Prepared by Monique CoveySenior Clinical Dietitian

August 2014

Low GI diets – what are they and why are they good for people with Mitochondrial Disease?

Outline

General Nutrition

Diabetes

Carbohydrates

Glycaemic Index

Carbohydrate – amount and spread

Low Carbohydrate diets

Nutrition for life

Adequate nutrition essential in managing mitochondrial disease.

Key nutrients

– Carbohydrate

– Fat

– Protein

– Vitamins and Minerals

Mitochondria use glucose from CHO to form ATP (energy)

Low GI diet used to manage IGT and diabetes in mitochondrial disease

What happens when carbohydrate is eaten?

Glucose

Insulin

Blood stream

Body cell

What is Diabetes?

Insulin

Glucose

What are

Cereals and grains

– Rice

Flour-based staples

– Bread

– Pasta

Starchy veggies

– Potato & sweet potato

– Corn

What are carbohydrate foods?

What are carbohydrate foods?

• Lentils and legumes eg. beans, chickpeas, split

peas

• Milk• Yoghurt• Custard(not cream or cheese)

• Fruit• Fruit Juice• Dried Fruit

“Sometimes” foods

– Sugar

– Cake & biscuits

– Ice cream

– Soft drinks

– Sweets & chocolate

– Chips

What are carbohydrate foods?

Simple? Complex? Starchy? Sugary? Brown vs White

Carbs are Carbs They all end up as glucose molecules and are

absorbed into the bloodstream

The difference is the forms in which they’re eaten and the rate at which they break down to glucose in the gut (GI)

CHO glucose

Glycaemic Index (GI)

A ranking of foods based on their effect on blood sugar levels

Reflects both the structure and composition of foods

Low GI ≤55

Intermediate 56-69

High ≥70

“Fast acting” carbs – cause a sharp rise in BSL =HIGH GI

“Slow acting” carbs – gentle rise in BSL (slow release of glucose into blood) =LOW GI

Glycaemic Index (GI)

HIGH GI = Digested

fast

LOW GI = Digested

slowly

Low GI Foods (≤ 55)

Moderate GI Foods (56-69)

High GI Foods (≥ 70)

Useful Websites

http://www.gisymbol.com/

http://www.glycemicindex.com/

How much Carbohydrate?

Breakfast Lunch Dinner

8 am10 am

12 noon3 pm

6 pm9 pm

Aim for an even spread through the day

3 small meals & 3 snacks

Aim for:

– Breakfast 2- 3 serves

– Morning tea 1-2 serves

– Lunch 2-3 serves

– Afternoon tea 1-2 serves

– Dinner 2-3 serves

– Supper 1-2 serves

Avoid fasting

How much Carbohydrate?

What is 1 serve of carbohydrate?

15 grams– 3 teaspoons sugar

– 1 slice bread

– ¼ large Lebanese bread

– 1/3 cup cooked rice

– 1 glass milk

– 2 (small) scoops ice cream

– 1 medium piece fruit

Low CHO diets and mitochondrial disease

Minimal evidence

Based on Ketogenic diet for patients with refractory seizures that don’t respond to medication.

Last resort

Very restrictive

Needs close medical and dietetic supervision.

Summary: Points to remember

Adequate nutrition is vital in the management of mitochondrial disease

Aim for 3 meals and 3 snacks per day – avoid fasting

Include low GI CHO at every meal

Low GI diets are not suitable for everyone with mitochondrial disease

Seek further advice from your local dietitian

QUESTIONS?