Glycaemic responses to foods reflect the balance between glucose loading into, and its clearance from, the blood. Current in vitro methods for glycaemic analysis do not take into account the key role of glucose disposal. The present study aimed to develop a food intake-sensitive method for measuring the glycaemic impact of food quantities usually consumed, as the difference between release of glucose equivalents (GGE) from food during in vitro digestion and a corresponding estimate of clearance of them from the blood. Five foods -white bread, fruit bread, muesli bar, mashed potato and chickpeas -were consumed on three occasions by twenty volunteers to provide blood glucose response (BGR) curves. GGE release during in vitro digestion of the foods was also plotted. Glucose disposal rates estimated from downward slopes of the BGR curves allowed GGE dose-dependent cumulative glucose disposal to be calculated. By subtracting cumulative glucose disposal from cumulative in vitro GGE release, accuracy in predicting the in vivo glycaemic effect from in vitro GGE values was greatly improved.). Furthermore, the difference between the curves of cumulative GGE release and disposal closely mimicked in vivo incremental BGR curves. We conclude that valid measurement of the glycaemic impact of foods may be obtained in vitro, and expressed as grams of glucose equivalents per food quantity, by taking account not only of GGE release from food during in vitro digestion, but also of blood glucose clearance in response to the food quantity.
Carbohydrate: Glycaemic impact: Glucose disposal: In vitro digestionFor practical consumer and dietetic use in glycaemia management, food values are required which will '. . . communicate glycaemic response in grams per serving of food' (1) , and which should be measured using '. . . validated in vitro methodology that accurately mimics in vivo behaviour' (2) . Current in vitro digestion methods for predicting relative glycaemic responses to foods measure carbohydrate that is rapidly available (for example, Englyst et al. ), or the area under the glucose release curve relative to a reference (5) . However, they cannot provide accurate or robust predictions of relative responses to whole foods varying in quantity, or accurately mimic the in vivo glycaemic response, because they do not allow for the effects of homeostasis. They do not take into account the fact that glycaemic responses to foods are a net effect of the balance between blood glucose loading and blood glucose disposal (GD), which depends dynamically on the rates of both. Not allowing for blood GD, and its dependence on the amount and rate of blood glucose loading, may lead to large inaccuracies when using glycaemic impact values from experimental portions to gauge the effect of the very different and varying food quantities that are consumed in a community setting. For instance, customarily consumed food portions often have a much lower glycaemic impact than would be expected from a glycaemic load value calculated from the glycaemic in...