Ask Dr. Etingin: Circadian Rhythm & Weight Loss; Glycemic Index vs. Load

Q: Would I be able to maintain a healthier weight if I ate according to my body’s circadian rhythm?

A: Your circadian rhythm—a brain function based on a 24-hour internal clock that influences when you sleep and wake—can help your body more efficiently process nutrients, burn more calories and reduce risk of cardiovascular disease, obesity, and type 2 diabetes. But you still will need to eat the right foods in the right portions at the right times.

“Right time” eating is where your circadian rhythm can be helpful. Research shows that eating your largest meal in the morning gives you the energy you need to get through your day, while also burning the most calories at the time when you are most active. In the afternoon, your energy level starts to slow down, your body temperature lowers, and fewer calories are burned. Toward evening, your body powers down even more as it prepares for sleep.

In one study, teens who skipped breakfast and were re-evaluated at age 43 were 68 percent more likely to have metabolic syndrome—a condition in which you have three or more of the following: increased blood pressure, increased blood sugar, abdominal obesity, low HDL “good” cholesterol or high triglyceride levels. Other studies have linked irregular eating habits with increased risk of metabolic syndrome.

When planning meals, consume your largest meal in the morning and your lightest meal in the evening. If you follow this pattern, and maintain a healthy dietary plan and proper portion control, you should find your weight easier to manage.

Q: I’ve been diagnosed with type 2 diabetes. Which is more important for me to track, glycemic index or glycemic load?

A: They are equally important. Here’s why. The glycemic index (GI) ranks how quickly foods increase your blood glucose. The larger the number, the higher the spike. Eating low-GI foods (55 or less per food and an average of 45 or less per day) can help you avoid spikes.

Note that starchier vegetables have more carbs. More carbs means higher GIs. So limit your intake of starchy vegetables (white potatoes, corn, peas, winter squash) and eat more non-starchy vegetables (broccoli, tomatoes, legumes, lentils). Search for the glycemic index of different foods at

Monitoring glycemic load (GL) is critical because it measures the quantity of the foods you consume throughout the day. If you don’t monitor GL in addition to GI, you could easily over-indulge and knock your sugar and insulin off balance, which also increases your risk of cardiovascular, kidney, and other health issues.

To calculate GL, multiply a food’s GI by the number of carb grams, then divide that number by 100. For example: A medium baked potato has an 85 GI and 37 grams of carbs: 85 x 37 = 3,145/100 = a glycemic load of 31. It’s important to keep your glycemic load—for your combined daily food consumption—under a total of 100 per day.

—Editor-in-Chief Orli R. Etingin, MD

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