Glycaemic Index

A Physiological Classification of Dietary Carbohydrate

By: Thomas Wolever

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Hardcover | 28 January 2006

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The glycaemic index (GI) is a measure of the ability of a food to raise blood sugar. Written by one of the co-inventors of the term, this is a clear and balanced review of current knowledge on this controversial concept. The book explores all the key issues of the definition of the GI, how to
measure the GI of a food, how to apply GI information to meals and diets, the reasons why foods have different GI values and the impact of altering a diet GI on health and disease. The book highlights the benefits and the problems surrounding the GI concept, whilst encouraging readers to think
critically about the issues involved.

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Non-Fiction Medicine Medicine in General Public Health & Preventive Medicine Personal & Public Health / Health Education Dietetics & Nutrition Family & Health Fitness & Diet Diets & Dieting, Nutrition

Preface	p. ix
Historical Introduction	p. 1
The Dietary Fibre Hypothesis	p. 1
Early Studies on the Glycaemic Effects of Carbohydrates	p. 2
Studies before 1970	p. 3
Studies after 1970	p. 7
The Inception of the GI	p. 9
The Development of the GI	p. 10
Summary	p. 11
Determining the GI of Foods - Methodological Considerations	p. 12
Definition of the 'Glycaemic Index'	p. 12
Meaning of 'glycaemic index'	p. 12
Suggested protocol for determining the GI of foods	p. 17
Performance of method	p. 18
Effects of Variation in Methods	p. 18
Calculation of AUC	p. 18
Amount of 'available carbohydrate' in the portion tested	p. 20
Method of blood sampling and glucose measurement	p. 22
Type of subjects studied	p. 26
Type of reference food	p. 33
Time of day tests are done	p. 35
Preparation of subjects before the test day	p. 37
Effect of volume and type of drink consumed with the test meal	p. 38
Time to consume test meal	p. 41
Conclusions	p. 41
The Insulin Response to Carbohydrate Foods: Critical Evaluation of the Insulinaemic Index	p. 43
Insulin Sensitivity	p. 43
Use of the term 'insulin sensitivity'	p. 44
Measurement of insulin sensitivity	p. 45
Clinical utility of insulin sensitivity	p. 47
Are High Postprandial Insulin Responses Harmful?	p. 49
Hyperinsulinaemia and cardiovascular disease	p. 49
Hyperinsulinaemia and type 2 diabetes	p. 50
Hyperinsulinaemia and obesity	p. 51
Determinants of Postprandial Insulin Responses	p. 51
Dietary protein and acute insulin responses	p. 51
Dietary fat and acute insulin responses	p. 52
Dietary carbohydrate and insulin responses	p. 52
Dietary sucrose and fructose and insulin responses	p. 54
Relationship between glucose and insulin responses of foods	p. 56
Plasma Insulin Responses of Mixed Meals and Whole Diets	p. 59
Relevance of GI to Insulin Sensitivity and Related Outcomes	p. 60
Variation of Plasma Glucose and Insulin	p. 61
Cost of Measuring Glucose and Insulin	p. 61
Clinical Utility of II	p. 62
Conclusions	p. 63
Mechanisms by which Different Carbohydrates Elicit Different Glycaemic Responses	p. 64
The Monosaccharides Absorbed	p. 64
Glucose, fructose and galactose	p. 64
Polyols	p. 65
The Amount of Carbohydrate Metabolized	p. 66
The amount of carbohydrate consumed	p. 66
The proportion of carbohydrate absorbed	p. 69
Rate of Carbohydrate Absorption	p. 73
Addition of viscous fibre	p. 74
Rate of starch digestion in vitro	p. 74
Enzyme inhibitors	p. 75
Reducing the rate of carbohydrate consumption	p. 75
Studies using stable isotopes	p. 76
The euglycaemic hyperinsulinaemic clamp	p. 76
Is Carbohydrate Malabsorption the Mechanism for Low-GI Foods?	p. 78
Relation between RS measured in vitro and GI	p. 78
Quantification of carbohydrate malabsorption in humans in vivo	p. 79
Conclusions	p. 82
Glycaemic Index: Application to Mixed Meals	p. 83
Effect of Mixing Carbohydrate Foods on Glycaemic Responses	p. 83
Effects of Fat on Glycaemic Responses	p. 86
Effects of fat added to fixed amount of carbohydrate	p. 86
Mechanism for the effect of fat on glycaemic responses	p. 88
Isocaloric substitution of fat and carbohydrate	p. 90
Effects of Protein on Glycaemic Responses	p. 91
Effects of Combination of Fat and Protein on Glycaemic Responses	p. 94
Studies in normal subjects	p. 94
Studies in subjects with diabetes	p. 94
Interaction of GI with added protein and/or fat	p. 95
Calculation of Meal or Diet GI	p. 97
Different Meals with the Same Nutrient Composition	p. 100
What criteria should be used to determine whether the GI has utility?	p. 101
Studies concluding against the utility of the GI	p. 102
Statistical power	p. 105
Qualitative approach to prediction	p. 107
Quantitative approach to prediction	p. 111
Different Meals with Different Nutrient Composition	p. 112
Effect of Low-GI Diet on 24-hour Glucose Profile	p. 115
Conclusions	p. 115
Measuring Diet GI	p. 116
Assessing Available Carbohydrate Intake	p. 116
Direct observations	p. 116
Food records or recalls	p. 117
Food frequency questionnaires	p. 117
Assigning GI Values to Foods	p. 120
Distribution of Diet GI Values in Individuals	p. 123
Assessment of Diet GI by FFQ	p. 124
Population GI values assessed by FFQ	p. 124
Validity of FFQ for assessing diet GI	p. 125
Assessing Diet GI by Food Records	p. 126
Conclusions	p. 127
Glycaemic Index and Health	p. 129
GI and Athletic Performance	p. 129
GI and Cognitive Function	p. 130
GI and Weight Management	p. 131
Pathogenesis of obesity	p. 131
Effect of low-carbohydrate and low-GI diets on body weight	p. 132
Low GI and appetite regulation in adults	p. 138
Low-GI foods and appetite regulation in children	p. 141
GI and reduced fat storage	p. 143
GI and efficiency of energy absorption	p. 144
GI and Pregnancy	p. 145
GI and Miscellaneous Conditions	p. 145
GI and gastrointestinal tract function	p. 145
GI and dental caries	p. 146
Conclusions	p. 146
Glycaemic Index and Disease	p. 147
Diabetes	p. 147
Dietary carbohydrates and prevention of type 1 diabetes	p. 148
Dietary carbohydrates and prevention of type 2 diabetes	p. 148
Effect of diet GI on glycaemic control in diabetes	p. 153
Cardiovascular Disease	p. 154
Pathogenesis of cariovascular disease	p. 155
Effect of GI on risk for cardiovascular disease	p. 157
Effect of GI on cardiovascular disease risk factors	p. 157
Cancer	p. 158
Mechanisms of Action of Low-GI Foods	p. 160
Reduced glucose toxicity	p. 160
Reduced plasma insulin concentration	p. 160
Acute effects on gut hormone secretion	p. 160
Increased colonic fermentation	p. 161
Conclusions	p. 164
Glycaemic Index vs Glycaemic Load	p. 165
Definition of GL	p. 165
Glycaemic Load and Acute Glycaemic Responses	p. 166
Validity of the GL concept	p. 168
Glycaemic glucose equivalent	p. 169
Concluding remarks about GL and GGE	p. 173
Does Low GI Equal Low Carbohydrate Beyond Acute Responses?	p. 173
Evidence from epidemiological studies	p. 174
Evidence from second-meal studies	p. 176
Evidence from dietary intervention studies	p. 178
Clinical Utility of GI vs GL and GGE	p. 181
Conclusions	p. 182
References	p. 184
Index	p. 223
Table of Contents provided by Ingram. All Rights Reserved.

Glycaemic Index

A Physiological Classification of Dietary Carbohydrate

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