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July 2002
Glycemic index: overview of implications
in health and disease
ABSTRACT
Glycemic index: overview of implications
in health and disease
American Journal of Clinical Nutrition, July 2002; 76(1):
266S-273S.
Jenkins DJA, Kendall CWC, Augustin LSA, Franceschi S, Hamidi M,
Marchie A, Jenkins AL, Axelsen M
Clinical Nutrition and Risk Factor Modification Centre, St.
Michael's Hospital and Department of Nutritional Sciences, Faculty
of Medicine, University of Toronto, Toronto, Canada; Field and Intervention
Studies Unit, International Agency for Research on Cancer, Lyon,
France; Lundberg Laboratory for Diabetes Research, Department of
Internal Medicine, Sahlgrenska University Hospital, Goteborg, Sweden
The glycemic index concept is an extension of the fiber hypothesis,
suggesting that fiber consumption reduces the rate of nutrient influx
from the gut. The glycemic index has particular relevance to those
chronic Western diseases associated with central obesity and insulin
resistance.
Early studies showed that starchy carbohydrate foods have very
different effects on postprandial blood glucose and insulin responses
in healthy and diabetic subjects, depending on the rate of digestion.
A range of factors associated with food consumption was later shown
to alter the rate of glucose absorption and subsequent glycemia
and insulinemia. At this stage, systematic documentation of the
differences that exist among carbohydrate foods was considered essential.
The resulting glycemic index classification of foods provided a
numeric physiologic classification of relevant carbohydrate foods
in the prevention and treatment of diseases such as diabetes.
Since then, low-glycemic-index diets have been shown to lower urinary
C-peptide excretion in healthy subjects, improve glycemic control
in diabetic subjects, and reduce serum lipids in hyperlipidemic
subjects. Furthermore, consumption of low-glycemic index diets has
been associated with higher HDL-cholesterol concentrations and,
in large cohort studies, with decreased risk of developing diabetes
and cardiovascular disease. Case-control studies have also shown
positive associations between dietary glycemic index and the risk
of colon and breast cancers. Despite inconsistencies in the data,
sufficient, positive findings have emerged to suggest that the dietary
glycemic index is of potential importance in the treatment and prevention
of chronic diseases.
Link
to abstract
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