Nutrition · Blood sugar

High Glycemic Foods: List, GI Chart and How to Blunt the Spike

Which foods score 70 or more on the glycemic index, a chart of GI values for common foods, how glycemic load changes the picture, and how to eat these carbs so your blood sugar stays steady.

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Evidence-based41 sources citedUpdated November 7, 2026
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White bread, a croissant, pasta, noodles, potatoes, squash, watermelon, cornflakes, white rice, tortilla chips and brown sugar on a white table
Breads, pasta, noodles, potatoes, squash, watermelon, cereal, rice and sugar: carbohydrate foods whose glycemic index runs from low to high.
High glycemic foods at a glance

High glycemic foods are carbohydrate foods that score 70 or more on the glycemic index, such as white bread, white rice, potatoes, rice crackers, cornflakes and instant oatmeal, and they raise your blood sugar faster than foods that score 55 or less.12

  • What they do: they digest quickly, so blood sugar and insulin climb fast, and a few hours later blood sugar can dip lower than it would after a slower meal, which brings hunger back early.34
  • How much matters: glycemic load counts the carbohydrate in a real serving, so a cup of watermelon carries about a quarter of the load of a cup of white rice.567
  • How to eat them: protein and vegetables first and carbs last, starches cooked and cooled, and a 10-minute walk after meals.8910
  • What to cut: refined flour, sugary cereal, sweet drinks and juice, whatever their number, because the processing is what makes them a problem.811

High glycemic foods are carbohydrate foods that score 70 or more on the glycemic index, which means they raise your blood sugar quickly, and the common ones are white bread, white rice, boiled and instant mashed potatoes, rice crackers, cornflakes, instant oatmeal and watermelon.12 In my view, the number matters less than the form a carb comes in: refined, fiber-stripped carbs eaten on their own are what spike and then crash your blood sugar, while whole foods like potatoes, watermelon and bananas, eaten with protein, were never the problem people made them out to be.12131415

That midmorning slump after a bowl of cereal, the cravings that follow it and the blood sugar that creeps up year after year share the same root cause: carbohydrate that reaches you stripped of its fiber, cooked soft and eaten on its own. In my type 2 diabetes protocol, refined-carb and sugar overload is the number one driver, because it forces constant insulin surges until your cells turn down their insulin receptors.11 Your body was designed to handle carbohydrate that comes in whole-food form, and this guide shows you which foods score high, why the number tells only part of the story, and how to eat these carbs so they work with your blood sugar instead of against it.

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This happens so much today in medicine and in wellness: we tend to highlight one type of food or one type of nutrient for years, and then we change our mind. When I think about the late '90s and early 2000s, there was such an emphasis put on glycemic index and glycemic load. People looked so closely at that, and I remember there were people out there saying, don't eat beets, don't eat carrots, don't eat potatoes, don't eat watermelon, don't eat bananas.Dr. Josh Axe, DC, DNM, CNSFrom Why Restrictive Diets Do More Harm Than Good | Dr. Sarah Ballantyne, The Dr. Josh Axe Show (2024), at 26:44
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What are high glycemic foods?

Quick answer

High glycemic foods are carbohydrate foods with a glycemic index of 70 or more, which means your body digests them quickly and your blood sugar rises and falls faster and further after you eat them.15 Medium-GI foods score 56 to 69, and low-GI foods score 55 or less.5

The glycemic index, or GI, ranks carbohydrate foods by how much they raise your blood sugar in the two hours after you eat them. To test a food, researchers give 10 or more healthy people a portion that holds 50 grams of digestible carbohydrate, track their blood sugar for two hours, and compare that rise with the rise from the same amount of pure glucose, which sets the yardstick at 100.1 A food that scores 70 raised blood sugar about 70% as much as glucose did.

Because the GI measures carbohydrate, only foods that carry carbohydrate have one. Beef, chicken, fish, eggs, nuts, seeds and avocados contain so little that their GI can't be tested, and eaten alone they have little effect on your blood sugar.5 So when you see "high glycemic carbs" or "high GI carbs," they mean the same list as high glycemic foods: starches, grains, sugars and some fruits.

What pushes a food's number up is how easily your digestive enzymes can reach its starch. Finely milled flour, most ready-to-eat breakfast cereals and starch cooked until it's soft all digest fast, which is why many breakfast cereals score high even when they're full of fiber, and why overcooked pasta scores higher than pasta cooked firm to the bite.5 Soluble fiber, the gel-forming kind in beans, lentils, oats, barley and fruit, works the other way, because it thickens the food in your gut and slows those enzymes down, so foods rich in it tend to score low.5

The University of Sydney researchers who keep the international GI database compare it to rain. A gentle rain soaks into a garden, while a sudden downpour floods it, and a fast carb floods your bloodstream with glucose faster than your body can clear it, so your blood sugar climbs higher than it would if the same carbohydrate arrived slowly.5

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Glycemic index chart: high glycemic foods and their GI values

Quick answer

Apart from pure glucose itself, the highest glycemic foods among the 62 common foods averaged in the international GI tables are rice crackers and instant mashed potatoes, both at 87, followed by rice milk at 86, cornflakes at 81, instant oatmeal at 79, boiled potatoes at 78, watermelon at 76, white bread at 75 and white rice at 73.2 Pure glucose is the yardstick, set at 100.1

The chart and tables below give you the numbers to shop by, each one an average from the University of Sydney group's international GI tables, which pooled results from many labs for each common food.2 The same kind of food can vary by brand, recipe and country, especially breads and breakfast cereals, so read each value as typical rather than exact.16

High glycemic foods: 10 common foods scoring 73 to 87

High glycemic foods: 10 common foods scoring 73 to 87Average glycemic index from many labs · glucose = 100 · 70 or more is high. Rice crackers and crisps: 87 glycemic index; Instant mashed potatoes: 87 glycemic index; Rice milk: 86 glycemic index; Cornflakes: 81 glycemic index; Instant oatmeal: 79 glycemic index; Boiled potatoes: 78 glycemic index; Watermelon: 76 glycemic index; White bread: 75 glycemic index; Whole wheat bread: 74 glycemic index; White rice, boiled: 73 glycemic indexAverage glycemic index from many labs · glucose = 100 · 70or more is highRice crackersand crisps87 glycemic indexInstant mashedpotatoes87 glycemic indexRice milk86 glycemic indexCornflakes81 glycemic indexInstant oatmeal79 glycemic indexBoiled potatoes78 glycemic indexWatermelon76 glycemic indexWhite bread75 glycemic indexWhole wheatbread74 glycemic indexWhite rice,boiled73 glycemic index
Source: Atkinson, Foster-Powell and Brand-Miller · Diabetes Care, 2008 [2]Watermelon scores high, but a cup carries little carbohydrate, so its glycemic load stays low.

High glycemic foods list (GI 70 or more)

FoodGlycemic index
Rice crackers and crisps87
Instant mashed potatoes87
Rice milk86
Cornflakes81
Instant oatmeal79
Boiled potatoes78
Rice porridge (congee)78
Watermelon76
White bread75
Whole wheat bread74
White rice, boiled73
Unleavened wheat bread70

Bagels, pretzels, refined-flour crackers, pastries and doughnuts don't have a single average in the tables, but they're built on the same refined white flour as white bread, and white flour, white bread, pastries, dried cereal and instant oatmeal are all on the list of foods I recommend avoiding.17

Medium-GI foods (56 to 69)

FoodGlycemic index

Brown rice, boiled

68

Millet porridge

67

Couscous

65

Popcorn

65

Table sugar (sucrose)

65

Pumpkin, boiled

64

French fries

63

Sweet potato, boiled

63

Wheat roti

62

Honey

61

Pineapple

59

Soft drinks (soda)

59

Muesli

57

Potato chips

56

Medium or low GI, and still worth cutting

Some of the foods most worth cutting post modest numbers: soda averages 59, french fries 63, potato chips 56, ice cream 51, chocolate 40, orange juice 50 and apple juice 41, so none of them counts as a high glycemic food.2 Fructose, one of the main sugars in fruit and half of table sugar, scores just 15, and adding protein to a fast carb brings a meal's overall GI down, so a sweet, rich or mixed food can post a lower number than plain white rice.25 The researchers who built the tables put it plainly: the GI shouldn't be used in isolation.2

These foods stay on my cut list for other reasons. Sweet drinks and fruit juice deliver sugar without the fiber, and soda, juice and sweet coffee drinks top the list of foods I recommend cutting for the first 30 days, along with white bread, pastries and sugary cereal, candy and desserts, alcohol, "low-fat" packaged foods, late-night snacking and carbs eaten on their own, because they keep insulin high.8 Fries and chips pair fast starch with fat, and as I've said on my show, high carb typically isn't a good idea at any meal, but high carb and high fat together will cause you to gain the most weight.18 Most of these are ultra-processed foods, which is the bigger reason to leave them behind. Dark chocolate is the exception I make: 1 to 2 squares a day of 85% cacao or higher, for the cocoa flavanols that support blood flow and your mitochondria.19

Honey averages 61 and table sugar 65, so both are medium-GI sweeteners.2 Raw honey is the far better choice of the two, and my everyday amount is 1 teaspoon to 1 tablespoon of raw local honey in place of other sweeteners,20 the kind of measure Scripture describes: "Hast thou found honey? eat so much as is sufficient for thee, lest thou be filled therewith, and vomit it" (Proverbs 25:16).21

Glycemic index vs. glycemic load: why the number isn't the whole story

Quick answer

The glycemic index tells you how strongly a food's carbohydrate raises your blood sugar, gram for gram, and glycemic load tells you how much a real serving will raise it, because it multiplies the GI by the grams of carbohydrate in that serving and divides by 100.522 A food can score high on the index and still carry a modest load.5

That 50-gram test portion is often far more carbohydrate than a normal serving of the food holds, so glycemic load scales the number to the serving on your plate instead, and watermelon shows why that matters. It scores 76 in the 2008 tables, but a cup of diced watermelon, 152 grams, carries only about 11 grams of digestible carbohydrate, so its glycemic load comes to about 8,26 and four varieties tested in Malaysia for the 2021 tables averaged a GI of just 50.16 A cup of cooked white rice, 158 grams, scores 73 and carries about 44 grams, for a load of about 32, roughly four times the watermelon's.27 Doubling a serving doesn't change a food's GI, but it does raise your blood sugar response, which is why the portion matters as much as the number.5

For years, numbers like watermelon's 76 led people to give up some of the most nourishing foods there are, even carrots, which average just 39 when boiled,2 and the research since then shows why whole fruit never deserved that reputation. In three long-term Harvard studies of 187,382 U.S. health professionals, a fruit's glycemic index or load didn't decide its link with type 2 diabetes. The whole fruits with the highest glycemic load, including bananas, grapes, raisins, apples, pears and prunes, were linked to a lower risk as people ate more of them, every 3 servings a week of blueberries went with a 26% lower risk, and fruit juice went with a 7% higher risk.23

Fruit contains sugars, but it also contains fiber, vitamins, minerals and water, which contribute to better health compared to refined sugar.Dr. Josh Axe, DC, DNM, CNSFrom 11 Foods with SHOCKINGLY High Amounts of Sugar (Best Sugar Substitutes), The Dr. Josh Axe Show (2024), at 22:05

A 2019 series of reviews on carbohydrate quality in The Lancet points the same way. Across 185 long-term studies and 58 clinical trials, people who ate the most fiber had 15% to 30% lower rates of early death, heart disease, stroke, type 2 diabetes and colorectal cancer than people who ate the least. Choosing foods by a low glycemic index or load brought smaller benefits or none, and the reviewers rated that evidence low to very low in certainty.24 The GI works best as a speed rating, and what decides how a carb lands in your body is the whole package: its fiber, how it was processed and cooked, how much of it you eat and what you eat it with.

How processing and cooking change the number

Oats show how much processing matters: rolled-oat porridge averages 55, right at the top of the low range, while instant oatmeal averages 79.2 Bread tells the same story: whole wheat bread averages 74, almost level with white bread at 75, because finely milled flour digests fast whether or not the bran is in it, while specialty grain breads average 53.25 Fermentation helps too, because the slow fermentation of traditional sourdough bread produces organic acids that slow how fast your stomach empties.5 Whole-grain sourdough has a lower glycemic index than highly processed white-flour bread, which is one reason it's the bread I rank first.17

Cooking time matters as well: pasta cooked firm to the bite keeps its low GI, and overcooking raises it.5 Cooling, on the other hand, works in your favor: when cooked rice or potatoes chill, part of their starch turns into resistant starch, which your small intestine can't break down, and the how-to section below shows how much that lowers the rise.9

How high glycemic foods work in your body

Quick answer

A high-GI food eaten on its own sends glucose into your blood quickly, your pancreas answers with a surge of insulin, and a few hours later your blood sugar can dip lower than it would after a slower meal, which brings on hunger and cravings.34 Repeated day after day, those insulin surges are what wear down your cells' response to insulin.11

When you eat a slice of white bread on its own, your body breaks its starch down to glucose quickly, and the glucose pours into your blood faster than your muscles and liver can take it in.5 Your pancreas answers with a surge of insulin to clear it, and a few hours later your blood sugar can fall lower than it would after a slower meal, which you feel as hunger, fatigue and a pull toward something sweet.4 On my show I've described it this way: a sugary or refined-carb meal spikes your glucose, then it crashes, and that crash feels exactly like exhaustion.12

I teach this as a cycle, because each step feeds the next. Refined carbs and sugar bring fast glucose and fast insulin, the pancreas works overtime, fat moves into the liver and belly, cells stop listening to insulin, and cravings and crashes leave you hungry again in two hours, while sitting and poor sleep make every step worse.8 Most of these steps show up in studies of people:

1Fast carbs, fast rise

When 11 adults with type 2 diabetes ate bread and orange juice before their chicken and vegetables, their blood sugar reached 199.4 mg/dL an hour later, against 125.6 mg/dL when they ate the same meal with the carbs last.3

2Insulin rises to match

Over the next two hours, eating the carbs first called up nearly twice as much insulin as eating the same meal carbs last.3

3The dip that brings hunger

Four hours after a high-GI meal, 12 men who were overweight or obese had lower blood sugar than after a low-GI meal with the same calories (4.7 against 5.3 mmol/L, about 85 against 95 mg/dL), felt hungrier, and showed more activity in the brain's reward and craving center.4

4More eating at the next meal

When 12 teenage boys with obesity each ate high-, medium- and low-GI meals with the same calories, they ate 53% more over the next five hours after the high-GI meal than after the medium-GI one, and 81% more than after the low-GI one.25

5Cells stop listening

Day after day, constant insulin surges lead cells to turn down their insulin receptors, and insulin resistance in muscle, the body's main glucose sink, is the earliest measurable defect.11

6Order, cooling and a walk soften it

Eating the carbs last, cooling and reheating rice, and a 10-minute walk after meals each lowered the rise in studies of people.3910

The hunger study used a milkshake for each meal, matched for calories, protein, fat and taste, and each man drank both on separate occasions without knowing which shake was which, so the difference came from how fast the carbohydrate digested.4 The boys' study measured one day per meal, which shows the short-term pull of a fast carb rather than long-term weight change.25 Those hours repeat every time you eat a fast carb on its own, which is how a short-term spike turns into the long-term pattern at the end of the cascade.

Fast starches affect your teeth too. In a series of studies in healthy adults, white bread dropped the pH of dental plaque by 1.5 units, against 0.7 for canned chickpeas carrying the same carbohydrate, and a starchy food's GI explained 60% to 64% of how acidic the plaque became, which the researchers said may raise the risk of cavities.26 Choosing slower starches helps your teeth as well as your blood sugar.

How to eat high glycemic foods without the spike

Quick answer

Eat your protein and vegetables first and your carbs last, never eat carbs on their own, cook and cool your starches, add fiber or vinegar to the meal, and take a 10-minute walk afterward.82792810 In a study of 14 healthy adults who each ate both, white rice that was cooked, chilled for 24 hours and reheated raised blood sugar about 18% less than freshly cooked rice.9

You don't have to give up rice, potatoes or bread to keep your blood sugar steady, because a few habits change what the same meal does to your blood sugar. The things that spike blood sugar are everyday ones, such as sweet drinks and juice, bread and cereal eaten alone, late-night snacking, sitting after meals and short sleep, and the things that steady it are just as ordinary: protein first, fiber with meals, a walk after eating and vinegar before meals.8

Eating vegetables and protein first and carbohydrates last leads to a smaller blood-sugar rise than the same meal in reverse. Add a short walk afterward, and you've lowered the spike without changing what's on the plate.Dr. Josh Axe, DC, DNM, CNSWritten in Insulin Resistance & Prediabetes: The 90-Day Healing Protocol (2026), p. 12

1. Eat your vegetables and protein first, and your carbs last

This is meal sequencing, and it's the simplest change on this list. In the study that tested it, 11 adults with type 2 diabetes ate the same 628-calorie meal of grilled chicken, salad, broccoli, ciabatta bread and orange juice on two days a week apart, with the bread and juice first on the first visit and 15 minutes after the chicken and vegetables on the second. With the carbs last, their blood sugar was 28.6% lower at 30 minutes, 37.0% lower at an hour and 16.8% lower at two hours, and the total rise over two hours was 73.5% smaller.3

2. Never eat carbs on their own

The rule I give is to never eat carbs naked: always pair them with protein or fat.27 Eggs, chicken, wild-caught salmon, beans and lentils all work, and so do plain goat's or sheep's milk yogurt and kefir, or unsweetened coconut yogurt if you avoid dairy, with a handful of nuts or a spoonful of nut butter for fat.

My own glucose monitor taught me the same lesson. When I wore a continuous glucose monitor a couple of years ago, I was shocked by what did and didn't impact my blood sugar. What impacted it the most was eating fruit by itself: I could eat a piece, but if I had more than that, all of a sudden it was through the roof. The potatoes, mostly sweet potatoes, which I usually ate with a chicken breast or another protein, hardly moved it.14 Enjoy your fruit a piece at a time, ideally alongside a little protein or fat.

3. Add fiber to the meal

As I've explained on my show, the fiber in fruit slows down the absorption of sugar, preventing spikes in blood glucose levels.13 The same goes for the fiber in vegetables, beans, lentils and seeds, so add a side salad, a scoop of beans or a spoonful of chia or flax to any meal built around a high-GI starch, and choose whole fruit over juice. Our list of high-fiber foods gives you plenty to choose from, and if you want a fiber supplement, 5 grams of psyllium before meals is the one I recommend for blood sugar.8

4. Cook your starches ahead and cool them

Cooling changes the starch itself. When cooked rice or potatoes chill, part of their starch rearranges into resistant starch, which behaves like fiber and passes through your small intestine undigested.9 In a study in which healthy adults each ate both kinds of rice in random order, without being told which was which, white rice that was cooked, chilled for 24 hours at 4°C (39°F) and then reheated carried 1.65 grams of resistant starch per 100 grams, against 0.64 grams in freshly cooked rice. Across the 14 people with usable blood sugar results, it raised blood sugar about 18% less, 125 against 152 on the researchers' measure of the total rise.9

Cooled, reheated rice raised blood sugar about 18% less

Cooled, reheated rice raised blood sugar about 18% less14 healthy adults with usable results · each ate both · white rice fresh vs. chilled 24 hours at 4°C, then reheated. Freshly cooked white rice: 152 mmol·min/L; Cooled 24 hours, then reheated: 125 mmol·min/L14 healthy adults with usable results · each ate both ·white rice fresh vs. chilled 24 hours at 4°C, then reheated
152 mmol·min/L
FRESHLY COOKED WHITE RICE
125 mmol·min/L
COOLED 24 HOURS, THEN REHEATED
Source: Sonia, Witjaksono and Ridwan · Asia Pacific Journal of Clinical Nutrition, 2015 [9]Cooling raised the rice's resistant starch from 0.64 to 1.65 grams per 100 grams.

Potatoes respond the same way. The Sydney researchers note that potato salad made the day before, tossed with a vinaigrette and kept in the fridge, has a much lower GI than potatoes served hot from the pot, because cold storage raises the resistant starch by more than a third and the acid in the dressing slows how fast your stomach empties.5 Make extra rice or potatoes, refrigerate them soon after cooking, and enjoy them cold in a salad or reheated the next day.

5. Take a 10-minute walk after you eat

Muscle is your body's biggest glucose sink, and when you walk after eating, your muscles pull sugar out of your blood.8 In a study of 41 adults with type 2 diabetes who each tried both plans for two weeks, a 10-minute walk after each main meal shrank the rise in blood sugar over the three hours after eating by 12% compared with a single 30-minute walk each day, and by 22% after the evening meal, when people ate the most carbohydrate.10 A short loop around the block after each main meal, and especially after dinner, is the habit that study tested.

6. Try vinegar before the meal

A little vinegar with a starchy meal slows how fast your blood sugar climbs. In a study of 12 healthy adults who ate white bread with three different amounts of vinegar or with none, in random order, more vinegar meant lower blood sugar and insulin 30 minutes after eating. The largest amount kept blood sugar lower at 30 and 45 minutes and left people feeling fuller for two hours, while the total rise measured over the full two hours came out about the same.28 I recommend 1 to 2 teaspoons, or up to a tablespoon, of apple cider vinegar stirred into water before meals.811

7. Save your bigger carbs for earlier in the day

Timing matters too, and what I recommend for my patients is high protein and moderate carbohydrate in the morning; high protein and high fiber at lunch, with either carbs or fat; and high protein, high fat and very low carbs at dinner.18 Breakfast is the place to start: about 30 grams of protein, from eggs, goat's milk kefir or a protein shake, is the first step I give for steadier blood sugar.8 If you train hard, put your higher-GI carbs after your workout, when your muscles are ready to refill their stores, as the next section explains.

8. Watch the portion

Portion is where glycemic load comes in. My type 2 diabetes protocol builds the plate this way: half non-starchy, colorful vegetables, a quarter protein and a quarter smart carbs, with the carbs eaten last and never on their own, and a 10- to 15-minute walk to finish.11 You don't have to swap every carb, either, since the Sydney researchers note that only about half the carbohydrate in a diet needs to move from high to low GI to bring health benefits.5

Learn your own response

Everyone's blood sugar answers a little differently, so for numbers that won't move, a continuous glucose monitor is one of the tools I reach for, because 14 days of wearing a sensor shows exactly which meals, sleep and stress spike your blood sugar, and most people find two or three surprises.8 In a study that tracked 800 people with continuous glucose monitors for a week, their responses to identical meals varied widely, and a computer model built on their blood tests, diet, activity and gut bacteria predicted each person's response; when the researchers built diets on those predictions, blood sugar after meals came down.29 When I wore one, even driving pushed my blood sugar up, a reminder that stress hormones move it as well as food does.14 Our guide to normal blood sugar shows the numbers to look for before you start.

A steadier Thanksgiving plate

Thanksgiving dinner is one of the highest-GI meals of the year, with mashed potatoes, rolls, stuffing and pie on one table, and you can keep every tradition and still keep your blood sugar steady. Fill your plate first with turkey and vegetables, keep the roasted sweet potatoes and squash, make your potato salad or roasted potatoes the day before and reheat them, and take a family walk after the meal.3510 For recipes, browse our Thanksgiving side dishes, which keep the holiday flavors and lean on whole foods.

When high glycemic foods help

Quick answer

High glycemic foods are the right choice in two situations: refueling your muscles after long, hard exercise, and raising low blood sugar quickly.3031 In a study of 5 trained cyclists who each tried both diets a week apart, a day of high-GI foods after a draining ride restored about 48% more muscle glycogen than a day of low-GI foods with the same amount of carbohydrate.30

After long, hard training

When you train long and hard, your muscles burn through glycogen, the stored form of glucose they run on, and fast carbs refill it fastest. In that cyclists' study, the riders spent two hours on the bike followed by sprints, then ate 10 grams of carbohydrate per kilogram of body weight over the next 24 hours, and their muscles restocked about 48% more glycogen on the high-GI foods, 106 against 71.5 mmol/kg.30 How much carbohydrate you eat, what kind and when you eat it all shape how quickly glycogen comes back.32 After a hard workout, sweet potato, oats or rice are the carbs I recommend, the whole-food version of the same idea.8

When blood sugar runs low

When your blood sugar runs low, a fast carb is exactly what you need. If you have diabetes and your blood sugar falls below 70 mg/dL or below your target, take 15 to 20 grams of fast carbohydrate right away, such as 1 tablespoon of honey or sugar, half a cup of juice or 4 glucose tablets, then check again in 15 minutes and repeat until you're back in your range.31 If your next meal is more than an hour away, follow with a snack such as crackers or a piece of fruit.31

Whole foods that happen to score high

Whole foods that score high still belong on your plate: watermelon is mostly water and carries little carbohydrate per cup, as the glycemic load section showed, and potatoes and white rice change character when you cook and cool them.69 On my show I've put fruit plainly: berries are the best, because they have more fiber, they're lower glycemic and they have less sugar, but other fruits like grapes, apples and watermelon are fantastic choices too.13

Who needs to care most: insulin resistance, prediabetes and diabetes

Quick answer

People with insulin resistance, prediabetes, type 2 diabetes or gestational diabetes gain the most from cutting back on high glycemic foods.1833 In a 2021 BMJ analysis of randomized trials in people with diabetes, diets built on low-GI or low-glycemic-load foods lowered HbA1c by 0.31 percentage points more than higher-GI diets across 22 trial comparisons with 1,502 people.33

Of the thousands of patients I've treated over the years, many were surprised to learn their blood sugar was a problem. Their fasting glucose was "normal" or "a little high," and nobody had mentioned it as urgent, yet their HbA1c was creeping up year after year.8 HbA1c is your average blood sugar over about three months, and fasting insulin shows how hard your pancreas is working to hold that average where it is. The optimal range for HbA1c is 4.8% to 5.3%, and the optimal range for fasting insulin is 2 to 8 µIU/mL.

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The trials in people with diabetes show what changing the carbs on your plate can do. That BMJ analysis pooled 29 trial comparisons lasting 3 weeks or longer in people with type 1 or type 2 diabetes. Besides the lower HbA1c, the low-GI diets lowered fasting blood sugar, LDL and non-HDL cholesterol, ApoB (a marker of cholesterol-carrying particles), triglycerides, body weight, BMI and C-reactive protein, a marker of inflammation, and the lower a diet's GI went, the more systolic blood pressure came down, while blood insulin, HDL cholesterol, waist size and diastolic blood pressure didn't differ.33

Low-GI diets lowered HbA1c by 0.31 points in people with diabetes

Low-GI diets lowered HbA1c by 0.31 points in people with diabetes22 randomized trial comparisons · 1,502 people with type 1 or type 2 diabetes · 3 weeks or longer. HbA1c 0.31 percentage points lower on low-GI or low-glycemic-load diets than on higher-GI diets22 randomized trial comparisons · 1,502 people with type 1or type 2 diabetes · 3 weeks or longerHbA1c 0.31 percentage pointslower on low-GI orlow-glycemic-load diets thanon higher-GI diets
Source: Chiavaroli et al. · BMJ, 2021 [33]The researchers rated their certainty in the HbA1c result as high.

Over years, those daily spikes add up, because each insulin surge pushes your cells to turn the signal down a little further,11 and the long-term studies show where that leads: in a 2019 analysis of long-term studies in adults who started out healthy, every 10 points of dietary glycemic index went with a 27% higher risk of type 2 diabetes.34 In the PURE study, which followed 137,851 adults aged 35 to 70 on five continents for a median of 9.5 years, people whose diets had the highest glycemic index had a 51% higher risk of a major cardiovascular event or death if they already had heart disease, and a 21% higher risk if they didn't, compared with people whose diets had the lowest.35 In 338,325 Europeans followed for nearly 13 years, a high glycemic load went with a 16% higher risk of coronary heart disease, mostly in people carrying extra weight.36 These studies show links in people's real diets rather than proof of cause, and they all point toward the same plate.

For insulin resistance, the key is high protein, high fiber, moderate fat and low to moderate carbs, not low carb and not keto, with carbohydrates that are high in fiber and nutrients.18 The insulin resistance diet turns that into a daily menu, our guide to metabolic syndrome covers the wider pattern, and my free type 2 diabetes protocol walks through the eight drivers behind blood sugar that keeps climbing.

High vs. low glycemic foods: the best low-GI swaps

High-GI foods digest and absorb quickly, while low glycemic foods digest slowly and release their sugar gradually.15 The table below shows how they compare.

High-GI foodsLow-GI foods

Glycemic index

70 or more1

55 or less1

How fast they digest

Fast1

Slow5

Blood sugar after eating

Faster, higher peaks and deeper dips5

A smaller rise and fall5

Hunger afterward

Returns sooner4

Held off longer4

Best time to eat them

After long, hard exercise, or to raise low blood sugar3031

Everyday meals

What to eat them with

Protein, fat and fiber, with the carbs last327

Protein and vegetables

When blood sugar is the goal, the swaps are simple. On my show I've told people with insulin resistance to skip white flour products and refined pasta and to choose very high-fiber, low-glycemic fruits such as pomegranate, apples and berries, and that sweet potato, butternut squash, quinoa and whole-grain brown rice are better carbohydrates to choose.18 The table below pairs each common high-GI food, along with juice and soda, with a swap, and gives the swap's GI where the international tables have one.2

Instead ofTryGI of the swap

Instant oatmeal (79)

Rolled or slow-cooked oats

55

White bread (75)

Whole-grain sourdough or 100% sprouted grain bread

Not in the tables; specialty grain breads average 53

Rice crackers (87)

An apple with almond butter

36 for the apple

Cornflakes (81)

Goat's or sheep's milk yogurt or kefir with berries

Not in the tables

Instant mashed potatoes (87)

Potatoes cooked and cooled, or a boiled sweet potato

63 for sweet potato

White rice (73)

Rice cooked, cooled and reheated, or barley, lentils or chickpeas

28 for barley, 32 for lentils, 28 for chickpeas

Fruit juice

Whole fruit

43 for an orange, 36 for an apple

Soda

Sparkling water with a squeeze of lemon

No carbohydrate to test

For a whole day of eating this way, our low glycemic diet guide and our list of healthy carbs put these swaps into meals.

Who should be careful with high glycemic foods?

Quick answer

High glycemic foods are safe for most people as part of a whole-food diet; take extra care if you take glucose-lowering medication, if you're prone to low blood sugar, or if you have reflux and want to try vinegar before meals.3137

  • Glucose-lowering medication: insulin and some other diabetes medicines make low blood sugar more likely.31 As these habits bring your numbers down, keep checking your blood sugar at home, and have your prescriber adjust your dose as your blood sugar improves. If one of your diabetes medicines slows carbohydrate digestion, treat a low with glucose tablets or gel, because other carbs won't raise it fast enough.31
  • Severe low blood sugar: confusion, trouble seeing or speaking clearly, passing out or a seizure means blood sugar is dangerously low and needs treatment right away.31 If someone can't treat it themselves, give their prescribed glucagon if they have it and call emergency services.31
  • Kidney disease: if you treat low blood sugar with juice, choose apple, grape or cranberry juice over orange juice, which is high in potassium.31
  • Reflux: vinegar before meals helps some people and worsens others, and it can irritate an already inflamed esophagus, so dilute it every time and leave it out while your reflux is active.37

The bottom line

The bottom line

High glycemic foods are the carbs that reach your blood fastest, and the ones worth cutting are mostly refined, like white bread, sugary cereal, instant oatmeal and rice crackers, along with soda and juice, whatever their number. Whole foods with a high number, like watermelon, potatoes and rice, still belong on your plate, because a real serving, the way it's cooked and what you eat with it change how it lands.25

Eat your protein and vegetables first and your carbs last, never eat carbs on their own, cook and cool your potatoes and rice, and take a short walk after meals.8910 If your blood sugar has been creeping up, the free Insulin Resistance & Prediabetes protocol puts these steps into a 90-day plan.

Your body was designed to run on carbohydrate in the form it grows, so choose carbs that come whole and eat them beside the protein and vegetables they belong with.

High glycemic foods: frequently asked questions

Are high glycemic foods bad for everyone?

No: whole foods with a high glycemic index, such as watermelon, potatoes and white rice, fit a healthy diet, and fast carbs are the right choice after long, hard exercise and when blood sugar runs low.23031 The ones most people should cut are the refined ones, such as white bread and sugary cereal, and soda and juice belong on that list too, whatever their number.8 People with insulin resistance or diabetes gain the most from eating fewer high-GI foods and pairing the rest with protein.833

Does cooking change the glycemic index?

Yes: cooking starch until it's soft raises its glycemic index, so overcooked pasta scores higher than pasta cooked firm to the bite, and cooling cooked starch brings the response back down.5 In a study of 14 healthy adults who each ate both, white rice that was cooked, chilled for 24 hours and reheated raised blood sugar about 18% less than freshly cooked rice.9

Is sugar the only high-GI food?

No: many starchy foods that don't taste sweet score higher than table sugar, including boiled potatoes at 78, white bread at 75 and white rice at 73, while table sugar averages 65.2

What are the lowest glycemic foods?

Beans, lentils and barley are among the lowest glycemic carbohydrate foods: kidney beans average 24, chickpeas and barley 28, and lentils 32.2 Most non-starchy vegetables, along with nuts, seeds, eggs, fish and meat, have so little carbohydrate that their GI can't be tested, and eaten alone they barely move your blood sugar.5

What is the worst food for your blood sugar?

Sugar-sweetened drinks are the worst for most people, because sweet drinks and juice deliver sugar fast, with no fiber, protein or fat to slow it.8 In a 2010 analysis of long-term studies that included 310,819 people, those who drank the most, most often 1 to 2 servings a day, had a 26% higher risk of type 2 diabetes than those who drank the least.38 Soda's glycemic index is only 59, so the problem is the liquid sugar and how much of it people drink, more than the number.2

Do high glycemic foods cause acne?

High glycemic diets are linked to more acne, and eating a lower glycemic load can reduce breakouts.3940 A 2022 review of 34 studies found that a high glycemic index and load went with more frequent and more severe acne, a pattern backed by randomized trials, and in a 12-week randomized trial of 43 young men aged 15 to 25, a low-glycemic-load diet cut acne lesions by 23.5 on average, against 12.0 on a carbohydrate-heavy diet, though the low-glycemic-load group also lost weight, so the two effects can't be separated.3940 Our guide to hormonal acne covers the other steps.

Are eggs high on the glycemic index?

No: eggs don't have a glycemic index at all, because they contain so little carbohydrate that they can't be tested, and on their own they barely affect your blood sugar.5 That makes eggs one of the best foods to pair with a higher-GI carb, such as eggs alongside a slice of sourdough toast.

What food has the highest glycemic index?

Pure glucose is the yardstick at 100, and among the other common foods averaged in the international tables, rice crackers and instant mashed potatoes rank highest at 87, followed by rice milk at 86 and cornflakes at 81.12

What are the best low glycemic foods?

The best low glycemic foods are whole foods that carry fiber or protein: non-starchy vegetables, beans and lentils, nuts and seeds, eggs and wild fish, whole fruits such as apples (36) and oranges (43), and plain goat's or sheep's milk yogurt or kefir.25 Our guide to low glycemic foods has the full list.

Which fruits are best during pregnancy if blood sugar is a concern?

Whole fruits are a good fit during pregnancy, and berries lead the list, because they have more fiber and less sugar and they're lower glycemic.13 In a 2023 analysis of 12 long-term studies with 32,794 pregnant women, eating more fruit was linked to an 8% lower risk of gestational diabetes, while fruit juice showed no link.41

Which fruits are highest on the glycemic index, and should people with diabetes avoid them?

Watermelon is the main high-GI fruit, at 76 in the 2008 tables, and people with diabetes don't need to avoid it or any other whole fruit, since a cup of watermelon carries a glycemic load of only about 8,26 and four varieties tested for the 2021 tables averaged a low 50.16 Pineapple (59) is medium, and bananas and mango (both 51) are low.2 In my type 2 diabetes protocol, the problem is refined carbs, added sugar and juice, not a bowl of blueberries.11 Dried fruit concentrates its sugar, so keep it to a small handful, and enjoy fresh fruit alongside a little protein or fat.

What can eating high-GI foods often raise your risk of?

Eating high-GI foods often is linked to a higher risk of type 2 diabetes and heart disease, and in short studies it led to more hunger and more eating at the next meal.343525 In a 2019 analysis of long-term studies in adults who started out healthy, every 10 points of dietary glycemic index went with a 27% higher risk of type 2 diabetes, and when 12 teenage boys with obesity each ate meals of the same calories, they ate 53% to 81% more over the five hours after a high-GI meal than after medium- or low-GI meals.3425

Is honey high glycemic?

No: honey averages 61 on the glycemic index, which makes it a medium-GI food, a little under table sugar at 65.2 Raw honey is the better sweetener of the two, and 1 teaspoon to 1 tablespoon a day in place of other sweeteners keeps it in the measure Proverbs 25:16 describes.2021

Freshness & method note

November 7, 2026 — Rewrote the page in Dr. Axe's voice, replacing the March 1, 2026 version. Kept the glycemic index explainer, the high glycemic foods list, the uses for high-GI foods (after hard exercise and for low blood sugar), what they do in your body, the high vs. low comparison table, the five how-to steps, the risks and all 11 questions, plus two new ones on long-term risk and honey. Corrected the list: french fries, potato chips, soda, popcorn, ice cream, chocolate, juice, honey, table sugar and pineapple, which the earlier list called high glycemic, now carry their measured medium or low values from the international GI tables, and the processed ones sit on their own cut list. Eggs now read as having no glycemic index rather than a GI of zero, the fruit question now answers which fruits score highest instead of listing fruits to avoid, and the earlier citations for inflammation, weight gain, heart disease and dental health now point to studies that measured those outcomes. Added GI values for each food, three charts, glycemic load with worked examples, a section on how these foods work in your body, Dr. Axe's experience with a continuous glucose monitor, meal order, cooking and cooling, walking and vinegar, low-GI swaps, a Thanksgiving plate and 41 numbered references.

References

  1. University of Sydney, Glycemic Index Research and GI News. About Glycemic Index (GI ranks carbohydrates 1 to 100; high GI 70 or more, low GI 55 or less; the international standard method: 10 or more healthy people, a portion with 50 grams of available carbohydrate, two-hour blood glucose against glucose as the reference). Accessed 2026-11-06.
  2. Atkinson FS, Foster-Powell K, Brand-Miller JC. International tables of glycemic index and glycemic load values: 2008. Diabetes Care. 2008;31(12):2281-3. doi:10.2337/dc08-1239. PMID:18835944. Table 1, average GI of 62 common foods from multiple laboratories (glucose = 100).
  3. Shukla AP, Iliescu RG, Thomas CE, Aronne LJ. Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels. Diabetes Care. 2015;38(7):e98-9. doi:10.2337/dc15-0429. PMID:26106234. Table 1 (glucose and insulin by time point).
  4. Lennerz BS, Alsop DC, Holsen LM, Stern E, Rojas R, Ebbeling CB, et al. Effects of dietary glycemic index on brain regions related to reward and craving in men. Am J Clin Nutr. 2013;98(3):641-7. doi:10.3945/ajcn.113.064113. PMID:23803881
  5. University of Sydney, Glycemic Index Research and GI News. FAQs (medium GI 56 to 69; GL = GI x grams of carbohydrate / 100; serving size and the GI; foods with too little carbohydrate to test; soluble fiber and milling; the rain comparison; pasta al dente and overcooking; potato salad made the day before with vinaigrette; only about half the carbohydrate needs to move from high to low GI; sourdough fermentation acids). Accessed 2026-11-06.
  6. U.S. Department of Agriculture, Agricultural Research Service. FoodData Central: Watermelon, raw (SR Legacy, FDC ID 167765): carbohydrate 7.55 g and fiber 0.4 g per 100 g; 1 cup, diced = 152 g.
  7. U.S. Department of Agriculture, Agricultural Research Service. FoodData Central: Rice, white, long-grain, regular, enriched, cooked (SR Legacy, FDC ID 168878): carbohydrate 28.2 g and fiber 0.4 g per 100 g; 1 cup = 158 g.
  8. Axe J. Insulin Resistance & Prediabetes: The 90-Day Healing Protocol. DrAxe.com. 2026 (p. 3, letter: "Of the thousands of patients I've treated..."; p. 8, "The Insulin Cycle"; p. 12, "What spikes blood sugar, and what steadies it" and "Does meal order really change blood sugar?"; Phase 2, Build: muscle is the body's biggest glucose sink, sweet potato, oats or rice after training; p. 22, "Cut these: they keep insulin high"; p. 23, "For stubborn cases": continuous glucose monitor for 14 days; Phase 1, Stabilize: 30 g of protein at breakfast; p. 19, "Supplements that support healing": psyllium 5 g before meals; apple cider vinegar, 1 tbsp in water before meals).
  9. Sonia S, Witjaksono F, Ridwan R. Effect of cooling of cooked white rice on resistant starch content and glycemic response. Asia Pac J Clin Nutr. 2015;24(4):620-5. PMID:26693746
  10. Reynolds AN, Mann JI, Williams S, Venn BJ. Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study. Diabetologia. 2016;59(12):2572-2578. doi:10.1007/s00125-016-4085-2. PMID:27747394
  11. Axe J. The Type 2 Diabetes Protocol. DrAxe.com. 2026 (p. 7, "The eight drivers": refined-carb and sugar overload, the number one driver, and insulin resistance in muscle, the body's main glucose sink; the plate panel before the 7-day meal plan: half non-starchy color, a quarter protein, a quarter smart carbs, the carbs last and never on their own, then a 10- to 15-minute walk; troubleshooting and FAQ: "The problem is refined carbs, added sugar and juice, not a bowl of blueberries"; 1 to 2 tsp apple cider vinegar in water before large meals).
  12. Axe J. The Real Reason You Wake Up Tired Every Morning. The Dr. Josh Axe Show. 2026 (a sugary or refined-carb meal spikes glucose, then it crashes, at 5:45; YouTube https://www.youtube.com/watch?v=UYvHrFB_g50&t=345s).
  13. Axe J. 11 Foods with SHOCKINGLY High Amounts of Sugar (Best Sugar Substitutes). The Dr. Josh Axe Show. 2024 (fruit's fiber, vitamins, minerals and water, at 22:05; the fiber in fruit slows the absorption of sugar, at 22:25; sugar without fiber and nutrients, at 22:43; berries are the best, and grapes, apples and watermelon are fantastic choices, at 23:13; YouTube https://www.youtube.com/watch?v=KG7_2ZYmHLU&t=1325s).
  14. Axe J. They Said You Can't Reverse Cancer Naturally. He's Done It for 30 Years | Dr. Gez Agolli. The Dr. Josh Axe Show. 2026 (Dr. Axe on wearing a continuous glucose monitor: fruit eaten by itself raised his blood sugar most, potatoes eaten with protein hardly at all, at 51:48-52:24; driving raised it too, at 52:24; YouTube https://www.youtube.com/watch?v=Ibyy3c_hVa8&t=3108s).
  15. Axe J. Why Restrictive Diets Do More Harm Than Good | Dr. Sarah Ballantyne. The Dr. Josh Axe Show. 2024 (Dr. Axe on medicine and wellness highlighting one food or nutrient for years and then changing its mind, and on the late-1990s and early-2000s emphasis on glycemic index and glycemic load, when people were told not to eat beets, carrots, potatoes, watermelon or bananas, at 26:44-27:44; YouTube https://www.youtube.com/watch?v=U053LO-mzWk&t=1604s).
  16. Atkinson FS, Brand-Miller JC, Foster-Powell K, Buyken AE, Goletzke J. International tables of glycemic index and glycemic load values 2021: a systematic review. Am J Clin Nutr. 2021;114(5):1625-1632. doi:10.1093/ajcn/nqab233. PMID:34258626
  17. Axe J, Rubin J. The Biblio Diet. Hachette Book Group; 2025. ISBN 9781546008439. Bread chapter ("Whole-grain sourdough breads have a lower glycemic index compared to highly processed breads made with white flour"; whole-grain sourdough ranked first among breads); food lists (avoid: white flour or bread, pastries, dried cereal, instant oatmeal).
  18. Axe J. How to Reverse Insulin Resistance Naturally in 30 Days. The Dr. Josh Axe Show. 2025 (high protein, high fiber, moderate fat, low to moderate carb, at 11:54; low-glycemic fruits and better carbohydrates, at 12:12; high carb with high fat, at 12:48; what he recommends for his patients at each meal, at 12:58; YouTube https://www.youtube.com/watch?v=CisGqhRrErY&t=714s).
  19. Axe J. The Mitochondrial Longevity Protocol. DrAxe.com. 2026 (p. 22, "Top 10 longevity foods": dark chocolate, 85% or higher, 1 to 2 squares; cocoa flavanols support blood flow and mitochondria).
  20. Axe J. What Happens In Your Body If You Eat Honey Every Day? The Dr. Josh Axe Show. 2025 (Dr. Axe speaking, solo; his daily amount, a teaspoon up to a tablespoon of raw honey, in the 20:40 segment of the episode transcript, with "1 teaspoon, 2 teaspoons" at a time for people who aren't very active; honey used in place of other sugars, not on top of them).
  21. The Holy Bible, King James Version. Proverbs 25:16.
  22. Foster-Powell K, Holt SH, Brand-Miller JC. International table of glycemic index and glycemic load values: 2002. Am J Clin Nutr. 2002;76(1):5-56. doi:10.1093/ajcn/76.1.5. PMID:12081815
  23. Muraki I, Imamura F, Manson JE, Hu FB, Willett WC, van Dam RM, et al. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ. 2013;347:f5001. doi:10.1136/bmj.f5001. PMID:23990623. Fruit juice result as corrected in BMJ 2013;347:f6935 (hazard ratio 1.07 per 3 servings a week; individual fruits unchanged).
  24. Reynolds A, Mann J, Cummings J, Winter N, Mete E, Te Morenga L. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet. 2019;393(10170):434-445. doi:10.1016/S0140-6736(18)31809-9. PMID:30638909
  25. Ludwig DS, Majzoub JA, Al-Zahrani A, Dallal GE, Blanco I, Roberts SB. High glycemic index foods, overeating, and obesity. Pediatrics. 1999;103(3):E26. doi:10.1542/peds.103.3.e26. PMID:10049982
  26. Atkinson FS, Khan JH, Brand-Miller JC, Eberhard J. The Impact of Carbohydrate Quality on Dental Plaque pH: Does the Glycemic Index of Starchy Foods Matter for Dental Health? Nutrients. 2021;13(8). doi:10.3390/nu13082711. PMID:34444871
  27. Axe J. The PCOS Protocol. DrAxe.com. 2026 ("Never eat carbs 'naked': always pair with protein or fat," p. 10).
  28. Ostman E, Granfeldt Y, Persson L, Björck I. Vinegar supplementation lowers glucose and insulin responses and increases satiety after a bread meal in healthy subjects. Eur J Clin Nutr. 2005;59(9):983-8. doi:10.1038/sj.ejcn.1602197. PMID:16015276
  29. Zeevi D, Korem T, Zmora N, Israeli D, Rothschild D, Weinberger A, et al. Personalized Nutrition by Prediction of Glycemic Responses. Cell. 2015;163(5):1079-1094. doi:10.1016/j.cell.2015.11.001. PMID:26590418
  30. Burke LM, Collier GR, Hargreaves M. Muscle glycogen storage after prolonged exercise: effect of the glycemic index of carbohydrate feedings. J Appl Physiol (1985). 1993;75(2):1019-23. doi:10.1152/jappl.1993.75.2.1019. PMID:8226443
  31. National Institute of Diabetes and Digestive and Kidney Diseases. Low Blood Glucose (Hypoglycemia) (below 70 mg/dL or your target: 15 to 20 grams of glucose or carbohydrates, such as four glucose tablets, 1/2 cup of fruit juice or 1 tablespoon of sugar, honey or corn syrup; recheck after 15 minutes; with kidney disease, apple, grape or cranberry juice rather than orange juice; insulin and some other diabetes medicines raise the risk; severe symptoms). Accessed 2026-11-06.
  32. Murray B, Rosenbloom C. Fundamentals of glycogen metabolism for coaches and athletes. Nutr Rev. 2018;76(4):243-259. doi:10.1093/nutrit/nuy001. PMID:29444266
  33. Chiavaroli L, Lee D, Ahmed A, Cheung A, Khan TA, Blanco S, et al. Effect of low glycaemic index or load dietary patterns on glycaemic control and cardiometabolic risk factors in diabetes: systematic review and meta-analysis of randomised controlled trials. BMJ. 2021;374:n1651. doi:10.1136/bmj.n1651. PMID:34348965
  34. Livesey G, Taylor R, Livesey HF, Buyken AE, Jenkins DJA, Augustin LSA, et al. Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies. Nutrients. 2019;11(6). doi:10.3390/nu11061280. PMID:31195724
  35. Jenkins DJA, Dehghan M, Mente A, Bangdiwala SI, Rangarajan S, Srichaikul K, et al. Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality. N Engl J Med. 2021;384(14):1312-1322. doi:10.1056/NEJMoa2007123. PMID:33626252
  36. Sieri S, Agnoli C, Grioni S, Weiderpass E, Mattiello A, Sluijs I, et al. Glycemic index, glycemic load, and risk of coronary heart disease: a pan-European cohort study. Am J Clin Nutr. 2020;112(3):631-643. doi:10.1093/ajcn/nqaa157. PMID:32619242
  37. Axe J. The Acid Reflux & GERD Protocol. DrAxe.com. 2026 (apple cider vinegar: it helps some people and worsens others, and it can irritate an already inflamed esophagus).
  38. Malik VS, Popkin BM, Bray GA, Després JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010;33(11):2477-83. doi:10.2337/dc10-1079. PMID:20693348
  39. Meixiong J, Ricco C, Vasavda C, Ho BK. Diet and acne: A systematic review. JAAD Int. 2022;7:95-112. doi:10.1016/j.jdin.2022.02.012. PMID:35373155
  40. Smith RN, Mann NJ, Braue A, Mäkeläinen H, Varigos GA. A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr. 2007;86(1):107-15. doi:10.1093/ajcn/86.1.107. PMID:17616769
  41. Liao YP, Zheng QX, Jiang XM, Chen XQ, Gao XX, Pan YQ. Fruit, vegetable, and fruit juice consumption and risk of gestational diabetes mellitus: a systematic review and meta-analysis. Nutr J. 2023;22(1):27. doi:10.1186/s12937-023-00855-8. PMID:37208776
Dr. Josh Axe

Dr. Josh Axe, DC, DNM, CNS

Doctor of Natural Medicine · Founder, DrAxe.com

Dr. Axe is a certified doctor of natural medicine, clinical nutritionist, and multiple New York Times bestselling author. He has spent 20+ years in clinical practice helping people heal at the root cause and founded one of the most-visited natural-health platforms in the world.

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