Re: Glycaemic Index, Glycaemic Load and Dysglycaemia

[Guest guest]

,

If you want negative reviews, I recommend this rebuttal of the GI/GL

by Beals PhD, RD, representing the US Potato industry.

Take into account the interests of the industry if you read this, but

the review is well worth reading and is fully referenced. I like it a

lot.

http://healthypotato.com/downloads/GlycemicIndex-WhitePaper.pdf

I also recommend the diabetes site of Mendosa, who has much

interesting history, background and snippets, including lists of GI

and GL. It is a bit dated now, but it is a nice summary -- and

definitely a pro-GI site.

http://www.mendosa.com/gi.htm

http://www.mendosa.com/gilists.htm

If you like to look through PubMed or Medline, look for Brand-,

Wolever, and Willett (combined with GI or GL) and you will

pick up much of interest. You are probably familiar with these names

already.

Gympie, Australia

>

> Happy new year to all members of the forum,

>

Firstly thanks for all the fantastic posts over the last year, it's

difficult for me to keep at at times with the vast amount of

information that it is possible to obtain from these posts, and I am

very grateful. I have a presentation to do shortly on Dysglycaemia,

Glycaemic Index and Glycaemic Load. I'd like to gather as much

information on the subject as possible, no matter how obscure and was

wondering if any of you perhaps may have links to some information I

may not have come across as of yet.

>

> I'd be most thankful for any help, especially with regard to

negative views on GI and GL.

> Thanks for your time.

>

> Mc Cambridge

> Nuffield Hospitals Health Physiologist

> London, UK.

>

[Guest guest]

The American Diabetes Association just updated their

Guidelines for nutritional treatment of Diabetes

Below is a summary concerning glycemic index and load.

You may want to read the full text. I do no have

that available.

**********************************************************

ADA Updates Guidelines for Medical Nutrition Therapy

Intake of low-glycemic index foods that are rich in

fiber and other vital nutrients should be encouraged

(E), both for the general population and for those

with diabetes

A key strategy for achieving glycemic control is to

monitor carbohydrate by counting, exchanges, or

experienced-based estimation (A). Use of glycemic

index and load may be modestly beneficial vs

considering only total carbohydrate (.

**********************************

Ralph Giarnella MD

Southington Ct USA

>

>

> >

> > Happy new year to all members of the forum,

> >

>

> Firstly thanks for all the fantastic posts over the

> last year, it's

> difficult for me to keep at at times with the vast

> amount of

> information that it is possible to obtain from

> these posts, and I am

> very grateful. I have a presentation to do shortly

> on Dysglycaemia,

> Glycaemic Index and Glycaemic Load. I'd like to

> gather as much

> information on the subject as possible, no matter

> how obscure and was

> wondering if any of you perhaps may have links to

> some information I

> may not have come across as of yet.

> >

> > I'd be most thankful for any help, especially

> with regard to

> negative views on GI and GL.

> > Thanks for your time.

> >

> > Mc Cambridge

> > Nuffield Hospitals Health Physiologist

> > London, UK.

> >

>

>

>

[Guest guest]

There was a series of postings on this forum within

the past year on this very topic. You may wish to

research the archives. There were many pro and con

opinions.

I first learned of the glycemic index some 20+ years

ago and my initial impression was that it was a great

concept. Within the past 10 years I had heard

discussions concerning the glycemic load and thought

that was an even better approach.

While the concept makes a lot of sense, the practical

application in every day treatment of diabetics is

somewhat cumbersome and difficult to utilize.

One of the problems with the glycemic index is that

the glycemic index of a specific food may vary based

on the way it is utilized, prepared or cooked.

Different lists will give a different glycemic index

for the same food.

The glycemic load would seem to make more sense than

the glycemic index since it takes into account the

amount of food an individual is consuming.

Both suffer from the fact that individual foods are

more often consumed as part of a meal and not

individually.

For instance if you eat two slices of bread and

nothing else there is a fixed glycemic index. However

the glycemic load of two slices is twice the glycemic

load of one slice of bread.

If you add to those two slices of bread some ham,

cheese lettuce, tomatoes and mayonnaise the glycemic

load remains virtually the same (glycemic load of

tomatoes and lettuce are negligible) wheareas the

glycemic index of he ham and cheese sandwich is much

lower than the glycemic index of the two slices of

bread.

The glycemic index and load do not take into account

the variability in gastric emptying between patients.

The rise in blood sugar after a meal is very dependent

on the rapidity with which leaves the stomach and

enters the small intestine. This varies from patient

to patient. The amount of fiber, fat and protein in a

meal will also affect the gastric emptying time.

While glycemic load and index make for great

discussions amongst academics, dietitians and

nutritionists. However when it comes to treating real

live patients with limited nutritional knowledge it is

very cumbersome and in my opinion of very little

practical use.

I have hundreds of well controlled diabetics ( HgbA1c

in the 6-7 or less range) in my practice and rarely if

ever discuss the glycemic index or load unless the

patient brings up the topic.

I have personally studied the glycemic index and load

for my own benefit but find it of very little use when

it comes to patient nutritional education.

I have attended many conferences and educational

sessions on diabetes given by diabetologists and have

rarely heard them discuss the glycemic index or load

as practical tool in the treatment of diabetes.

Ralph Giarnella MD

Southington Ct USA

> >

> >

> > >

> > > Happy new year to all members of the forum,

> > >

>

> >

> > Firstly thanks for all the fantastic posts over

> the

> > last year, it's

> > difficult for me to keep at at times with the vast

> > amount of

> > information that it is possible to obtain from

> > these posts, and I am

> > very grateful. I have a presentation to do

> shortly

> > on Dysglycaemia,

> > Glycaemic Index and Glycaemic Load. I'd like to

> > gather as much

> > information on the subject as possible, no matter

> > how obscure and was

> > wondering if any of you perhaps may have links to

> > some information I

> > may not have come across as of yet.

> > >

> > > I'd be most thankful for any help, especially

> > with regard to

> > negative views on GI and GL.

> > > Thanks for your time.

> > >

> > > Mc Cambridge

> > > Nuffield Hospitals Health Physiologist

> > > London, UK.

> > >

> >

> >

> >

>

>

[Guest guest]

>

>>>Happy new year to all members of the forum,

Firstly thanks for all the fantastic posts over the last year, it's

difficult for me to keep at at times with the vast amount of

information that it is possible to obtain from these posts, and I am

very grateful. I have a presentation to do shortly on Dysglycaemia,

Glycaemic Index and Glycaemic Load. I'd like to gather as much

information on the subject as possible, no matter how obscure and was

wondering if any of you perhaps may have links to some information I

may not have come across as of yet.>>>

***

What type of audience will you be presenting to?

-lay audience

-peers

-educated

-specialist

-combination

How long is the presentation?

The below may be useful:

International table of glycemic index and glycemic load values:

20021,2

Kaye -, na HA Holt, and Janette C Brand-

Am J Clin Nutr 2002;76:5–56.

ABSTRACT Reliable tables of glycemic index (GI) compiled

from the scientific literature are instrumental in improving

the quality of research examining the relation between GI,

glycemic load, and health. The GI has proven to be a more useful

nutritional concept than is the chemical classification of

carbohydrate (as simple or complex, as sugars or starches, or as

available or unavailable), permitting new insights into the relation

between the physiologic effects of carbohydrate-rich foods

and health. Several prospective observational studies have shown

that the chronic consumption of a diet with a high glycemic load

(GI dietary carbohydrate content) is independently associated

with an increased risk of developing type 2 diabetes, cardiovascular

disease, and certain cancers. This revised table contains

almost 3 times the number of foods listed in the original table

(first published in this Journal in 1995) and contains nearly 1300

data entries derived from published and unpublished verified

sources, representing > 750 different types of foods tested with

the use of standard methods. The revised table also lists the

glycemic load associated with the consumption of specified

serving sizes of different foods....

WHY DO GI VALUES FOR THE SAME TYPES OF FOODS

SOMETIMES VARY?

Many people have raised concerns about the variation in published

GI values for apparently similar foods. This variation may

reflect both methodologic factors and true differences in the

physical and chemical characteristics of the foods. One possibility

is that 2 similar foods may have different ingredients or may

have been processed with a different method, resulting in significant

differences in the rate of carbohydrate digestion and hence

the GI value. Two different brands of the same type of food, such

as a plain cookie, may look and taste almost the same, but differences

in the type of flour used, in the moisture content, and in

the cooking time can result in differences in the degree of starch

gelatinization and consequently the GI values. In addition, it

must be remembered that the GI values listed in the table for

commercially available processed foods may change over time if

food manufacturers make changes in the ingredients or processing

methods used.

Another reason GI values for apparently similar foods vary is

that different testing methods are used in different parts of the

world.

=========

New dietary guidelines for diabetes from the American Diabetes Association

2002 British Nutrition Foundation Nutrition Bulletin, 27, 93–96

Sarbjit Kunar

Glycaemic index

The glycaemic index (GI), which refers to the blood glucose-raising potential of

individual carbohydrates or foods, is a concept that has been around for 20

years. However, its value in preventing and managing disease is still hotly

debated. While accepting that low GI diets might reduce postprandial glycaemia,

the ADA review found that the ability of individuals to maintain these diets in

the long term has not been established. Studies lasting 6–12 weeks in people

with type 1 and type 2 diabetes have shown no consistent improvements in insulin

or other markers of blood glucose control. Moreover, the numbers of studies are

limited, with study design and implementation subject to criticism. It is

therefore recommended that ‘there is not sufficient evidence of long-term

benefit to recommend use of low GI diets as a primary strategy in food/meal

planning’ (B-level evidence).

-------------

http://www.glycemicindex.com/

=================

Carruthers

Wakefield, UK