Vietnam Urban Forum

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If you’re one of those people who can’t stand all the counting and tracking and adding and charting that some diets require, you could find a refuge in one simple numerical scale: the glycemic index. On the other hand, you might find it another maddening way to complicate the simple act of eating.

The glycemic index is a measure of the quality of carbohydrate foods. It’s kind of a good carbs/bad carbs thing, based on how they affect your blood sugar. Though it’s not new, it did start getting a lot of press when the anti-carb movement took hold.

It works like this: in the glycemic index , pure glucose is arbitrarily assigned the score of 100; it doesn’t mean anything in particular; it’s just a set reference point for how it has affected the blood sugar by about two hours after eating. Then all other foods in the index are given a number relative to glucose and its affect on the blood sugar.

Foods with a low index typically break down slowly and don’t cause drastic fluctuations in blood sugar. Foods with a high index typically do. For instance, green peas have an index of 39, while corn flakes have an index of 92.

Originally developed to help folks—particularly diabetics—control their blood sugar, the index includes mainly carbohydrate foods, because protein and fat don’t have much immediate effect on blood sugar.

But assigning numbers to different foods based on their glycemic effect just happens to create a scaled list of foods that ends up being a very useful tool for people dealing with obesity and other health issues, as well. That’s because simply maintaining a low-glycemic index diet tends to guide people toward healthier eating and weight loss, even when that is not their specific goal.

Consider: Type II diabetes, as well as various cancers and cardiovascular disease, are all highly correlated with high index diets. There’s abundant research that shows that reducing the overall glycemic index also reduces the risks of those problems.

That’s because almost by default, a low-index diet will include more fresh fruits and vegetables, more fiber, more dairy, all foods that offer essential nutrients, that are more likely to be lower in calories and which tend to keep the body sated longer, holding off the next hunger spell. All that usually adds up to weight loss, no matter what the program.

Proponents of the index say it’s more helpful than counting calories or grams of fats or carbs, and actually offers a simplified approach to learning to eat better, but some experts caution that people shouldn’t get too wrapped up in worrying about the precise numbers. Instead, they urge that people pay attention to whether the foods they’re eating have a low, medium or high index.

That’s because, as with any rule, there are exceptions to the fairly consistent physiological rules that underlie the index. For instance, watermelon has a pretty high glycemic index, about 75, which is even higher than table sugar. Does that make it bad for you? No. Because in spite of its high index, watermelon actually has a pretty low glycemic load. That’s a measure based on the amount of food you’d actually consume, not just an arbitrary quantity used in testing, as with the index.

The glycemic load of a food can be determined using the glycemic index number for a food, divided by 100 and multiplied times the available carbohydrate you’d eat. With most foods, low index is consistent with low load, but there are the quirky exceptions. Of course, to find them, you’d be back to doing a bunch of math again, and that’s just not the way people normally eat.

That’s why doctors and nutritional experts encourage people who are trying to develop a healthy diet to avoid getting caught up in the numbers game and look more generally at the foods in the index, leaning toward those at the low end. Anything over 70 is considered high index, 55 through 69 is medium and below 55 are foods with a low glycemic index.

And look what’s in those groups: high index foods include most breakfast cereals, white breads and other processed baked goods, most potatoes, ice cream, candies and table sugar, your veritable Atkins nightmare.

Lower index foods include cherries, grapefruit, broccoli, legumes like lentils and beans, most whole grain baked goods and most dairy foods. So even without counting calories or keeping track of specific index numbers, you can see that steering your diet toward the low end of the index is bound to do you good.

We like to encourage patients to think of glycemic index and glycemic load as just two more tools that can be helpful in developing healthier thinking and planning about dietary habits.

A final thing to remember: there’s not one standardized

glycemic index list and most indexes include brand-name items that people buy on a typical shopping trip, as well as the more generic items like vegetables and fruits. This is one of the more helpful aspects of the lists, but only if you get one that relates to where you live.

If your average Southwest Florida resident looked at an index created in Australia, it wouldn’t be much help, because really, when’s the last time you had a couple Golden Pikelets with a nice glass of Milo?

THROUGH THICK & THIN

Fruits tend to have a high glycemic index, so I recommend that people take their fruits with a meal, or with some protein like cottage cheese or regular cheese. These protein sources help mitigate the fruits glycemic effect. Don’t let a high index number keep you away from your apple a day.

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Caroline J. Cederquist, M.D. is a board certified Family Physician and a board certified Bariatric Physicians (the medical specialty of weight management). Dr. Cederquist is the founder of Bistro MD formerly Diet To Your Door, a home diet delivery program that specializes in low calorie gourmet food that is delivered to your home or office. Bistro MD serves as culmination of Dr. Cederquist’s expertise and experience in the world of medical weight loss.

Whole life insurance has been around for over 150 years. Universal life was introduced in the early 1980’s. Universal Life offered the ability to increase or decrease the premium and death benefit and credited the cash values each year with a current interest rate. Variable life followed, which allowed policy owners to invest their cash values in equities. All three have their plusses and minuses.

Now there is a new kid on the block: Indexed Universal Life.

Here are the salient features:

1. Indexed Universal Life (IUL) is similar to Universal Life (UL); premiums and death benefits are flexible. You can increase or decrease premiums, or even stop them altogether. As your situation changes, you can decrease or increase (subject to insurability) the death benefit.

2. IUL is similar to Variable Life (VL) or Variable Universal Life (VUL) as the cash value is based on the increases of one or more stock indexes. The most common are the DJIA, NASDAQ 100 and the S & P 500.

Variable Life contracts allow direct investment in equities, much like a mutual fund. Indexed Universal Life policies do not invest directly in equities, so you do not have the same downside risk. The insurance company assumes all the risk.

If the index that you have chosen goes up over a given time frame (usually one year), your cash value goes up. However, if the index goes down, your cash value either stays the same or is credited with a minimum guaranteed interest rate, i.e. 2%.

3. How cool is that? If the market goes up, you get to participate in the growth. However, if the market goes down, your account doesn’t go down; it stays the same. It gets even better. Any gains are locked in. They can never be taken away due to future decreases in the market. It’s like walking up a flight of stairs. If the market goes up, you take a step up; if the market goes down, you stay where you are.

4. Indexed Universal Life has only been around for a few years. Only a few companies offer this contract. However, since 2000 the annual growth rate for this type of policy has been 24%.

When you speak with your life insurance agent about IUL, there are a few new terms you will need to understand:

1. Crediting Options

Crediting options are the math behind how the insurance company determines how much to credit your cash value at the end of each crediting period. The two most common are point to point and monthly average.

Point to point looks at the value of the stock index you chose at the beginning of each contract year and compares it to the value at the end of the point-to-point period. This is normally one year, but could be 2 or 5 years, depending on your contract choice.

Whatever happens in the interim doesn’t matter. You could have a very high growth rate if the market and the corresponding index have a growth spurt during the last few months of the term. On the other hand, you could end up with a healthy loss if the index takes a dive during the latter part of your term with what to a regular investor would be a gain for the year.

The monthly average method takes a reading of the index each month. Then at the end of the year, adds them up and divides by twelve. This approach tends to smooth out the fluctuations.

Which one is better? It depends on your tolerance for risk and how the market performs during your policy’s time frame. Since a life insurance policy is a long-term proposition, in the real world both should end up about the same over an extended period of time.

2. Participation Rate

Participation rate is the percentage of the increase in the index credited to your Indexed Universal Life policy each year. It could be, for example, 55%, 80%, 100% or 135%. Any given percentage rate is not necessarily better than another. It is simply the insurance company’s way of factoring in their downside risk and is a component that allows you to negate a cash value decrease if the market goes down.

3. Cap Rate

The cap rate is the maximum rate of return the insurance company will credit to your policy each year. For example, if the cap rate is 12% and the index you chose went up 10%, your policy is credited with a 10% gain. However, if the index increased 15%, your policy is credited with 12%, the cap. Not all Indexed Universal Life contracts have a cap. Participation rates and cap rates work in conjunction with each other.

Indexed Universal Life is an exciting new approach. If you are looking for a rate of return that is higher than traditional whole life or universal life, but don’t want the market risk of variable life, indexed universal life may be for you. The fact that the cash values are based on the performance of the equity market, coupled with the feature that prevents loses and locks in gains should be enough to warrant further exploration.

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