Glycemic load and blood sugar control -
Sydney University's table of GI values also includes GL values. The GL values are divided into:. A GI value tells you nothing about other nutritional information. For example, cantaloupe has a medium to high GI score and a medium GL score. But it is a good source of vitamin C, beta carotene and other important nutrients.
Whole milk has a low GI value and a low GL value. But it's high in fats and calories. So it may not a good choice for losing or controlling weight. The published GI database is not a complete list of foods. Instead, it's a list of foods that have been studied. Many nutritious foods with low GI values may not be in the database.
The list also includes highly processed foods which may be less nutritious than unprocessed foods. And some foods with low GI values may not be good sources of nutrients. The GI value of any food item depends on many factors. It matters how the food is prepared and how it is processed. Also, there can be a range in GI values for the same foods.
So the values may not be reliable for all food choices. If you follow a low-GI diet, your foods with carbs are mostly limited to choices with low values. You usually will avoid foods with high values. Examples of foods with low, middle and high GI values are:.
Commercial low-GI diets may refer to foods as having slow carbs or fast carbs. This is because foods with a low GI value are digested and absorbed over a longer time. Foods with high values are absorbed over a shorter time.
Studies of low-GI diets have shown varied results. In general, they have shown a low-GI diet may be helpful for:. Researchers have noted the benefit of the diet may be linked to the nutrient-rich foods and high-fiber foods in the studies.
The overall nutritional quality of the food may be more important than the GI value of each food item. Following a low-GI diet may help you lose weight or keep a healthy weight. It may help you manage a diabetes plan. It may lower your risk of diabetes and heart and blood vessel diseases. The glycemic index also could be one tool, rather than the main tool, to help you make healthier food choices.
The Dietary Guidelines for Americans recommends a focus on healthy dietary patterns and nutrient-rich foods. A healthy dietary pattern means making consistently healthy choices over time.
Foods that fit in that pattern vary. They include a variety of fruits and vegetables that provide vitamins, minerals and fiber. A healthy dietary pattern also includes whole-grain foods that are high in fiber and other nutrients. Beans, legumes, fish, low-fat dairy and lean meats are also good choices.
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Show references Liu S, et al. Dietary carbohydrates. Accessed Sept. American Diabetes Association Professional Practice Committee. Facilitating behavior change and well-being to improve health outcomes: Standards of Medical Care in Diabetes — Diabetes Care.
Zeratsky KA expert opinion. Mayo Clinic. Chiavaroli L, 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.
Dwivedi AK, et al. Associations of glycemic index and glycemic load with cardiovascular disease: Updated evidence from meta-analysis and cohort studies.
Current Cardiology Reports. Ni C, et al. Low-glycemic index diets as an intervention in metabolic diseases: A systematic review and meta-analysis.
Glycemic index. University of Sydney. FoodData Central. Department of Agriculture, Agricultural Research Service. Glycemic index food guide. Diabetes Canada. Sievenpiper JL. Low-carbohydrate diets and cardiometabolic health: The importance of carbohydrate quality over quantity.
The value is multiplied by to represent a percentage of the control food 5 :. In contrast, cooked brown rice has an average GI of 50 relative to glucose and 69 relative to white bread. In the traditional system of classifying carbohydrates, both brown rice and potato would be classified as complex carbohydrates despite the difference in their effects on blood glucose concentrations.
While the GI should preferably be expressed relative to glucose, other reference foods e. Additional recommendations have been suggested to improve the reliability of GI values for research, public health, and commercial application purposes 2 , 6.
By definition, the consumption of high-GI foods results in higher and more rapid increases in blood glucose concentrations than the consumption of low-GI foods.
Rapid increases in blood glucose resulting in hyperglycemia are potent signals to the β-cells of the pancreas to increase insulin secretion 7.
Over the next few hours, the increase in blood insulin concentration hyperinsulinemia induced by the consumption of high-GI foods may cause a sharp decrease in the concentration of glucose in blood resulting in hypoglycemia. In contrast, the consumption of low-GI foods results in lower but more sustained increases in blood glucose and lower insulin demands on pancreatic β-cells 8.
Many observational studies have examined the association between GI and risk of chronic disease , relying on published GI values of individual foods and using the following formula to calculate meal or diet GI 9 :.
Yet, the use of published GI values of individual foods to estimate the average GI value of a meal or diet may be inappropriate because factors such as food variety, ripeness, processing, and cooking are known to modify GI values.
In a study by Dodd et al. Besides the GI of individual foods, various food factors are known to influence the postprandial glucose and insulin responses to a carbohydrate-containing mixed diet. A recent cross-over , randomized trial in 14 subjects with type 2 diabetes mellitus examined the acute effects of four types of breakfasts with high- or low-GI and high- or low- fiber content on postprandial glucose concentrations.
Plasma glucose was found to be significantly higher following consumption of a high-GI and low-fiber breakfast than following a low-GI and high-fiber breakfast. However, there was no significant difference in postprandial glycemic responses between high-GI and low-GI breakfasts of similar fiber content In this study, meal GI values derived from published data failed to correctly predict postprandial glucose response, which appeared to be essentially influenced by the fiber content of meals.
Since the amounts and types of carbohydrate, fat, protein , and other dietary factors in a mixed meal modify the glycemic impact of carbohydrate GI values, the GI of a mixed meal calculated using the above-mentioned formula is unlikely to accurately predict the postprandial glucose response to this meal 3.
Using direct measures of meal GIs in future trials — rather than estimates derived from GI tables — would increase the accuracy and predictive value of the GI method 2 , 6. In addition, in a recent meta-analysis of 28 studies examining the effect of low- versus high-GI diets on serum lipids , Goff et al.
indicated that the mean GI of low-GI diets varied from 21 to 57 across studies, while the mean GI of high-GI diets ranged from 51 to 75 Therefore, a stricter use of GI cutoff values may also be warranted to provide more reliable information about carbohydrate-containing foods.
The glycemic index GI compares the potential of foods containing the same amount of carbohydrate to raise blood glucose. However, the amount of carbohydrate contained in a food serving also affects blood glucose concentrations and insulin responses.
For example, the mean GI of watermelon is 76, which is as high as the GI of a doughnut see Table 1. Yet, one serving of watermelon provides 11 g of available carbohydrate, while a medium doughnut provides 23 g of available carbohydrate. The concept of glycemic load GL was developed by scientists to simultaneously describe the quality GI and quantity of carbohydrate in a food serving, meal, or diet.
The GL of a single food is calculated by multiplying the GI by the amount of carbohydrate in grams g provided by a food serving and then dividing the total by 4 :. Using the above-mentioned example, despite similar GIs, one serving of watermelon has a GL of 8, while a medium-sized doughnut has a GL of Dietary GL is the sum of the GLs for all foods consumed in the diet.
It should be noted that while healthy food choices generally include low-GI foods, this is not always the case. For example, intermediate-to-high-GI foods like parsnip, watermelon, banana, and pineapple, have low-to-intermediate GLs see Table 1.
The consumption of high-GI and -GL diets for several years might result in higher postprandial blood glucose concentration and excessive insulin secretion. This might contribute to the loss of the insulin-secreting function of pancreatic β-cells and lead to irreversible type 2 diabetes mellitus A US ecologic study of national data from to found that the increased consumption of refined carbohydrates in the form of corn syrup, coupled with the declining intake of dietary fiber , has paralleled the increased prevalence of type 2 diabetes In addition, high-GI and -GL diets have been associated with an increased risk of type 2 diabetes in several large prospective cohort studies.
Moreover, obese participants who consumed foods with high-GI or -GL values had a risk of developing type 2 diabetes that was more than fold greater than lean subjects consuming low-GI or -GL diets However, a number of prospective cohort studies have reported a lack of association between GI or GL and type 2 diabetes The use of GI food classification tables based predominantly on Australian and American food products might be a source of GI value misassignment and partly explain null associations reported in many prospective studies of European and Asian cohorts.
Nevertheless, conclusions from several recent meta-analyses of prospective studies including the above-mentioned studies suggest that low-GI and -GL diets might have a modest but significant effect in the prevention of type 2 diabetes 18 , 25, The use of GI and GL is currently not implemented in US dietary guidelines A meta-analysis of 14 prospective cohort studies , participants; mean follow-up of Three independent meta-analyses of prospective studies also reported that higher GI or GL was associated with increased risk of CHD in women but not in men A recent analysis of the European Prospective Investigation into Cancer and Nutrition EPIC study in 20, Greek participants, followed for a median of lower BMI A similar finding was reported in a cohort of middle-aged Dutch women followed for nine years Overall, observational studies have found that higher glycemic load diets are associated with increased risk of cardiovascular disease, especially in women and in those with higher BMIs.
A meta-analysis of 27 randomized controlled trials published between and examining the effect of low-GI diets on serum lipid profile reported a significant reduction in total and LDL - cholesterol independent of weight loss Yet, further analysis suggested significant reductions in serum lipids only with the consumption of low-GI diets with high fiber content.
In a three-month, randomized controlled study, an increase in the values of flow-mediated dilation FMD of the brachial artery, a surrogate marker of vascular health, was observed following the consumption of a low- versus high-GI hypocaloric diet in obese subjects High dietary GLs have been associated with increased concentrations of markers of systemic inflammation , such as C-reactive protein CRP , interleukin-6, and tumor necrosis factor-α TNF-α 40, In a small week dietary intervention study, the consumption of a Mediterranean-style, low-GL diet without caloric restriction significantly reduced waist circumference, insulin resistance , systolic blood pressure , as well as plasma fasting insulin , triglycerides , LDL-cholesterol, and TNF-α in women with metabolic syndrome.
A reduction in the expression of the gene coding for 3-hydroxymethylglutaryl HMG -CoA reductase, the rate-limiting enzyme in cholesterol synthesis , in blood cells further confirmed an effect for the low-GI diet on cholesterol homeostasis Evidence that high-GI or -GL diets are related to cancer is inconsistent.
A recent meta-analysis of 32 case-control studies and 20 prospective cohort studies found modest and nonsignificant increased risks of hormone -related cancers breast, prostate , ovarian, and endometrial cancers and digestive tract cancers esophageal , gastric , pancreas , and liver cancers with high versus low dietary GI and GL A significant positive association was found only between a high dietary GI and colorectal cancer Yet, earlier meta-analyses of prospective cohort studies failed to find a link between high-GI or -GL diets and colorectal cancer Another recent meta-analysis of prospective studies suggested a borderline increase in breast cancer risk with high dietary GI and GL.
Adjustment for confounding factors across studies found no modification of menopausal status or BMI on the association Further investigations are needed to verify whether GI and GL are associated with various cancers.
Whether low-GI foods could improve overall blood glucose control in people with type 1 or type 2 diabetes mellitus has been investigated in a number of intervention studies. A meta-analysis of 19 randomized controlled trials that included diabetic patients with type 1 diabetes and with type 2 diabetes found that consumption of low-GI foods improved short-term and long-term control of blood glucose concentrations, reflected by significant decreases in fructosamine and glycated hemoglobin HbA1c levels However, these results need to be cautiously interpreted because of significant heterogeneity among the included studies.
The American Diabetes Association has rated poorly the current evidence supporting the substitution of low-GL foods for high-GL foods to improve glycemic control in adults with type 1 or type 2 diabetes 51, A randomized controlled study in 92 pregnant women weeks diagnosed with gestational diabetes found no significant effects of a low-GI diet on maternal metabolic profile e.
The low-GI diet consumed during the pregnancy also failed to improve maternal glucose tolerance , insulin sensitivity , and other cardiovascular risk factors, or maternal and infant anthropometric data in a three-month postpartum follow-up study of 55 of the mother-infant pairs At present, there is no evidence that a low-GI diet provides benefits beyond those of a healthy, moderate-GI diet in women at high risk or affected by gestational diabetes.
Obesity is often associated with metabolic disorders, such as hyperglycemia , insulin resistance , dyslipidemia , and hypertension , which place individuals at increased risk for type 2 diabetes mellitus , cardiovascular disease , and early death 56, Lowering the GI of conventional energy-restricted, low-fat diets was proven to be more effective to reduce postpartum body weight and waist and hip circumferences and prevent type 2 diabetes mellitus in women with prior gestational diabetes mellitus Yet, the consumption of a low-GL diet increased HDL - cholesterol and decreased triglyceride concentrations significantly more than the low-fat diet, but LDL -cholesterol concentration was significantly more reduced with the low-fat than low-GI diet Weight loss with each diet was equivalent ~4 kg.
Both interventions similarly reduced triglycerides, C-reactive protein CRP , and fasting insulin , and increased HDL-cholesterol. Yet, the reduction in waist and hip circumferences was greater with the low-fat diet, while blood pressure was significantly more reduced with the low-GL diet Additionally, the low-GI diet improved fasting insulin concentration, β-cell function, and insulin resistance better than the low-fat diet.
None of the diets modulated hunger or satiety or affected biomarkers of endothelial function or inflammation. Finally, no significant differences were observed in low- compared to high-GL diets regarding weight loss and insulin metabolism It has been suggested that the consumption of low-GI foods delayed the return of hunger, decreased subsequent food intake, and increased satiety when compared to high-GI foods The effect of isocaloric low- and high-GI test meals on the activity of brain regions controlling appetite and eating behavior was evaluated in a small randomized , blinded, cross-over study in 12 overweight or obese men During the postprandial period, blood glucose and insulin rose higher after the high-GI meal than after the low-GI meal.
In addition, in response to the excess insulin secretion, blood glucose dropped below fasting concentrations three to five hours after high-GI meal consumption.
Cerebral blood flow was significantly higher four hours after ingestion of the high-GI meal compared to a low-GI meal in a specific region of the striatum right nucleus accumbens associated with food intake reward and craving.
If the data suggested that consuming low- rather than high-GI foods may help restrain overeating and protect against weight gain, this has not yet been confirmed in long-term randomized controlled trials. However, the dietary interventions only achieved a modest difference in GI ~5 units between high- and low-GI diets such that the effect of GI in weight maintenance remained unknown.
Table 1 includes GI and GL values of selected foods relative to pure glucose Originally written in by: Jane Higdon, Ph. Linus Pauling Institute Oregon State University. Updated in December by: Jane Higdon, Ph.
Updated in February by: Victoria J. Drake, Ph. Updated in March by: Barbara Delage, Ph. Reviewed in March by: Simin Liu, M. Professor of Epidemiology, Professor of Medicine Brown University. Liu S, Willett WC. Dietary glycemic load and atherothrombotic risk. Curr Atheroscler Rep. Brouns F, Bjorck I, Frayn KN, et al.
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Mosdol A, Witte DR, Frost G, Marmot MG, Brunner EJ. Dietary glycemic index and glycemic load are associated with high-density-lipoprotein cholesterol at baseline but not with increased risk of diabetes in the Whitehall II study. Sahyoun NR, Anderson AL, Tylavsky FA, et al. Dietary glycemic index and glycemic load and the risk of type 2 diabetes in older adults.
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Dietary glycemic index, glycemic load, and digestible carbohydrate intake are not associated with risk of type 2 diabetes in eight European countries.
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The glycemic index Flavonoids in herbal medicine a measure used to determine how much a food can affect your blood sugar levels. Several xugar affect the cohtrol index Glycemic load and blood sugar control conntrol food, including the ripeness, nutrient composition, and cooking method. Several blodo Glycemic load and blood sugar control the glycemic index of a food, including bkood nutrient composition, cooking method, ripeness, and the amount of processing it has undergone. This article takes a closer look at the glycemic index, including what it is, how it can affect your health, and how to use it. The glycemic index GI is a value used to measure how much specific foods increase blood sugar levels. The lower the GI of a specific food, the less it may affect your blood sugar levels 1. Foods high in refined carbs and sugar are digested more quickly and often have a high GI, while foods high in protein, fat, or fiber typically have a low GI.
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