Perceived Barriers to Application of Glycaemic Index: Valid Concerns or Lost in Translation?

Abstract

The term glycaemic-index (GI) originally appeared in the literature in the early 1980s. GI categorizes carbohydrate according to glycaemic effect postprandially. Since its inception, GI has obtained and maintained interest of academics and clinicians globally. Upon review of GI literature, it becomes clear that the clinical utility of GI is a source of controversy. Can and should GI be applied clinically? There are academics and clinicians on both sides of the argument. Certainly, this controversy has been a stimulus for the evolution of GI methodology and application research, but may also negatively impact clinicians’ perception of GI if misunderstood. This article reviews two assessments of GI that are often listed as barriers to application; the GI concept is (1) too complex and (2) too difficult for clients to apply. The literature reviewed does not support the majority of purported barriers, but does indicate that there is a call from clinicians for more and improved GI education tools and clinician GI education. The literature indicates that the Registered Dietitian (RD) can play a key role in GI knowledge translation; from research to application. Research is warranted to assess GI education tool and knowledge needs of clinicians and the clients they serve.

Dietary Glycemic Index during Pregnancy Is Associated with Biomarkers of the Metabolic Syndrome in Offspring at Age 20 Years

“…GL represents both the quality and the quantity of the food, taking into account that the glycemic effect of a food item depends not only on the GI but also on the amount of carbohydrate eaten. Application of GI and GL in research and partly in clinical settings is widespread though the concept of GI is still contentious because of controversies relating to methodology and clinical applicability [19], [20].…”

Integrating the Glycemic Index into Clinical Practice: Written Education Materials and Perceptions of Utility

“…Investigation into the barriers causing disagreement among health professionals' opinions as to the use of the GI has been recommended (14). Looking at the quality of currently available written GI education tools is an important piece to this puzzle.…”

Use of the glycemic index in nutrition education

“…Despite the GI importance, the current barriers preventing the widespread use of this important education tool are the complexity of the associated concepts and the difficulties related to its use 5 . Recently, emphasis has been placed on the need of publishing studies that provide instructions for its use, so scientific knowledge about the GI can be disclosed in a way that ensures its clinical use 5 .…”

“…The glycemic index has received and maintained the interest of academics and dieticians worldwide since its development 5 . Many internationally relevant agencies, like the Food and Agriculture Organization (FAO) 3 , European Association for the Study of Diabetes 6 and National Health and Medical Research Council of Australia 7 have recommended the consumption of low GI foods/diets to improve health.…”

“…Recently, emphasis has been placed on the need of publishing studies that provide instructions for its use, so scientific knowledge about the GI can be disclosed in a way that ensures its clinical use 5 . Therefore, the purposes of the present study are to synthesize the main points regarding the use of the GI and to provide information for its use in nutrition education in a way that encourages people to select foods that have a lower impact on blood glucose level.…”