Infographic; trying to get the message over in a picture. feedback please

phoenix

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No 100g of bread has 46-50% carbohydrate, 100g of sugar has 100g of carbohydrate. Half of the sugar in sucrose is glucose and half fructose but that still doesn't add up to more glucose. In fact starches are also broken down into a number of different types of sugar. Here's a primer on sugars http://healthyeating.sfgate.com/types-carbohydrates-turn-sugar-3322.html
If you ate 50g of sugar (sucrose) and 100g of bread (both about 50g of carbs) then you would see a slightly greater amount of blood glucose with the bread over a period of 2 hours, though the initial spike could actually be more rapid with the sucrose.
The black squares are glucose, the back circles are white bread, the white triangles are sucrose and the black triangles are fructose
50g CHO.PNG

http://www.nature.com/ejcn/journal/v52/n12/pdf/1600666a.pdf?origin=publication_detail

The GI index site answers some questions about the GI in the FAQs http://www.glycemicindex.com/faqsList.php#1
 
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SunnyExpat

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OK a very simplified - and probably hypothetical - illustration to try and explain:

100g Sucrose = 100g carbohydrate (sucrose)
100g Bread = 46g carbohydrate (complex)

Hypothetical example by way of explanation

sucrose = 1 glucose chain + 1 fructose chain = 1 g carbohydrate. So 100g sucrose = 100 glucose chains

complex = 5 glucose chains + 1 fructose chain = 2 g carbohydrate. So 2.5 glucose chains in 1g carbohydrate - ergo 115 glucose chains in 46g carbohydrate.

So the amount of carbs are no indication at all to the amount of glucose, if bread has 5 glucose chains compared to 1 in sugar.
Is 5 a high or low number generally?

It's getting complicated with carbs now!
 

zand

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So the amount of carbs are no indication at all to the amount of glucose, if bread has 5 glucose chains compared to 1 in sugar.
Is 5 a high or low number generally?

It's getting complicated with carbs now!
Well I'm going to listen to what my meter says, that's easy enough for me. :);):)
 
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SunnyExpat

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Well I'm going to listen to what my meter says, that's easy enough for me. :);):)
That's the only way to do it, in my opinion, as we all handle carbohydrates individually!


That's the way I do it, which for me is a lot higher for sugar than it is for bread, so I've no idea if the infographic is right or not, I know it's wrong for me though!
 

phoenix

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Sorry, I don't agree with the premise that there is more glucose in 46g of starch than 100g of sucrose since the latter more or less 50% fructose 50% glucose. How much glucose there is in a gram of starch depends on it's structure, the molar mass varies.
BUT I don't think that anyone needs to go into the chemistry at that level
so I agree on the meter and that tells me when hypo, to eat 10g of glucose or if stuck without it 10 g of sugar, 10 grams of bread wouldn't be nearly as effective.
 
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Southbeds

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Liked the Info graphic very much, nice and simple,understood it straight away better that the suger cubes,who uses suger cubes?l will have to re think my slice of Bergen ,the rest of the forum left me bamboozled ,showing that a picture is worth a thousand words
 
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carol43

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I think the infrographic would be very useful for newly diagnosed patients. It would show them straightaway what happens to the food they are consuming, think perhaps that honey be included as diabetic friends think it's OK because it's natural.
 

SunnyExpat

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Liked the Info graphic very much, nice and simple,understood it straight away better that the suger cubes,who uses suger cubes?l will have to re think my slice of Bergen ,the rest of the forum left me bamboozled ,showing that a picture is worth a thousand words

Do you have a meter.
I wouldn't do it myself, but that graphic suggests the burgen is worse than a cup of tea with 13 sugars.
So I don't know if those thousand words are the right ones.
 
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AndBreathe

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@Southport GP - Can I ask how you intend this image to be used, and how do you expect or the reader to interpret the image they are looking at?

The foregoing are likely to influence my feedback, quite considerably.

(Sorry, I am the Queen of Questions, always.)
 

VinnyJames

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I like it a lot.

I would add some 'carrot pics' too such as bacon and sausage or chicken wings etc so people are aware that we can eat good food too!
 
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SunnyExpat

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I like it a lot.

I would add some 'carrot pics' too such as bacon and sausage or chicken wings etc so people are aware that we can eat good food too!

I would be interested to see processed meat on there.
Unprocessed is a maybe.
 

Southport GP

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@Southport GP - Can I ask how you intend this image to be used, and how do you expect or the reader to interpret the image they are looking at?

The foregoing are likely to influence my feedback, quite considerably.

(Sorry, I am the Queen of Questions, always.)
Its very much an early draft -but I was wondering about another way of showing the dramatic effect of say bread on blood glucose for folk just after diagnosis
I suspect the multiple eggs thing is a mistake and wonder about replacing the almonds with potato
Glyaemic index is a more complicated thing than glucose content, as its a measure of glucose absorption for any specific food RELATIVE to Glucose and im not sure if I have done that bit correctly
anyway thanks folks for the feedback will get my thinking cap on
 
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Southport GP

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I also agree 'except the eggs' confuses things.

I also think that the foods should be shown sequentially in terms of the amount of glucose, so high to low from left to right, as I personally feel the message is then better conveyed at a glance..
As you see in the new photo good point - action taken!
 

dawnmc

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Can I derail it slightly - to think as kids our occasional treat was sugar sandwiches.
Love the graphic idea though gets the point over very well.
 

phoenix

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A definition of GL from the Diogenes project website http://www.mrc-hnr.cam.ac.uk/research/research-sections/nutrition-health-interventions/gi-database/
'GL takes into account the amount of carbohydrate consumed and is a more accurate measure of the impact of a food on blood sugars.'
There is a link to an excel list of the GIs for UK foods. The GL is worked out for 100g portions of each food which is what you are using.The highest GL other than glucose on the list is actually cornflakes at 83 (you get a lot of cornflakes in 100g so you would need a very big bowl ,banana is still only 12.Scrambled eggs come in at 1. ( of course the GI only measures carb containing foods not proteins and we have had many debates on here as to the extent that they raise glucose [cf insulin index])
 

AndBreathe

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@Southport GP - Thanks for responding. Having given the original image a quick look, and asked my questions, I then tried to express my feedback from a couple of standpoints. Firstly, how I felt when first diagnosed, and what information I needed and wanted at that time, then secondly overlaying that having considered the sorts of questions we've seen from newly diagnosed/new members we have see come through the virtual doors to the forum.

My first comment would be that the new image is better, in that most people would contentedly eat most of the items in the graphic. On the earlier one, I think almonds might not be a big day-to-day feature for your newly diagnosed individual. When you have your composition finished, I’d consider your staging background, as I don’t think the brown background with beige carpet presents the images in their best light. It’s all a bit brown, and maybe says 70’s, rather than 2015 to me. Finally, on the image itself, I would recommend you have your source of data in the footer, so that it’s easy for anyone with an enquiring mind to validate and/or explore for themselves.

Moving forward. As a newly diagnosed patient, whilst I was in shock/angry/frustrated, I was also a sponge for information. I wanted to know everything, in simple messages, so that I could apply it quickly, and develop my battle plans. For me, I’m certain the glycaemic index wouldn’t have hit me between the eyes. I’d have written down those numbers, or photographed your image on my phone, then gone to check it out. When I tried to do that last night (without using any of my existing bookmarks or knowledge), it took me a while to pin down information that matched your graphic. When I Googled, “how much sugar is in brown bread”, Dr Google told me, link, on link, on link, 4.1gr (per 100gr). OK, that isn’t the whole picture either, but maybe you see where I’m coming from? In my time of frustration, my confidence would have been dented, there and then. My thoughts would have been along the lines of “How hard should this be?”

Newly diagnosed, I wanted to know what to eat, and how to choose, fairly promptly, when shopping. And, I had to translate whatever I was learning about diet, to my partner, who is chief cook on Planet Breathe. I’m sure that’s a common occurrence, one way or another. For me, the answer has always been to read the labels, and most packaged foods these days have nutritional information on them. Looking at the nutritional information label for brown bread, on any of the big supermarket websites, I don’t ever see any reference matching the numbers you had posted on the original image. That would have confused me more, and I would have felt it to be an unhelpful image.

From the second standpoint, of new member queries: Quite a few arriving (or maybe it’s by the time they register to ask a question), they’ve read that they need to trim carbs. The two most common quantitative questions we see are, I feel, Is it total carbs or surely it’s sugars we’re counting?”, or “How many carbs do I start at?” We rarely have anyone asking about glycaemic index. We do in a roundabout way where individuals have converted from white to wholemeal pasta (and the like), but aren’t seeing the results they expected.

I’m sure your images are being created to inspire or reinforce an action. If you want individuals to take an action they can carry out easily in their day-to-day lives, then I’m not sure your image gives them a fast track. In order to do that, they need a handle on the GI, and probably a resource – either by an app or a hard copy book, and surely shopping becomes even more of a nightmare, going around the supermarket, looking up items in their book or app, when there is great information on the packaging of almost every item.

Whilst using the product labelling doesn’t give an indication of absorption rates, it’s a quick start way of getting the drift. For me, GI is almost finessing, and something to tackle, once someone has the hang of the big baddies.

Obviously, I’m swimming against the tide of the other feedback, but if I’m to respond, I have to respond honestly. If GI is how your studies have worked with patients, then I am even more impressed by the results you have achieved. It feels to me to be the harder route.

Please challenge, rubbish or whatever. My shoulders are broad, and my chin has taken the odd blow, over the years.
 
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I was once told that a camel is a horse designed by a committee.

I think you may all know where I am going with that thought.
 
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Brunneria

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Like @VinnyJames i am more of a carrot than a stick person.

I can imagine that a lot of people seeing that 2nd pic will go 'oh no! What CAN i eat?'
We get a lot of people turning up here going 'I am scared to eat ANYTHING. Help!'

So while i think that pic gets a useful, helpful message across in a clear and accessible way, you need another pic too - to get another clear message across - showing great foods that don't dump sugar in us.

Meat, cheese, salad, veggies. Good, plain foods that anyone can see are 'healthy'.

I totally agree that keeping it simple is essential, and GI/GL is instant complication for many. Especially since every time we have a GI thread on here, significant numbers of people pipe up with 'didn't work for me. Had to go LC to see the benefits'.
 
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Celeriac

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I would choose actual products and then a pile of sugar cubes next to them, indicating the amount of carbs ( including sugar) in that item. I think visually a tube or heap of sugar doesn't give an indication other than more, even more and the most.

Telling people what they shouldn't eat, should be balanced with items that people can eat in another infographic. The photo of real food used by Dr Andreas Eenfeldt MD on dietdoctor.com looks really inviting to me.

But to someone who has T2DM after a lifetime of ready meals and junk food, the sight of a raw fish for example, may be offputting.

So maybe a second infographic on things that can be eaten, could include something like frozen bagged salmon fillets, a popular brand of cheese, tinned or frozen vegetables and information about how to read nutrition labels ?
 
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SunnyExpat

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I'm with others on the accuracy of the information still.
I still don't understand the information.

I think the bottom line, after being given this handout from Southport GP after being diagnosed type 2, and going to the local diabetic clinic, if you ask a nurse, or a type 1 there, is it true I need more insulin for 100g of brown bread, and even more for 100g of potato, then 100g of white sugar, would the answer be yes?

I don't know the answer, hopefully the type 1's on here can answer it.

If it's yes, I'd be following anything he said, and thankful he told me.
If it's no, I'd bin it.
 
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