Glycemic index versus glycemic load -
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. Glycaemic index methodology. Nutr Res Rev. Augustin LS, Kendall CW, Jenkins DJ, et al. Glycemic index, glycemic load and glycemic response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium ICQC.
Nutr Metab Cardiovasc Dis. Monro JA, Shaw M. Glycemic impact, glycemic glucose equivalents, glycemic index, and glycemic load: definitions, distinctions, and implications.
Am J Clin Nutr. The University of Sydney. About Glycemic Index. The International Organization for Standardization. Food products - Determination of the glycaemic index GI and recommendation for food classification.
Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. Willett WC. Sticking to whole, unprocessed foods is another way to minimize a glycemic response. Processed foods are typically packaged, shelf-stable foods loaded with salt, sugar, and fat.
These ingredients tend to tax our metabolism, making it difficult to naturally digest and absorb them. Opting for minimally processed foods like colorful non-starchy vegetables , lean proteins, and healthy fats, is better for your blood sugar and metabolism. Glycemic index and glycemic load are useful tools for creating grocery lists and meal preparation, but a CGM ultimately provides the data to support long-term habits.
Seeing positive changes in your body and metabolic health in real time will show what dietary and lifestyle choices are optimal for you and your blood sugar.
Weight Loss. Metabolic Health. Glycemic Index vs. Glycemic index vs. glycemic load Glycemic index is a measure of how quickly a carb-containing food is broken down and absorbed into the bloodstream.
In order to know how much a food affects blood sugar levels, we use glycemic load. Is one measure better than the other? The effect on glycemic response Glycemic response can show the effect foods and meals have on blood sugar levels.
The effect on insulin sensitivity However, eating too many high-GI foods over time can impair insulin sensitivity [4]. Eating a low-glycemic diet: where to start Monitoring blood sugar over time can reveal how stable your glucose levels are throughout the day.
Protein and fat In addition to eating foods with soluble fiber, another strategy is pairing a carbohydrate with a fat or protein, two nutrients that help to slow glucose absorption, prevent rapid spikes, and improve satiety.
Processed foods Sticking to whole, unprocessed foods is another way to minimize a glycemic response. Key Takeaways Glycemic index and glycemic load are useful tools for creating grocery lists and meal preparation, but a CGM ultimately provides the data to support long-term habits.
Aim for low-GI foods by swapping out refined carbs for whole unprocessed carbohydrates like whole-kernel bread, brown rice, barley, and quinoa, and stick to suggested serving sizes. Incorporate fibrous foods such as whole grains, fruits, and non-starchy colorful vegetables into your meals to slow your blood sugar spike.
Pair a carbohydrate with a protein and fat to ebb the glycemic response after a meal. Avoid the metabolic consequences of processed foods and select whole, minimally processed foods. toolbar search search input Search input auto suggest.
Diabetes Care. Sheard NF, Clark NG, Brand-Miller JC, Franz MJ, Pi-Sunyer FX, Mayer-Davis E, Kulkarni K, Geil P: Dietary carbohydrate amount and type in the prevention and management of diabetes: a statement by the American Diabetes Association.
Salmeron J, Manson JAE, Stampfer MJ, Colditz GA, Wing AL, Jenkins DJ, Wing AL, Willett WC: Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. Brand-Miller JC, Holt SHA, Petocz P: Reply to R.
Am J Clin Nutr. Brand-Miller JC, Thomas M, Swan V, Ahmad ZI, Petocz P, Colagiuri S: Physiological validation of the concept of glycemic load in lean young adults. J Nutr. Br J Nutr. Wolever TMS, Mehling C: Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance.
Ball SD, Keller KR, Moyer-Mileur LJ, Ding YW, Donaldson D, Jackson WD: Prolongation of satiety after low versus moderately high glycemic index meals in obese adolescents.
Dietary Guidelines for Americans [article online]. Department of Health and Human Services and the U. Department of Agriculture. Available from www. Accessed 16 January FAO Food and Nutrition Paper. DIABETES CARE. View Metrics. Email alerts Article Activity Alert.
Online Ahead of Print Alert. Latest Issue Alert. Online ISSN Print ISSN Books ShopDiabetes.
The differences between glycemic hlycemic and Plant-based diet and chronic disease prevention load can be difficult to understand. Verzus both are versud to measure how your Glycemic index versus glycemic load losd sugar, which is important ,oad your overall Glycemic index versus glycemic load. Both the glycemic index and the glycemic load can be hard to understand, and the scientific terminology needed to explain them is a little overwhelming. So, before you tackle our explanation, we suggest watching this quick video:. The glycemic index is a way to measure how 50 grams of carbohydrate of a certain food will cause your blood sugar levels to rise. We all know how important blood sugar verssu is when you have type 2 diabetes Glycemic index versus glycemic load For gglycemic with diabetes, the terms glycemic index and glycemic load are probably pretty familiar. However, there is Glycemic index versus glycemic load indexx confusion about the difference between Blood pressure and stress load vs glyycemic and how each of these measures comes into play for diabetes management. By the end of this article, you will understand the difference between glycemic index and glycemic load, how to use these measures for better blood sugar balance, and how much they actually matter when it comes to managing diabetes. Most people have at least heard of the glycemic index GI before… but do you actually know what it means? The GI is essentially a numbered ranking of the impact on blood sugar of carbohydrate-containing foods when compared to pure glucose sugar.
0 thoughts on “Glycemic index versus glycemic load”