http://www.enfermeraspabellonyesterilizacion.cl/eventos/glycemic-index.pdf

International table of glycemic index and glycemic load values: 2002

Obesity adversely affects cardiac function, increases the risk factors for coronary heart disease, and is an independent risk factor for cardiovascular disease. The risk of developing coronary heart disease is directly related to the concomitant burden of obesity-related risk factors. Modest weight loss can improve diastolic function and affect the entire cluster of coronary heart disease risk factors simultaneously. This statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism reviews the relationship between obesity and the cardiovascular system, evaluates the effect of weight loss on coronary heart disease risk factors and coronary heart disease, and provides practical weight management treatment guidelines for cardiovascular healthcare professionals. The data demonstrate that weight loss and physical activity can prevent and treat obesity-related coronary heart disease risk factors and should be considered a primary therapy for obese patients with cardiovascular disease.

/pdf/clinical-implications-of-obesity-with-specific-focus-on-55atg36cly.pdf

Clinical Implications of Obesity With Specific Focus on Cardiovascular Disease A Statement for Professionals From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: Endorsed by the American College of Cardiology Foundation

The glycaemic index (GI) concept was originally introduced to classify different sources of carbohydrate (CHO)-rich foods, usually having an energy content of > 80 % from CHO, to their effect on post-meal glycaemia. It was assumed to apply to foods that primarily deliver available CHO, causing hyperglycaemia. Low-GI foods were classified as being digested and absorbed slowly and high-GI foods as being rapidly digested and absorbed, resulting in different glycaemic responses. Low-GI foods were found to induce benefits on certain risk factors for CVD and diabetes. Accordingly it has been proposed that GI classification of foods and drinks could be useful to help consumers make 'healthy food choices' within specific food groups. Classification of foods according to their impact on blood glucose responses requires a standardised way of measuring such responses. The present review discusses the most relevant methodological considerations and highlights specific recommendations regarding number of subjects, sex, subject status, inclusion and exclusion criteria, pre-test conditions, CHO test dose, blood sampling procedures, sampling times, test randomisation and calculation of glycaemic response area under the curve. All together, these technical recommendations will help to implement or reinforce measurement of GI in laboratories and help to ensure quality of results. Since there is current international interest in alternative ways of expressing glycaemic responses to foods, some of these methods are discussed.

/pdf/glycaemic-index-methodology-1m9owjyg57.pdf

Glycaemic index methodology.

Glycemic index: overview of implications in health and disease : Is the glycemic index important in human nutrition?

Glycemic index, glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women

Recently diabetic patients have been encouraged to increase their carbohydrate intake, but exact details of which foods to use are lacking. To determine whether sufficiently large differences existed to justify more specific dietary advice, we compared the glycaemic responses to 50 g carbohydrate portions of different foods, taken as breakfast test meals by groups of five to seven diabetic patients. Two-to threefold differences were seen amongst the 15 foods tested. The glycaemic responses for spaghetti, ‘All-bran’, rice and beans were significantly below those for bread, while ‘Cornflakes’ were above. Factors predicted to influence this were without effect, including: substituting wholemeal for white bread, increasing substantially the simple sugars (using ‘All-bran’ or bananas instead of wholemeal bread) and doubling meal protein by adding cottage cheese to bread. Paired comparisons of the glycaemic response to the five legumes with those of the seven other starchy foods (breads, spaghetti, rice, Cornflakes, oatmeal porridge and potatoes) showed that the mean peak rise in blood glucose concentration and mean area under the glucose curve after beans were 23 and 28% lower, respectively, than the mean for the other foods (p < 0.001). Such results suggest a potentially valuable role for dried leguminous seeds in carbohydrate exchanges for individuals with impaired carbohydrate tolerance. These large differences in the blood glucose response to different food cannot at present be predicted directly from tables of chemical composition. Nevertheless, physiological testing may both aid in understanding the factors responsible and help selection of the appropriate carbohydrate foods for the diabetic diet.

/pdf/the-glycaemic-index-of-foods-tested-in-diabetic-patients-a-4yavzpli5x.pdf

The glycaemic index of foods tested in diabetic patients: A new basis for carbohydrate exchange favouring the use of legumes

Unexpected plasma glucose responses to different mixed meals fed to normal and diabetic volunteers have recently been reported. We have therefore examined in normal volunteers the effect of mixing carbohydrate foods of different glycemic indices (GIs) without the addition of fat and protein. The observed GI of the mixed meal was within 2% of the expected value. In studies in the literature where fat and protein were added to mixed meals, the observed blood glucose responses also related significantly to the meal GIs calculated from the individual foods. Addition of fat and protein in the quantities used did not obscure this relationship. Studies to determine sources of error in comparing glycemic responses showed that type II diabetic patients displayed the least within-individual variation, and type I diabetic patients the most. Expression of results as the GI rather than as absolute glycemic response areas reduced by 50% the between-subject variation. The mean GI values of rice tested in type I and type II patients were similar (82 +/- 22 compared with 74 +/- 19) and the reproducibility 22 mo later in the same group of subjects was excellent (81 +/- 15 compared with 83 +/- 15). However, the lack of precise GI values for all foods fed in the test meals indicates a need for GI values to be derived for a wider range of individual foodstuffs. The GI approach to classifying foods according to physiologic effect may play a useful role in planning meals and diets in which specific blood glucose profiles are required.

Prediction of the Relative Blood Glucose Response of Mixed Meals Using the White Bread Glycemic Index

The blood glucose response to feeding 50-g carbohydrate portions of white and wholemeal bread and white spaghetti was studied in a group of nine diabetic subjects. Blood glucose rises after white and wholemeal bread were identical, but the response after spaghetti was markedly reduced. These results emphasize that food form rather than fiber may be important in determining the glycemic response and that pasta may be a useful source of carbohydrate in the diabetic diet.

Randolph Lee

Papers

The glycaemic index of foods tested in diabetic patients: A new basis for carbohydrate exchange favouring the use of legumes

Prediction of the Relative Blood Glucose Response of Mixed Meals Using the White Bread Glycemic Index

Glycemic Response to Wheat Products: Reduced Response to Pasta but No Effect of Fiber

Metabolic response to test meals containing different carbohydrate foods: 1. Relationship between rate of digestion and plasma insulin response