10 to 15 minutes (44) boiled 20 minutes (64)
10/23/2023 Melese .S 77
Type of starch Cooking
Physical entrapment Food processing
Viscosity of fiber Acid content
Sugar content Protein content

Fat content
How does all this affect our glycemic levels?
How does all this make us feel after eating

carbohydrate-containing foods?
10/23/2023 Melese .S 78
Glycemic load
• The glycemic index indicates only how quickly carbohydrates in a
food are absorbed into the bloodstream.
• It does not include how much carbohydrate a food contains, which
is also important.
• Glycemic load, a relatively new term, includes the glycemic index
and the amount of carbohydrate in a food.
• A food, such as carrots, bananas, watermelon, or whole-wheat
bread, may have a high glycemic index but contain relatively little
carbohydrate and thus have a low glycemic load. Such foods have
little effect on the blood sugar level.
• Glycemic load also includes how changes in blood sugar are
affected by the combination of foods eaten together. The glycemic
index does not.
10/23/2023 Melese .S 79
Glycaemic Load
• While GI is a very useful concept, it cannot be taken as the sole
predictor of the effects of eating a particular type of carbohydrate.
That is because blood glucose response is also determined by the
amount of food eaten. A more reliable rating system is the
'glycaemic load' (GL), which takes account of both the quality (GI
value) of a given carbohydrate and the amount consumed, so
more accurately predicting its effects on blood sugar.
• The glycaemic load, in units, of a portion of carbohydrate is
expressed as:
• GI rating x grams of carbohydrate in portion size / 100.
• Note that each unit of GL produces the same effect on blood sugar as eating 1g of pure glucose.
• A 120g banana contains around 24g of carbohydrate, which has a GI value of 58.
The GL is: (58 x 24) / 100 = 13.92 units.
• 120g of chocolate provides 75g of carbohydrate, which has a GI value of 49
The GL is: (75 x 49) / 100 = 36.75 units.
• By to talling up the GL units for foods you eat during the day, you can arrive at an overall GL for the
day. A Glycaemic Load of Less than 80 units is considered Low, 80 to 120 units is Medium and
greater than 120 units is High.
10/23/2023 Melese .S 80
What Is the Glycemic Load?
• The glycemic load (GL) takes into account the
amount of carbohydrate (CHO) in a common
serving in addition to its glycemic index (GI):
GL = (GI of CHO × grams of CHO per serving) ÷ 100
• Example:The GL G of carrots is: (47 × 5) ÷ 100 = 2.4

– Carrots (peeled, boiled) have a GI of 47 and 5 g
CHO per serving
Abbreviations: CHO, carbohydrate; GL, glycemic load; GI, glycemic index.

10/23/2023
Atkinson FS, et al. Diabetes Care. 2008;31(12):2281-2283. Melese .S 81
Glycemic Load
• Glycemic index relative to the serving size
• Some CHO have high GI but are consumed in
small quantities per serving
• GL = (GI x CHO/serving)/100
• Ratings of glycemic loads
– High GL = >20
– Medium GL = 11-19
– Low GL = <11
10/23/2023 Melese .S 82
High Glycemic Load Meals
• Eating high glycemic load meals, compared to
lower glycemic load meals, results in:
– Higher 24-hour blood sugar levels
– Higher insulin levels
– Higher glycosylated hemoglobin levels (HbA1c)
– Increased hunger following reactive low blood sugar
• It also results in increased risk for diabetes, obesity,
and coronary heart disease.
JAMA, May 8, 287:2415

10/23/2023 Melese .S 83
Glycemic Load (GL): What does it mean?
Glycemic load measures the degree of

glycemic response and insulin demand produced
by a specific amount of a specific food.
Glycemic load reflects both the quality and

the quantity of dietary carbohydrates.
GL = GI/100 x CHO (grams) per serving
Example: GL of an apple = 40/100 x 15g = 6g
10/23/2023 Melese .S 84
Glycemic Load (GL): Ranking
Individual food portion:

Low 0-10
Moderate 11-19
High 20+
Whole day:
Low < 80
Moderate 100
High > 120
10/23/2023 Melese .S 85
GI vs. GL
Glycemic Index: ranks carbohydrates based on

their immediate blood glucose
response.
GI = glycemic quality
Glycemic Load: helps predict blood glucose

response to specific amount of
specific carbohydrate food.
quality
GL = glycemic
quantity
10/23/2023 Melese .S 86
10/23/2023 Melese .S 87
Benefits of Low GI Diet
Are there any documented benefits to

lowering the GI of one’s diet?
YES!
BG levels type 2 DM risk
cholesterol levels heart disease risk
weight
10/23/2023 Melese .S 88
Glycemic Load and Risk of Heart Disease
2.00 N = 75,521
Risk of Heart Disease (RR)
10 year study 1.98
1.50
1.51
1.25
1.00
1.00 1.01
0.50
0.00
117 145 161 177 206
Low glycemic load High glycemic load
Glycemic Load Quintiles
AJCN, 71:1455-61
10/23/2023 Melese .S 89
Glycemic Index and Dietary Fiber and Risk of Diabetes
Women’s Health study 2.5
Risk of Getting Diabetes (RR)

• Women who ate the least fiber 2.50
were twice as likely to get 2.0
diabetes as those who ate the
most fiber. 1.80
1.5
• Women with the highest
glycemic index were 51% more
likely to get diabetes then 1.0
1.00
women who ate the lowest GI
diet. 0.5
• Overall risk was 2.5 times higher
on the low fiber, high GI diet. 0.0
Decreasing fiber
Increasing Glycemic Index
10/23/2023 Melese .S 90
Journal of the American Medical Association 277 (6): 474-477
Glycemic Index - Oats
Glycemic Index
52 Low GI is less than 55
Steel cut oats Medium GI = 55-59
High GI = 60+
55
Oatmeal
Quick oats 65
White bread 70
Cheerios 74
Table sugar 65
Glycemic Index (GI) based on glucose

0 10 20 30 40 50 60 70 80 90 100 110
University
10/23/2023of Sydney, Nutrition Department
Melese .S 91
Legumes Lower Glucose Levels and CHD Risk
• Legumes are high in fiber
and have a very low
glycemic index.
• Adding 1 cup of legumes to
the diets of 121 diabetics
for 3 months significantly
lowered:
– Blood A1C levels
– Body weight and blood
pressure
– Risk of coronary heart
disease
Archives
10/23/2023 of Internal Medicine 2012;172(21):1653-1660
Melese .S 92
Glycemic Load of Common Foods
Food Glycemic Load Food Glycemic Load

Instant rice, ½ C Banana, 1
25 13
Baked potato, sm. Spaghetti, ½ cup
16
20
Apple, 1 fresh
Corn flakes, 2/3 C 8
21 Lentils, ½ C
White bread, 2 s. 6
21 Carrot, 1
Rye bread, 2 slices
10/23/2023 Melese .S
5
Journal of the American Medical Association 287:2415 93
Glycemic Load Principle
High Glycemic Load Foods Low Glycemic Load Foods
• Snack foods • Fresh fruit & Vegetables
• Fast foods • Legumes, peas, beans,
• Pastry, cookies garbanzos, soy, tofu
• Sweets • Nuts
• Soda pop • Whole-grain breads and
cereals including oatmeal
• White bread/rice
and brown rice
• Refined carbohydrates
• Protein rich foods
• Potatoes
• Healthy fats
10/23/2023 Melese .S 94
Glycemic Index of Selected Foods
Foods Glycemic Index Foods Glycemic Index
White Bread 100 Oatmeal 82
Table sugar 84 Orange juice 75
Baked potato 104 Bran flakes 74
Cheerios 106 All bran 72
Pancake 119 Pasta 71
Cornflakes 120 Baked beans 60
White rice 102 Apple, raw 51
Instant rice 129 Skim milk 46
Fruit punch/soda pop 95 Soy beans (soy milk 43) 35
Banana 88 Peanuts 20
Pizza 86 Broccoli 15
Based on a “White Bread Standard”. To convert to the “Glucose Standard”, multiply by 0.7 .
Harvard
10/23/2023 Nutrition Department, (white Melese
bread .S standard) 95
Glycemic Standards - using glucose
Glycemic Index (GI) Glycemic Load (GL)/Food

Low GI Less than 55 Low GL 10 or less
Medium GI 56-59 Medium GL 11-19
High GI 60 or more High GL 20 or more
Glycemic Load/Day A GL of 150 or higher was linked

Low GL Less than 80 to a high risk of heart disease in
High GL 150 or more the Women's Health Study.
University
10/23/2023 of Sydney Melese .S 96
Grains – Glycemic Index
Food G.I. Food
French bread G.I.
136 Pastry
White rice 84
126 Rice (Basmati), white 83
Corn chips Pita bread
125 82
Brown rice
English muffin
79
110 Oatmeal cookie 79
Doughnut Sweet corn
108 78
Waffle Pound cake
109 77
Bread, White
10/23/2023 Melese WW
.S bread, stone ground 76 97
Cereals – Glycemic Index
Food G.I. Food G.I.
Barley, pearled, ckd 36 Corn meal 98
All-bran 60 Shredded wheat 99
Oatmeal, old fashioned 70 Cream of wheat 100
Whole wheat, quick 77
Millet 101
Kellogg’s mini-wheats 81
Bran chex 83
Cheerios 106
Wheat kernels, whole 84 Corn chex 118
LIFE cereal 94 Corn flakes 119
Grape-nuts 96 Rice chex 127
10/23/2023 Melese .S 98
Fruits – Glycemic Index
Food G.I. Food G.I.
Cherries 32 Grapes 66
Grapefruit 36 Orange juice 74
Apricots, dried 44 Banana 77
Pear 53 Apricots 81
Apple 54 Raisins 91
Apple juice 57 Apricots, canned syrup 91
Peach 60 Pineapple 94
Orange 63 Watermelon 103
10/23/2023 Melese .S 99
Legumes & Vegetables Glycemic Index
Legumes G.I. Vegetables G.I.

Soy beans 26 Parsnips 139
Soy milk 44 Potato baked 121
Lentils 41 French fries 107
Pumpkin 107
Kidney beans 42
Potato steamed 93
Butter beans 44 Beets 91
Split peas 45 Sweet corn 78
Pinto beans 55 Sweet potato 77
Chick peas 60 Carrot 70
Peanuts 21 Green peas 68
Broccoli, greens, cabbage 20
cauliflower, s. squash
10/23/2023 Melese .S 100

Sugars – Glycemic Index
Sugars G.I. Misc. foods G.I.
Fructose 32 Milk, skim 46
Lactose 65 Milk, full fat 39
Yogurt, sweetened 51
Honey 83
Tomato soup 54
HF corn syrup 89 Ice cream, full fat 87
Sucrose (table sugar) 92 Coca Cola 90
Glucose 137 Soft drink 97
Maltose 150 Soda crackers 106
Dates, dried 146
Tofu frozen dessert 164
10/23/2023 Melese .S 101

10/23/2023 Melese .S 102
Carbohydrates in the Diet
Increase complex carbohydrate intake: whole grains,
legumes, vegetables
– eat more breads, cereals, pasta, rice, fruits, vegetables &
legumes
– eat fruits and vegetables with the peel
– add fruits to muffins and pancakes
– add legumes to casseroles and mixed dishes as a meat
substitute
10/23/2023 Melese .S 103

10/23/2023 Melese .S 104
10/23/2023 Melese .S 105
Recommendations
On
Healthy life style
For all
10/23/2023 Melese.S 106
1. Do aerobic Physical exercise
F: Frequency: 3-6 times
per week
I: Intensity: Moderate ( Brisk walk)
T: Time: 30-60 Min/ session.
May split sessions (AM/PM)
T: Type: Type of Exercise: Aerobic

Physical activity could be formal exercise such as
jogging, swimming, or tennis or routine activities,
such as gardening, walking, and housecleaning.
10/23/2023 Melese.S 107
2.Reduce consuming the three whites
Sugar==9 TSP men, 6 TSP
women(AHA, 2009)
Men: 150 calories per day (37.5 grams or 9
teaspoons).Women: 100 calories per day (25 grams
or 6 teaspoons).
Salt=== 1500-2300mg/day
•American Diabetes Association (ADA): 1500 to 2300 mg.
Use iodized salt

Fat
Eat white meat and liquid vegetable oil and
avoid staurated fat and trans fat such as
solidified oils
10/23/2023 Melese.S 108
Hydrogenation Solidifies Vegetables oils
and changes them into transfats
Hydrogenation
Vegetable
10/23/2023
Oil Melese.S 109
3. Stop Smoking
• Smoking is widely accepted as a
major risk factor for cardiovascular
disease.
• studies have shown that smoking

reduces insulin sensitivity,
induces insulin resistance, and
enhances cardiovascular risk
factors, such as elevated plasma
triglycerides,reduced high density
lipoprotein–cholesterol, and
hyperglycemia
Nutrition Reviews® Vol. 69(12):745–

10/23/2023 Melese.S
753 110
4. Avoid drinking Excessive Alcohol
• Do not drink if you
can
• If you drink Limit

alcohol intake to <2
drinks/day
10/23/2023 Melese.S 111

Alcohol Consumption and BP
Panagiotakos D. et al J Hypertens 2003;21:1-7

10/23/2023 Melese.S 112
5. Eat diversified Diet
10/23/2023 Source:
Melese.S USDA, 1992 113
6. Do not Chew Khat
• Khat chewing== Leads to 2
times high risk of death
from CHD(Mayo Clin Proc.
2010;85(11):974-980)
• Many other problems[Al-

Motarreb et al. Journal of
Ethnopharmacology 132 (2010) 540–
548]
10/23/2023 Melese.S 114

7. Get adequate Sleep (6-8 hours per
day)
• <7 hrs sleep was 1.23 times
MetShigh(P<0.001)
• <6-7 hrs sleep was 1.16 times high

MetS(P=0.02)
• <5-6 hrs sleep was 1.28 times

high MetS(P=0.01)
• <5 hrs sleep was 1.51 times

high MetS(p<0.001 )
Sleep Duration and Metabolic Syndrome. An Updated Dose–Risk

Metaanalysis: Annals of the American Thoracic Society, 2015; 12(9): 1364-
10/23/2023 1372.
Melese.S 115
8. Do not Spend large amount of
time sitting
• People with Sedentarity life style
were1.66 time higher
risk of Metabolic syndrome
after adjusting for : age, sex, ethnicity,
education, alcohol consumption, smoking, BMI,
diabetes, heart disease, and physical activity
• Current results suggest older people

may benefit from reducing total
sedentary time and avoiding
prolonged periods of sedentary
time by increasing the breaks
during sedentary time
BANKOSKI et al, Diabetes Care 34:497–503, 2011
10/23/2023 Melese.S 116
9. Avoid eating Foods Fried in an Oil
• consumption of even
small amounts of TFAs
(2% of total energy intake)
is consistently associated
with a markedly
increased incidence of
coronary heart disease.
Micha, r.
10/23/2023 & Mozaffarian, D. Nat. Rev. Endocrinol. 5, 335–344 (2009)
Melese.S 117
10. Eat your meal as follows
• Do not share your breakfast with anyone
• Share your lunch with most your fiend
• Give your dinner to your enemy
10/23/2023 Melese.S 118

10/23/2023 Melese.S Jimma University
Thank you!
10/23/2023 Melese.S 120

Any Questions?
10/23/2023 Melese.S 121

Fiber Lecture 2021

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For 1st Year Msc nutrition Students

Not at all like

But you can enjoy it with

Can you fill half your plate with

Change the way

Enjoy small amounts

Enjoy some dairy

Greek or regular yogurt and a variety of

For brain and heart health, enjoy tuna,

When one night feels comfortable, try

6 Use good fats.

Think extra-virgin olive oil, nuts, seeds,

The fuller, nuttier taste of whole

Save sweets for a rare treat or special

Fish and Seafood

© 2009 Oldways Preservation and Exchange Trust • www.oldwayspt.org

Be creative! Eat a variety of fresh,

These are just a few examples.

 Spinach  Potatoes  Artichokes

Choose whole grain options whenever

Enjoy plenty of intact grains and pasta

©2009 Oldways Preservation and Exchange Trust • www.oldwayspt.org

 Bread  Pasta, any shape /size

Olive oil is the principal fat of the

Look for other healthy fats and oils,

©2009 Oldways Preservation and Exchange Trust • www.oldwayspt.org

Try as many varieties of beans, seeds

Fresh, frozen, canned or dried –

Tip: Choose whole fruit instead of

 Apples  Blueberries  Grapes

Omega-3 oils in fish contribute to

©2009 Oldways Preservation and Exchange Trust • www.oldwayspt.org

 Salmon  Oysters  Calamari

Dairy is enjoyed in the form of yogurt

©2009 Oldways Preservation and Exchange Trust • www.oldwayspt.org

Choose any cheese! We’ve list just a few.

Eggs are considered the “ideal protein” –

©2009 Oldways Preservation and Exchange Trust • www.oldwayspt.org

 Eggs provide protein; vitamins A, D,

 Poultry is a lean protein source.

Greater health benefits are linked to

©2009 Oldways Preservation and Exchange Trust • www.oldwayspt.org

 Sweets. Save sweets for  Red meat. Eat in small amounts as a

Make water your normal go-to drink at

©2009 Oldways Preservation and Exchange Trust • www.oldwayspt.org

Studies show health benefits from

©2009 Oldways Preservation and Exchange Trust • www.oldwayspt.org

 100% grape juice offers  Up to 1 glass a day for women (5 oz.

Instead of.... Choose....

Average American eats too much fat,

Where does it hide?

It’s recommended that we eat 8 oz of

Chitin in fungi, exoskeleton of insects and crustaceans

Xanthan production with Xanthomonas-bacteria from sugar substrates

water soluble dietary fibers

10/23/2023USDA National Nutrient DatabaseMelese .S 43

Whole grains are a good Grains fiber-g

USDA National Nutrient Database

USDA National Nutrient Database

Much of the fiber is Sample Foods fiber g

Soft drinks, ice cream, candy

USDA National Nutrient Database