Meta-analysis of the health effects of using the glycaemic index in meal-planning

Opperman, Maretha; Venter, C S; Oosthuizen, Welma; Thompson, Rachel; Vorster, Hester H.

doi:10.1079/bjn20041203

Cited by 164 publications

(123 citation statements)

References 67 publications

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“…Although current American Diabetes Association recommendations emphasize the amount rather than the source of carbohydrate in the diet, 14 a growing body of research is bringing this recommendation into question. 5,7,[15][16][17] Blood glucose response to the ingestion of carbohydrate-containing foods has been shown to vary dramatically, depending on factors including the molecular structure of the carbohydrate, fiber content, and degree of processing. 18 The blood glucose response to a carbohydrate-containing food is indicated by its glycemic index (GI), 19 defined as the incremental area under the glucose response curve following consumption of a food portion containing 50 grams of carbohydrate relative to that produced by a portion of a control food (either glucose or white bread) containing the same amount of carbohydrate.…”

Section: Introductionmentioning

confidence: 99%

“…[21][22][23] Findings from studies to date suggest that incorporation of GI principles into diabetes care has substantial promise for improving management of diabetes and reducing the risk for complications without evidence of adverse effects. [15][16][17] To extend these preliminary findings to larger-scale studies or clinical practice, however, the implementation of a lower GI diet must be acceptable and feasible. Given the prevalence of high-GI carbohydrates in the U. S. food supply, as well as the current dietary practices of most children and adolescents, 10-12 implementing a lower-GI diet may be a substantial challenge.…”

Section: Introductionmentioning

confidence: 99%

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Acceptability of Lower Glycemic Index Foods in the Diabetes Camp Setting

Nansel¹,

Gellar²,

Zeitzoff³

2006

Journal of Nutrition Education and Behavior

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Objective-To determine the acceptability of lower glycemic index (GI) foods served at diabetes camp.Design-Crossover design of standard and lower GI menus. Setting-Three consecutive 5-day diabetes camp sessions.Participants-140 youth, age 7-16, with type 1 or 2 diabetes.Intervention-A standard camp cycle menu was reformulated to include 2½ days of standard foods and 2½ days of lower GI foods.Main Outcome Measures-Youth provided satisfaction ratings after meals and snacks using measures designed for this study. Observations of food consumption were conducted on a random sample of youth for each meal.Analysis-Descriptive analyses and t-tests were conducted to assess differences in satisfaction with and consumption of standard and lower GI foods.Results-Lower GI foods served at dinner and for snacks received satisfaction ratings equal to standard foods (dinner: 3.68 lower GI versus 3.79 standard, P = .30; snacks: 3.74 lower GI versus 3.79 standard, P = .60). Lower GI foods served at breakfast and lunch received lower, though very acceptable, ratings (breakfast: 3.76 lower GI versus 4.04 standard, P < .01; lunch: 3.64 lower GI versus 3.88 standard, P < .01). Consumption of all meals was acceptable. No differences occurred in the frequency of high or low blood sugars between standard and lower GI days.Conclusions and Implications-Higher quality carbohydrates may be provided to youth in institutional settings while maintaining sufficient levels of acceptability; specific findings are instructive for designing efforts to increase their consumption.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acceptability of Lower Glycemic Index Foods in the Diabetes Camp Setting

Nansel¹,

Gellar²,

Zeitzoff³

2006

Journal of Nutrition Education and Behavior

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“…This implies that postprandial glucose spikes and fluctuations may be more indicative of the glycemic response of a food than the shape of the curve or the iAUC derived from it. Such observed pattern of glucose release is associated with high GI foods and could perhaps be reflective of reactive hyperglycemia, which is defined as the sudden rise in postprandial blood glucose proceeded by a sudden drop below baseline levels [6,20]. From a nutritional point of view, the addition of β-glucans had a beneficial effect in reducing the rate of starch breakdown during in vitro digestion, and hence in reducing sugar release as shown by the lower iAUC in the samples with 20% and 30% β-glucans.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, foods with a high glycemic index because a rapid increase in blood glucose after a meal, followed by a sudden drop and potential hypoglycemia. This pattern of glycemic response has been reported to have a positive correlation with an increased incidence of type II diabetes [6].…”

Section: Introductionmentioning

confidence: 99%

Effect of Substitution of β-Glucans on the Glycemic Response and Thermal Properties of Four Common Starches

Anderson¹

2016

Int J Agric Sc Food Technol

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Diabetes Mellitus (DM) is a major public health concern worldwide which can lead to a series of disabling complications and diseases. β-glucans are non-starch polysaccharides that are being used as food additives for their numerous health benefits including the ability to lower the postprandial glucose response. The aim of this study was to determine the effect of substituting β-glucans on the glycemic response and thermal properties of four commonly consumed starches. Oat β-glucans were added at concentration levels of 0%, 10%, 20%, and 30% (w/w) to each of the four starch types. Composite starches were incubated with α-amylase followed by further incubation with amyloglucosidase. Glucose released was measured using the 3, 5-dinitrosalicylic acid (DNSA) method. Incremental Area under the Curve (iAUC) was used to represent the estimated glycemic response of the β-glucan/starch composites. Thermal analysis of the starch composite starches was conducted using a differential scanning calorimeter. An overall reduction in the amount of glucose released after the addition of β-glucans was observed (p ≤ 0.05). Substituting starches with 20% and 30% β-glucans resulted in a significant reduction in the glucose release rate and thus improved the estimated glucose response of all starches. A marked increase in the enthalpy of gelatinization, ∆H, of all starches was observed. Substitution at 10% β-glucans caused a significant increase in ∆H of blank tapioca starch (p ≤ 0.05). The 20% and 30% β-glucan samples also had significantly higher ∆H than the blank and the 10% β-glucan samples. The data from this study suggest the potential use of β-glucan as a suitable food ingredient in diabetic food products.

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“…Similarly, low Gi diets have been shown to be associated with a greater reduction in HbA1C than with high GI diets [14,15]. However, the difference in HbA1C between the two groups is small and may not affect outcomes in the long term.…”

mentioning

confidence: 96%

Glycaemic index: challenges in translating concept to practice

Madhu

2017

Int J Diabetes Dev Ctries

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Dietary prescribing in diabetes mellitus based on glycaemic index (GI) of foods has always been an attractive concept. Food choices with lower GI are associated with lower glucose responses after consumption and hence would be the preferred choices in patients with diabetes. While this idea has been very promising, the real challenge over the years has been its implementation in day to day practice. Several issues like validity and reproducibility of GI measurements, factors affecting glycaemic responses, differences when consumed as single foods or in mixed meals and amount of absorbable/ digestable carbohydrate need consideration besides other methodological concerns.The concept of GI has evolved over time. When it was first proposed [1], it measured the glycaemic response of a test food as a percentage of the glycaemic response of a reference food containing a similar amount of carbohydrate. The reference food has traditionally been glucose or white bread. Even this lead to variability of GI values depending on whether it was glucose or white bread that was the reference. Individual foods have been tested and categorized as low, medium or high GI foods based on their glycaemic responses [2] when consumed alone. However, these values lose significance when the foods are consumed as part of a mixed meal [3].The concept of GI does not take into account the amount of carbohydrate consumed even though this is a major determinant of the glycaemic response. This lead to the extension of the concept of GI to glycaemic load (GL) which is the product of GI and the total amount of carbohydrate consumed [4]. GL gives a fair idea of the glucose load or burden that results from the ingestion of a carbohydrate containing meal. A high GI food can have a low GL if the portion size consumed is small and a low GI food can have a high GL if the serving size is big.It has also been realized that all carbohydrate in food is not available for conversion to glucose and hence only the amount of "available" carbohydrate also called glycaemic carbohydrate and not total carbohydrate should be used for calculation of GI. What constitutes available carbohydrate has also been a subject of debate and the consensus view is that the undigestable carbohydrate which includes the fibre and all resistant starch is taken as unavailable [5].There are several limitations to the usefulness of GI and GL. Studies suggest that GI could be affected by many factors including the amounts of other nutrients such as fat, protein and fibre, structure of the carbohydrate, particle size, food form, food processing and cooking method [5]. These factors lead to a lot of intra and inter individual variability of GI values and GL making these estimates less reliable and raise questions about their validity [6]. The rates of digestion of carbohydrates also vary with health status, race, gender and underlying insulin resistance all of which can affect GI [5]. Similarly, methodological differences such as the amount of tested food which contains 50 g of carbohydrate (...

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Meta-analysis of the health effects of using the glycaemic index in meal-planning

Cited by 164 publications

References 67 publications

Acceptability of Lower Glycemic Index Foods in the Diabetes Camp Setting

Acceptability of Lower Glycemic Index Foods in the Diabetes Camp Setting

Effect of Substitution of β-Glucans on the Glycemic Response and Thermal Properties of Four Common Starches

Glycaemic index: challenges in translating concept to practice

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