Article

Glycemic Index and Glycemic Load of Carbohydrates in the Diabetes Diet

Northside Nutrition & Dietetics, 74/47 Neridah Street, Chatswood, NSW, 2067, Australia.
Current Diabetes Reports (Impact Factor: 3.08). 04/2011; 11(2):120-7. DOI: 10.1007/s11892-010-0173-8
Source: PubMed

ABSTRACT

Medical nutrition therapy is the first line of treatment for the prevention and management of type 2 diabetes and plays an essential part in the management of type 1 diabetes. Although traditionally advice was focused on carbohydrate quantification, it is now clear that both the amount and type of carbohydrate are important in predicting an individual's glycemic response to a meal. Diets based on carbohydrate foods that are more slowly digested, absorbed, and metabolized (i.e., low glycemic index [GI] diets) have been associated with a reduced risk of type 2 diabetes and cardiovascular disease, whereas intervention studies have shown improvements in insulin sensitivity and glycated hemoglobin concentrations in people with diabetes following a low GI diet. Research also suggests that low GI diets may assist with weight management through effects on satiety and fuel partitioning. These findings, together with the fact that there are no demonstrated negative effects of a low GI diet, suggest that the GI should be an important consideration in the dietary management and prevention of diabetes.

    • "Simple sugars, oligosaccharides and dextrins are glycaemic and the starch in cereal foods is predominantly glycaemic. However, the extent to which the starch is available to digestion in cereal grains and foods is dependent on many intrinsic and extrinsic factors[9,10]. An area of great current interest is to modulate (limit) the availability of the energy supplying macronutrients in cereal foods to digestion and availability, in particular the starch[9,11]. "
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    ABSTRACT: One cause of obesity and related diseases like type-2 diabetes is overconsumption of cereal foods with readily available carbohydrates, resulting in hyperglycaemia and ultimately insulin resistance. A strategy to combat this is to modulate glycaemic response through starchy cereal foods that have low glycaemic index (GI) because their starch is less available to digestion. In cereals, many factors can limit accessibility of amylase to the starch. Of these, intact pieces of endosperm, high levels of oat or barley β-glucan and high amylose starch are probably the most important. Starch accessibility in cereal foods is also greatly affected by processing. Heat-moisture thermal processing at low moisture above glass transition temperature, but below gelatinization temperature is probably the most effective processing technology to reduce starch availability. Formation of starch-lipid complexes also appears promising. Whole grain (milled whole kernel) cereal foods are intrinsically low GI but may have a long-term role in preventing obesity and type 2 diabetes through their phytochemicals, particularly polyphenols. A novel approach is to structure starchy cereal foods to deliver their carbohydrate at the distal end of the gastrointestinal tract to trigger the ileal and colonic brakes feedback systems so as to enhance satiety and hence decrease energy intake.
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    • "Type II DM is usually influenced by environmental and genetic factors 1. Within environmental factors, diet is also important for pathogenesis of DM and glycemic diet will exacerbate the glucose control 2. Besides, there are several studies showing the connection between fat composition of diet and serum glucose in DM. "
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    ABSTRACT: Objective: This is an Asian study, which was designed to examine the correlations between biochemical data and food composition of diabetic patients in Taiwan. Methods: One hundred and seventy Taiwanese diabetic patients were enrolled. The correlations between biochemical data and diet composition (from 24-hour recall of intake food) of these patients were explored (Spearman correlation, p < 0.05). Diet components were also correlated with each other to show diet characteristics of diabetic patients in Taiwan. Linear regression was also performed for the significantly correlated groups to estimate possible impacts from diet composition to biochemical data. Results: Postprandial serum glucose level was negatively correlated with fat percentage of diet, intake amount of polyunsaturated fatty acid and fiber diet composition. Hemoglobin A1c was negatively correlated with fat diet, polyunsaturated fatty acid and vegetable diet. Fat composition, calorie percentage accounted by polyunsaturated fatty acid and monounsaturated fatty acid in diet seemed to be negatively correlated with sugar percentage of diet and positively correlated with vegetable and fiber composition of diet. Linear regression showed that intake amount of polyunsaturated fatty acid, calorie percentage accounted by polyunsaturated fatty acid, fat percentage of diet, vegetable composition of diet would predict lower hemoglobin A1c and postprandial blood sugar. Besides, higher percentage of fat diet composition could predict higher percentage of vegetable diet composition in Taiwanese diabetic patients. Conclusion: Fat diet might not elevate serum glucose. Vegetable diet and polyunsaturated fatty acid diet composition might be correlated with better sugar control in Taiwanese diabetic patients.
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