the avoid list… the most insulinogenic, energy dense low nutrient density foods

Generally I think it can be more useful to tell people what they should focus on rather than what they shouldn’t do.  It’s like the proverbial hot plate or ‘wet paint’ sign.  You can’t unsee it and you just want to touch it!

If you are busy focusing on the good stuff then you just won’t have any space left for the bad stuff, especially once you start feeling the benefits.

But when it comes down to it, what are the foods that everyone should avoid?

what’s so bad about sugar anyway?

For the past four decades mainstream food recommendations have been dominated by a fear of fat, particularly saturated fat and cholesterol, which if, taken to the extreme can lead us to avoid nutrient dense foods and towards insuilnogenic nutrient poor processed low fat foods.

More recently, a growing number of people are advising that we should eat less sugar… from Sarah Wilson’s I Quit Sugar, to Robert Lustig’s Sugar: The Bitter Truth and Damon Gameau’s That Sugar Film.  Even Gary Taubes seems to be softening his stance against carbohydrates in general and is about to release his new book The Case against Sugar.

The World Health Organisation are imploring people to reduce their sugar intake.[1]   Investment bank Credit Suisse is predicting a turn away from sugar and and back towards fat, effectively advising people to ‘short sugar’.[2]

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But what is it about sugar that makes it uniquely bad?  It just the ‘evaporated cane juice’ that we should avoid?  What about whole foods that contain some sugar?  Should we avoid them too?

While added sugars are not good, they’re also an easy target that everyone can get behind.  It’s easy to swing from demonising one thing to another, from fat to carbs, to sugar.  But perhaps this paradigm is overly simplistic?

I think we need to avoid are foods that quickly boost insulin and blood glucose levels without providing any substantial nutrition in return.  Foods that should be considered universally bad are foods that are:

  • highly insulinogenic,
  • have a low nutrient density, and
  • have a high energy density.

Most diet recommendations succeed largely because they eliminate these foods.

If you want to maximise the nutritional value of your food, give your pancreas a break so it can keep up, you should AVOID THESE FOODS.

The chart below (click to enlarge) shows the weightings used in the multi criteria analysis for the various dietary approaches.  The avoid list turns the system on its head to identify foods that have poor nutrient density as well as also being energy dense and insulinogenic.

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The charts below shows that, compared to the other approaches, the foods on the avoid list are energy dense…

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…highly insulinogenic…

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…as well as being nutrient poor, all at the same time!

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Considering any of these factors by themselves can be problematic.  But when we combine all these parameters them they  can be much more useful to identify the foods we should avoid, as well as the ones we should prioritise.

As you can see from this chart, the difference between the nutrients provided by the most nutrient dense foods and the least nutrient dense avoid foods is vast!

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Also included in the table are the nutrient density score, percentage of insulinogenic calories, insulin load, energy density and the multicriteria analysis score score (MCA) that combines all these factors.

So without further ado, here is the avoid list.

drinks

Soft drinks provide very little nutritional value, are very insulinogenic and have no fibre so will raise your blood sugar and insulin levels quickly.

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food ND % insulinogenic insulin load (g/100g) calories/100g MCA
cream soda -20 100% 13 51 1.02
root beer -20 100% 11 41 1.00
grape soda -19 100% 11 43 1.00
cola -20 99% 10 37 1.00
cranberry-apple juice -19 98% 16 63 0.98
orange and apricot juice -17 97% 13 51 0.86

sweets

Sweets provide minimal nutrition while being very energy dense and highly insulinogenic.  Sugar tops the list of badness, however there are a bunch of other sweets not far behind.

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food ND % insulinogenic insulin load (g/100g) calories/100g MCA
candies -20 100% 99 394 1.34
sugar -20 100% 100 389 1.33
jellybeans -20 100% 93 375 1.31
fructose -20 100% 100 368 1.31
brown sugar -19 99% 97 380 1.29
sucralose -20 100% 91 336 1.29
fruit syrup -20 100% 85 341 1.28
skittles -20 90% 91 405 1.28
aspartame -19 99% 91 365 1.24
twizzlers -20 93% 81 348 1.24
marshmallows -19 99% 83 318 1.24
high fructose corn syrup -20 100% 76 281 1.23
maple sugar -18 99% 91 354 1.21
jams and preserves -19 98% 68 278 1.17
orange marmalade -19 99% 66 246 1.17
chocolate frosting. -18 86% 91 389 1.16
chocolate pudding -18 91% 86 378 1.16
Candies, butterscotch -17 92% 90 391 1.15
M&Ms -20 61% 73 475 1.14
tootsie roll -17 91% 89 387 1.13
Milky Way -20 61% 70 463 1.13
chocolate syrup -18 100% 67 269 1.12
butterscotch topping -18 99% 58 216 1.08
Kit Kat -19 49% 65 520 1.08
frosting -18 65% 68 418 1.04
fudge -15 87% 83 383 1.01
honey -19 63% 52 304 0.99
caramels -15 81% 80 382 0.98
tapioca pudding (fat free) -18 94% 22 94 0.91
chocolate frosting -16 61% 63 397 0.90
Twix -16 41% 57 550 0.88

fruits and fruit juices

Fruit in its natural state provides fibre, nutrients with a lower energy density.  However fruit juice and dried fruit has a much lower nutritional value and are much more insulinogenic.

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food ND % insulinogenic insulin load (g/100g) calories/100g MCA
candied fruit -20 98% 81 322 1.25
dried apples -17 85% 82 346 1.04
raisins -17 89% 73 296 1.03
dried pears -16 87% 64 262 0.96
dried currants -16 88% 70 283 0.95
apple juice -17 97% 12 47 0.88
litchis -14 89% 69 277 0.87
dried pears -17 83% 32 140 0.86

cereals and baked products

Processed grains are cheap and have a long shelf life, however the processing removes most of the fibre and most of the nutrients which means they are highly insulinogenic and energy dense.

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food ND % insulinogenic insulin load (g/100g) calories/100g MCA
corn-starch -20 99% 91 381 1.31
rice puffs -17 93% 90 383 1.13
instant oatmeal -19 70% 68 353 1.06
fudge filled cookies -19 47% 63 533 1.06
girl scout cookies -19 51% 66 520 1.06
Grahams Crackers -17 73% 77 424 1.05
choc chip cookies -18 55% 69 498 1.04
cheesecake -19 49% 63 506 1.04
white flour -15 92% 82 367 1.04
white rice -15 95% 84 365 1.02
water biscuits -17 73% 70 384 1.01
rice flour -15 92% 82 366 1.00
wheat flour -14 91% 81 363 0.96
ice cream cones -13 88% 89 402 0.94
pound cake (fat free) -14 93% 64 283 0.90
Cookies -15 76% 69 348 0.90
cornmeal -13 89% 81 370 0.90
fruitcake -16 71% 60 324 0.88
white flour -12 92% 82 366 0.88
English muffins -16 83% 51 245 0.87

other approaches

The table below contains links to separate blog posts and printable .pdfs detailing optimal foods for a range of dietary approaches (sorted from most to least nutrient dense) that may be of interest depending on your situation and goals.   You can print them out to stick to your fridge or take on your next shopping expedition for some inspiration.

dietary approach printable .pdf
weight loss (insulin sensitive) download
autoimmune (nutrient dense) download
alkaline foods download
nutrient dense bulking download
nutrient dense (maintenance) download
weight loss (insulin resistant) download
autoimmune (diabetes friendly) download
zero carb download
diabetes and nutritional ketosis download
vegan (nutrient dense) download
vegan (diabetic friendly) download
therapeutic ketosis download
avoid download

If you’re not sure which approach is right for you and whether you are insulin resistant, this survey may help identify the optimal dietary approach for you.

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references

[1] http://www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/

[2] https://www.credit-suisse.com/us/en/articles/articles/news-and-expertise/2013/09/en/is-sugar-turning-the-economy-sour.html

Jimmy Moore’s keto eggs

During his yearlong n=1 ketosis experiment Jimmy Moore in 2012 didn’t give too much away about exactly what he was eating which made me a little frustrated but inquisitive.

What was he doing to keep his blood glucose consistently low and ketones high?  Could this help me lose some weight or perhaps my type 1 diabetic wife normalise her blood glucose levels

Jimmy did  publish a list of healthy high fat foods (i.e. avocados, butter, whole eggs, coconut oil, bacon, sour cream, 70% ground beef, full fat cheddar cheese and coconut) on the Carb Smart blog but he didn’t give away much more detail.

I suppose it’s part of what drove me to dig into the food insulin index to create a ranking of all foods.

One meal he did blog as one of his favourites was his “keto eggs” which he included in Keto Clarity and on his blog here.  He says it helps him “rock the ketones”.  This was often his meal for the day with intermittent fasting.  The recipe is shown below:

  • 4-5 pastured eggs
  • 2-3 oz grass-fed butter and/or coconut oil
  • sea salt
  • parsley (or your favorite spice)
  • 2 oz full-fat cheese (optional)
  • 2 Tbs Sweet Chili Sauce
  • 3 Tbs sour cream
  • 1 whole avocado

The nutritional analysis for the recipe below shows that it’s certainly ketogenic with 83% fat, 13% protein and 4% carbs.  This recipe provides a solid protein score though the vitamins and minerals aren’t as high as some of the other meals.  However if your primary aim is therapeutic ketosis then this meal will likely be great for you.

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The ranking for the keto eggs recipe, compared to the 241 other meals that have been analysed so far,  for each of the approaches is:

  • therapeutic ketosis – 18 / 242
  • diabetes – 54 / 242
  • weight loss – 175 / 242
  • nutrient dense (maintenance)  – 159 / 242

net carbs

insulin load carb insulin fat protein

fibre

6g 31g 21% 83% 13%

3g

nutrient dense insulinogenic foods for athletes and bulking

As well as identifying nutrient dense diabetic friendly foods, we can use the food insulin index to highlight more insulinogenic nutrient dense higher energy density foods for use by athletes or people wanting gain weight.

This article highlights more insulinogenic nutrient dense foods that could be used by metabolically healthy people to strategically “carb up” before events, to intentionally trigger insulin spikes (e.g. Carb Back-Loading, Alt Shift Diet or the targeted ketogenic diet) or to maximise growth for people who are underweight while still maintaining high levels of nutrition.

insulin load, a refresher

Many people with diabetes will try to reduce the insulin load of their diet to normalise blood glucose levels.  It’s the non-fibre carbohydrates, and to a lesser extent protein, that drive insulin and blood glucose, particularly for someone who is insulin resistant.

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Managing the insulin load of your diet is an effective way to get off the blood glucose roller coaster and stabilise blood glucose levels.  We can calculate the insulin load of our diet based on the carbohydrates, fibre and protein using the formula shown below.

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We can also calculate the percentage of insulinogenic calories to identify the foods that will affect our blood glucose levels the least, or the most.

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but why would you want to spike your glucose levels?

Much of the nutrition and diabetes world is focused on helping people who are struggling with insulin resistance and trying to normalise blood glucose.  However, there are others who are blessed to be metabolically healthy who may want to strategically refill their glycogen tanks or raise their insulin levels.

  • Some follow a targeted ketogenic diet and strategically replenish glucose around workouts by eating higher carbohydrate foods.
  • Some bodybuilders use a cyclical ketogenic diet where they deplete glucose and then replenish glucose periodically.
  • Some fat adapted endurance athletes will look to ‘carb up’ before an event so that they have both glucose and fat based fuel sources (a.k.a. train low, race high).

  • Others find success with dietary approaches such as the AltShift Diet, Carb Back-Loading which alternating periods of extreme high and low carb dietary approaches (not always with the most nutritious high carb foods).

the mission…

Dr Tommy Wood approached me to design a high insulin load and a low insulin load diet regimen that he could try for a month of each to see how his body responded. The constraint was that both the high and low insulin load foods would have to be nutrient dense whole foods so as to be a fair comparison of the effect of insulin load.

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The foods listed below represent the top 10% of the USDA food database prioritised for higher insulin load, higher nutrient density and higher energy density.  In terms of macronutrients they come out at 36% protein, 15% fat and 44% net carbohydrates.

While these foods might not be ideal for someone with diabetes they actually look like a pretty healthy list of foods compared to the “food like products” that you’d find in the isles of the supermarket.

This chart shows the nutrients provided by the top 10% of the foods using this ranking compared to the average of all foods in the USDA foods database.

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Also included in the tables below are the nutrient density score, percentage of insulinogenic calories, insulin load, energy density and the multicriteria analysis score score (MCA) that combines all these factors.

vegetables

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food ND insulin load (g/100g) calories/100g MCA
watercress 19 2 11 1.2
seaweed (wakame) 13 11 45 1.0
shiitake mushrooms 5 72 296 0.9
spinach 17 4 23 0.9
brown mushrooms 11 5 22 0.7
asparagus 15 3 22 0.7
chard 14 3 19 0.7
seaweed (kelp) 9 10 43 0.7
yeast extract spread 8 27 185 0.6
white mushroom 11 5 22 0.6
spirulina 10 6 26 0.6
mung beans 9 4 19 0.6
Chinese cabbage 12 2 12 0.5
celery flakes 4 42 319 0.5
portabella mushrooms 11 5 29 0.5
broccoli 11 5 35 0.4
parsley 12 5 36 0.4
lettuce 12 2 15 0.4
radicchio 8 4 23 0.4
shiitake mushroom 9 7 39 0.4
peas 7 7 42 0.4
dandelion greens 9 7 45 0.3
endive 15 1 17 0.3
okra 10 3 22 0.3
pumpkin 6 4 20 0.3
bamboo shoots 8 5 27 0.3
beet greens 12 2 22 0.3
snap beans 8 3 15 0.3
zucchini 11 2 17 0.3

animal products

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food ND insulin load (g/100g) calories/100g MCA
ham (lean only) 11 17 113 0.7
veal liver 9 26 192 0.7
beef liver 9 25 175 0.7
lamb liver 11 20 168 0.7
lamb kidney 11 15 112 0.6
chicken breast 8 22 148 0.5
pork liver 7 23 165 0.5
chicken liver 9 20 172 0.5
pork chop 7 23 172 0.5
veal 6 24 151 0.5
beef kidney 8 20 157 0.5
lean beef 7 23 149 0.5
leg ham 7 22 165 0.5
turkey liver 8 21 189 0.5
pork shoulder 6 22 162 0.4
ground beef 6 20 144 0.4
sirloin steak 6 24 177 0.4
ground pork 6 25 185 0.4

seafood

food ND insulin load (g/100g) calories/100g MCA
cod 14 48 290 1.5
crab 15 14 83 1.1
lobster 14 15 89 1.1
crayfish 12 13 82 0.9
shrimp 11 19 119 0.9
pollock 11 18 111 0.8
octopus 9 28 164 0.8
halibut 11 17 111 0.8
fish roe 13 18 143 0.8
haddock 10 19 116 0.8
white fish 10 18 108 0.8
clam 9 25 142 0.8
scallop 8 22 111 0.7
rockfish 10 17 109 0.7
salmon 11 20 156 0.7
whiting 9 18 116 0.7
perch 10 14 96 0.7
oyster 11 14 102 0.7
flounder 11 12 86 0.6
anchovy 9 22 210 0.6
trout 10 18 168 0.6
caviar 10 23 264 0.6
sturgeon 10 16 135 0.5
tuna 6 23 184 0.3
orange roughy 4 17 105 0.3
sardine 7 19 208 0.3

legumes

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food ND insulin load (g/100g) calories/100g MCA
cowpeas 2 68 336 0.8
black beans 2 63 341 0.6
soybeans 3 49 446 0.6
pinto beans 1 64 347 0.6
kidney beans 1 63 337 0.6
broad beans 2 54 341 0.5
peas 0 57 352 0.4

grains

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food ND insulin load (g/100g) calories/100g MCA
oat bran 6 65 246 0.7
baker’s yeast 10 16 105 0.5
baking powder 2 45 97 0.4
wheat bran 8 34 216 0.4
rye flour 0 58 325 0.4
quinoa 1 22 120 0.1

dairy

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food ND insulin load (g/100g) calories/100g MCA
whey powder 10 82 339 1.6
cream cheese (low fat) 12 19 105 1.0
cottage cheese (low fat) 6 14 72 0.5
parmesan cheese 3 35 420 0.4
cottage cheese (low fat) 7 13 81 0.4
cheddar (non-fat) 6 20 173 0.3
mozzarella 4 26 304 0.3
kefir 6 7 41 0.3
gruyere cheese 3 23 413 0.3
low fat milk 6 8 56 0.2
Greek yogurt (low fat) 5 11 73 0.2
Swiss cheese 3 22 393 0.2
gouda cheese 3 21 356 0.2
cheddar cheese 3 20 410 0.2
egg yolk 6 12 275 0.2
edam cheese 3 21 357 0.1

other dietary approaches

The table below contains links to separate blog posts and printable .pdfs detailing optimal foods for a range of dietary approaches (sorted from most to least nutrient dense) that may be of interest depending on your situation and goals.   You can print them out to stick to your fridge or take on your next shopping expedition for some inspiration.

dietary approach printable .pdf
weight loss (insulin sensitive) download
autoimmune (nutrient dense) download
alkaline foods download
nutrient dense bulking download
nutrient dense (maintenance) download
weight loss (insulin resistant) download
autoimmune (diabetes friendly) download
zero carb download
diabetes and nutritional ketosis download
vegan (nutrient dense) download
vegan (diabetic friendly) download
therapeutic ketosis download
avoid download

If you’re not sure which approach is right for you and whether you are insulin resistant, this survey may help identify the optimal dietary approach for you.

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Dr Rhonda Patrick’s Ultimate Micronutrient Smoothie versus Zero Carb Gregg

I recently ran the numbers on Dr Rhonda Patrick’s Ultimate Micronutrient Smoothie that she says she and her husband have this for breakfast every day.   

I’ve been enjoying Rhonda’s podcasts as well as her mentor Bruce Ames’ great work on nutrient density.   I was pretty hopeful that Rhonda’s daily breakfast would knock it out of the park.  

So far I’ve run 235 meals though a system that ranks meals in terms of nutrient density, protein score, energy density, fibre and insulin load.  A score of 100 in the Nutrition Data analysis means that you would achieve all your daily requirements with 1000 calories (notwithstanding the limitations of bio-availability, anti-nutrients, fat soluble vitamins etc etc etc).  

So here is how Dr Rhonda’s morning smoothie scores in the nutritional analysis.  

rhonda's smoothie

In terms of vitamins and minerals it did pretty well ranking at number 40 of 235 meals analysed to date. Liberal doses of kale and spinach always tend to boost the vitamin and mineral score.  These green leafies contain heaps of vitamins A, C, K, B and folate as well as solid amounts of the minerals magnesium, phosphorus, copper and manganese.   

If you’re interested, the meal that ranks the highest in terms of vitamins and minerals score is Terry Wahls’ lamb skillet meal.  While you might think that a vegetarian meal might win in the vitamins and minerals category, Dr Wahls’ combination of broccoli, garlic, and spinach along with lamb and coconut oil actually does even better with a score of 94 compared to the green smoothie which has a score of 75.   

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The good thing about blending everything into a smoothie though is that you will be able to get more green leafy veggies down the hatch.  The downside is that you might lose a little bit of the effect of the fibre.  The same thing can be said for cooking.  

In terms of amino acids though, the micro-nutrient smoothie was a bit disappointing coming in at 196 of 235. Some people will argue that low protein isn’t a big deal and that 9% protein is adequate.  Others think protein is really important. 

The answer for you probably depends on whether you want to be really big and strong or whether you have some muscle that you don’t mind donating in the name of nutrition and weight loss.  

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The 57g of fibre was pretty good from all those leafy greens, ranking at 75 of 235 in terms of fibre. Energy density was also pretty good ranking at 100 of 235 meaning that the smoothie will be quite filling and not easy to binge on.   

The insulin load was where things got a bit disappointing.  At 50% carbs the smoothie mixture came in just above the porridge with blueberries.  This may not be a problem if you’re insulin sensitive but I think people who are struggling with diabetes might suffer a bit with the apple and banana which don’t add a lot in terms of nutrient density (other than sweetness and palatability).  Maybe drinking fruit is not such a great idea?  

Minus the apple and banana

Just for interest I dropped out the apple and banana and the ranking improved in terms of vitamins and minerals, though it didn’t change the protein score.   The insulin load ranking improved marginally from 228 of 235 to 206 of 235.  

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Overall, this may not be a bad option for breakfast if you’re not diabetic and get some additional protein later in the day, especially if you’re looking to maintain / build lean muscle.

And now for something completely different… zero carb Gregg

After releasing the ketogenic fibre article a while back in October 2015 I got into a discussion about zero carb and ended up running the numbers on Gregg’s typical daily diet which largely consists of meat, butter and cream.

Not surprisingly the protein score of Gregg’s daily diet is high though the vitamin and mineral scores are not so great (214 of 235).

The insulin load of Gregg’s typical daily diet is pretty good coming in at #50. 

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[Just for interest Bulletproof Coffee comes in at #1 on the insulin ranking but comes in last on the vitamins and minerals and second last on the protein.]

Many people find that they do really well with a zero carb approach, particularly if they have had major digestive issues.  People who are fans of zero carb often speak highly of Fibre Menace by Kanstantin Monastrysky.  It seems that people with major digestive issues can get much needed relief from their inability to digest FODMAPS using a zero carb approach.  

Overall I’m a fan of fibre and wonder if people might benefit from the slow reintroduction of some fibre for the sake of their digestion and well rounded nutrition once their gut has settled.  

It’s also it’s interesting that the the protein level is only 22% in the zero carbohydrate (with 76% calories from fat) because of the solid amount of fat from the beef and the added fat from the butter and cream.  You can see how this might work really well for people who are insulin resistant.  

Can you get enough vitamins and minerals from a zero carb diet?

Lots of people who use a zero carb approach say that they can get all the vitamins and minerals they could even need from animal products, so I threw in some sardines and liver to see how high we could get the vitamins and minerals score without any green stuff.  

As you can see below, the protein score improves with the fish and liver (I’m not vouching for the palatability though).  This meal now ranks at #1 for protein score with a massive score of 159 on the amino acid score!  The vitamins and minerals take a significant jump to #142 of 235.

So it seems that there are some benefits of a zero carb dietary approach, but perhaps still some limitations when it comes to the vitamin and mineral side of the equation.  

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Combining forces

But then I thought, “what if Rhonda made Gregg breakfast and Gregg made dinner for Rhonda?”

As you can see from the analysis below combining the green smoothie (no fruit) with the zero carb approach (with sardines and liver) went really well in both the vitamins and minerals ranking (#20) and amino acid score (#41).  Not a bad balance overall!  

On the weight loss ranking this meal combination would come in at #26 of 235, on the athlete ranking it comes in at #10, on the diabetes and nutritional ketosis ranking it comes in at #23, and for therapeutic ketosis ranking it comes in at #67.  

Overall, not a bad balance of the extremes?

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What to make of all this?

Lots of people get hung up on a particular magic nutrient and spend a lot of money to supplement just that one missing ingredient.  However perhaps it would be optimal (and cheaper?) to get a high quantity of a broad range of nutrients from natural sources.

Real foods that were recently alive are going to be a better bet than relying on supplements as there are probably a bunch of other things that are good for us that we haven’t isolated and quantified yet.  

Should you eat more plant foods, more protein, or more fat?  

The answer will depend on your situation, your goals and your preferences.

As always, optimal lies somewhere between the extremes.  

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Further reading