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• December 2008 - Glycemic Index and Glycemic Load: A Review

  Should Glycemic Index and Glycemic Load be Considered in Dietary Recommendations?

  Hare-Bruun H, Nielson BM, Grau K, Oxlund AL, Heitmann BL.
  Research Unit for Dietary Studies, Institute of Preventive Medicine, Copenhagen University Hospital, Centre for Health and Society, DK 1357 Copenhagen K, Denmark.
  Nutrition Reviews. 2008 Oct; 66(10):569-90.

  High glycemic index (GI) and glycemic load (GL) have been proposed to be associated with increased risk of lifestyle diseases. Since protein intake varies little in humans, adherence to the common recommendation to reduce fat intake probably leads to increases in carbohydrate intake, which emphasizes the need to investigate the effects of carbohydrate on diet-related conditions and diseases.

  This review examines the epidemiological literature linking GI and GL to heart disease, insulin sensitivity, type 2 diabetes, dyslipidemia, and obesity among initially healthy people. The evidence for associations between GI and particularly GL and health among free-living populations is mixed. Only the positive association between GI and development of type 2 diabetes was consistent across cross-sectional and longitudinal studies for both sexes. Low GI/GL may protect against heart disease in women, and cross-sectional studies indicate low GI/GL may reduce high-density-lipoprotein cholesterol and triacylglycerol levels in both sexes.

  Based on the evidence found in this review, it seems premature to include GI/GL in dietary recommendations

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• October 2008 - New Resources: Glycemic Index; A Taste of Sugar

  New Resources 2008

  The Canadian Sugar Institute (CSI) Nutrition Information Service is pleased to provide you with the latest edition of our annual health professional publication, Carbohydrate News, as well as the first edition of our new recipe collection, now called A Taste of Sugar

  • Carbohydrate News – The Glycemic Index: Clinical and Public Health Significance (PDF Format)
  • A Taste of Sugar - Desserts (PDF Format)

  This edition of Carbohydrate News features an article by Dr. Harvey Anderson on the practical limitations of the Glycemic Index, as well as a summary of “useful” and “less useful” carbohydrate terms based on an article by Dr. Alison Stephen.

  The Desserts edition of A Taste of Sugar is the first instalment of our new recipe collection featuring two delectable dessert recipes, nutrition-based content, and information on the functional roles of sugar in foods. Enjoy!

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• August 2008 - Sweetened Beverages and BMI in Children and Adolescents: a Meta-Analysis

  Sweetened Beverages and BMI in Children and Adolescents: a Meta-Analysis

  Sugar-sweetened Beverages and Body Mass Index in Children and Adolescents: a Meta-analysis.

  Forshee RA, Anderson PA, Storey ML.

  Center for Food, Nutrition, and Agriculture Policy, University of Maryland, College Park, MD, USA. Am J Clin Nutr. 2008 Jun;87(6):1662-71.

  BACKGROUND: Rates of overweight and obesity have increased. Consumption of sugar-sweetened beverages (SBs) may play a role.

  OBJECTIVE: The purpose of this meta-analysis was to determine whether the results of original research with the use of longitudinal and randomized controlled trials (RCTs) support the hypothesis that SB consumption is associated with weight gain among children and adolescents.

  DESIGN: The MEDLINE database was used to retrieve all original studies of SBs and weight gain involving children and adolescents. Twelve (10 longitudinal and 2 RCT) studies were reviewed. Eight of the longitudinal studies and both RCT studies were incorporated into a quantitative meta-analysis. Forest plots and overall estimates and CIs for the association of the difference (Delta) in SB consumption with Deltabody mass index (BMI; in kg/m(2)) were produced. Funnel plots were examined as a diagnostic test for publication bias. Databases of unpublished scientific studies were searched. Sensitivity tests were conducted to examine the robustness of the meta-analysis results.

  RESULTS: The overall estimate of the association was a 0.004 (95% CI: -0.006, 0.014) change in BMI during the time period defined by the study for each serving per day change in SB consumption with the fixed-effects model and 0.017 (95% CI: -0.009, 0.044) with the random-effects model. The funnel plot is consistent with publication bias against studies that do not report statistically significant findings. The sensitivity tests suggest that the results are robust to alternative assumptions and new studies.

  CONCLUSION: The quantitative meta-analysis and qualitative review found that the association between SB consumption and BMI was near zero, based on the current body of scientific evidence.

   

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• June 2008 - Sucrose and Behaviour: A Scientific Review

  Sucrose and Behavioural Problems

  Benton D.
  Department of Psychology, University of Wales Swansea, Swansea, United Kingdom.
  Crit Rev Food Sci Nutr. 2008 May;48(5):385-401.

  Various mechanisms by which sucrose could influence behavior are reviewed. Firstly there is food intolerance. There are dozens of foods to which an adverse reaction has been demonstrated, although a reaction to sucrose is less frequent than many other foods. A second possible mechanism is hypoglycemia. There is evidence that a tendency to develop low blood glucose levels, but higher than those that can be described clinically as hypoglycemic, is associated with irritability and violence. However, sucrose is not the predominant cause of swings in blood glucose levels. Thirdly, the role of sucrose intake on micro-nutrient status has been considered as studies have found that micro-nutrient supplementation decreased anti-social behavior. Micro-nutrient intake is more closely associated with the total energy rather than sucrose intake; typically the amount of sucrose in the diet does not lead to micro-nutrient deficiency. In fact meta-analysis of well designed studies that have examined the impact of sucrose on the behavior of children produced no evidence that it has an adverse influence.

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• April 2008 - Carbohydrate Terminology and Classification

  Carbohydrate Terminology and Classification

  Cummings JH, Stephen AM.
  Division of Pathology and Neuroscience, Ninewells Hospital and Medical School, Dundee, UK. j.h.cummings@dundee.ac.uk
  Eur J Clin Nutr. 2007 Dec;61 Suppl 1:S5-18.

  Dietary carbohydrates are a group of chemically defined substances with a range of physical and physiological properties and health benefits. As with other macronutrients, the primary classification of dietary carbohydrate is based on chemistry, that is character of individual monomers, degree of polymerization (DP) and type of linkage (alpha or beta), as agreed at the Food and Agriculture Organization/World Health Organization Expert Consultation in 1997. This divides carbohydrates into three main groups, sugars (DP 1-2), oligosaccharides (short-chain carbohydrates) (DP 3-9) and polysaccharides (DP> or =10). Within this classification, a number of terms are used such as mono- and disaccharides, polyols, oligosaccharides, starch, modified starch, non-starch polysaccharides, total carbohydrate, sugars, etc.

  While effects of carbohydrates are ultimately related to their primary chemistry, they are modified by their physical properties. These include water solubility, hydration, gel formation, crystalline state, association with other molecules such as protein, lipid and divalent cations and aggregation into complex structures in cell walls and other specialized plant tissues.

  A classification based on chemistry is essential for a system of measurement, predication of properties and estimation of intakes, but does not allow a simple translation into nutritional effects since each class of carbohydrate has overlapping physiological properties and effects on health. This dichotomy has led to the use of a number of terms to describe carbohydrate in foods, for example intrinsic and extrinsic sugars, prebiotic, resistant starch, dietary fibre, available and unavailable carbohydrate, complex carbohydrate, glycaemic and whole grain.

  This paper reviews these terms and suggests that some are more useful than others. A clearer understanding of what is meant by any particular word used to describe carbohydrate is essential to progress in translating the growing knowledge of the physiological properties of carbohydrate into public health messages.

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• February 2008 - Effects of Sucrose and Glucose/Fructose Beverages on Satiety and Food Intake.

  Effects of Glucose-to-Fructose Ratios in Solutions on Subjective Satiety, Food Intake, and Satiety Hormones in Young Men.

  Akhavan T, Anderson GH.
  Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
  Am J Clin Nutr. 2007 Nov;86(5):1354-63.

  BACKGROUND: The greater prevalence of obesity and the metabolic syndrome in the past 35 y has been attributed to the replacement of sucrose in the food supply with high-fructose corn syrup (HFCS).

  OBJECTIVE: Two experiments were conducted to determine the effect of solutions containing sucrose, HFCS, or various ratios of glucose to fructose (G:F) on food intake (FI), average appetite (AA), blood glucose (BG), plasma insulin, ghrelin, and uric acid (UA) in men.

  DESIGN: Sugar solutions (300 kcal/300 mL) were (in %) G20:F80, HFCS 55 (G45:F55), sucrose, and G80:F20 (experiment 1, n = 12) and G20:F80, G35:F65, G50:F50, sucrose, and G80:F20 (experiment 2, n = 19). The controls were a sweet energy-free control (experiment 1) and water (both experiments). Solutions were provided in a repeated-measures design. AA, BG, and FI were measured in all subjects. Hormonal responses and UA were measured in 7 subjects in experiment 2. Measurements were taken from baseline to 75 min. FI was measured at 80 min.

  RESULTS: Sucrose and HFCS (experiment 1) and sucrose and G50:F50 (experiment 2) had similar effects on all dependent measures. All sugar solutions similarly reduced the AA area under the curve (AUC). FI and plasma UA concentrations were significantly (P < 0.05) lower after high-glucose solutions than after low-glucose solutions. The lower FI was associated with a greater BG AUC (P < 0.05) and smaller AA and ghrelin AUCs (P < 0.01). Insulin and BG AUCs were positively associated (P < 0.001).

  CONCLUSION: Sucrose, HFCS, and G50:F50 solutions do not differ significantly in their short-term effects on subjective and physiologic measures of satiety, UA, and FI at a subsequent meal.

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