So it's worthwhile talking
about the glycemic index
and how that impacts on our advice 
within the low-carb diet.
So the glycemic index 
is looking at carbohydrates
and it predicts for us
how much glucose you're going
to absorb into your bloodstream
in the two hours 
following a starchy meal.
And it's an index so it's against a meal
of pure glucose which would be 100.
So everything is relative 
in terms of glucose absorption
to pure glucose itself.
So looking at the glycemic index,
pure glucose as I've said is 100,
brown bread I think comes in 
at something like 67,
cornflakes are in the 80s
and interestingly table sugar itself has
a lower glycemic index than brown bread.
So I think table sugar is in 63, 
something like that.
So you see the glycemic index
in its ability to predict 
the effect of foods on blood sugar
is actually quite useful.
Various things affect its accuracy,
so the glycemic index 
is only a broad indicator,
because it actually can make a difference
of the things you eat at the time.
Also if you look 
at the glycemic index of a banana,
it depends on how ripe 
that banana is,
but it's still a really useful system.
When it came to communicating
with patients about the glycemic index,
we made a significant improvement
or I hope it's an improvement
at the Norwood practice,
because the partners here 
were annoyed with the glycemic index,
because they've really struggled
to explain the glycemic index to patients.
So the challenge was...
it was thrown down this challenge
by one of the partners here
and she said, "What don't you go away
and sort out the glycemic index?
Why can't you give it to us in terms
that patients can really understand?"
And that's how we came up 
with the teaspoon of sugar equivalent system,
where we've reinterpreted
the glycemic index
in terms of four gram teaspoons of sugar.
We did this because I discovered
that really most patients
have no idea 
what 20 g of glucose looks like or 40 g.
In fact they have no idea 
what glucose looks like at all.
But all of us are familiar 
with the four gram teaspoon of sugar
and so actually the calculations
are not too difficult
to reinterpret the glycemic index
in terms of teaspoons of sugar.
And this gives you a really easy way 
to talk to patients
about the consequences 
of the dietary choices that they make
so that they're in a better position 
to make changes.
And this is how I can tell you
that a slice of brown bread
is equivalent in glycemic terms
to about three teaspoons of sugar.
Or a baked potato, a small baked potato 
is equivalent to 6 to 8 teaspoons of sugar.
Or the thing that really surprised me 
is 150 g of boiled rice
is exactly the same in terms of your
blood sugar as 10 teaspoons of sugar.
Now these teaspoons of sugar equivalents
a really great fast way for patients
to grasp the choices
that lie before them.
And that you're putting them 
in a much better position
to make a positive choice
to perhaps have, I don't know,
full fat yogurt and blueberries
rather than a bowl of cornflakes,
because they can see 
it's going to make a difference.
For the patients 
with a blood sugar meter, of course,
that's great because they can check up.
I really encourage them
to experiment, try.
But be honest, when you're using 
a blood sugar meter
use it, say, an hour, 
an hour and a half after your meal
and not in the fasting state,
which is what so many of them do.
So really that was a quick explanation 
of how it is that the...
first of all the glycemic index
and secondly this teaspoon
of sugar equivalent system
can be very useful 
to communicate with you patients,
giving them information that they can use
when making dietary choices.
And again we'll put with this video 
a link to the publication,
because this was published last year.
Thank you.