OBJECTIVE -To systematically tabulate published and unpublished sources of reliable glycemic index (GI) values. Unpublished data were also included where the data quality could be verified. The data were separated into two lists: the first representing more precise data derived from testing healthy subjects and the second primarily from individuals with impaired glucose metabolism. RESULTS -The tables, which are available in the online-only appendix, list the GI of over 2,480 individual food items. Dairy products, legumes, and fruits were found to have a low GI. Breads, breakfast cereals, and rice, including whole grain, were available in both high and low GI versions. The correlation coefficient for 20 staple foods tested in both healthy and diabetic subjects was r ϭ 0.94 (P Ͻ 0.001). RESEARCH DESIGN AND METHODSCONCLUSIONS -These tables improve the quality and quantity of GI data available for research and clinical practice.

OBJECTIVE -The use of diets with low glycemic index (GI) in the management of diabetes is controversial, with contrasting recommendations around the world. We performed a metaanalysis of randomized controlled trials to determine whether low-GI diets, compared with conventional or high-GI diets, improved overall glycemic control in individuals with diabetes, as assessed by reduced HbA 1c or fructosamine levels.RESEARCH DESIGN AND METHODS -Literature searches identified 14 studies, comprising 356 subjects, that met strict inclusion criteria. All were randomized crossover or parallel experimental design of 12 days' to 12 months' duration (mean 10 weeks) with modification of at least two meals per day. Only 10 studies documented differences in postprandial glycemia on the two types of diet.RESULTS -Low-GI diets reduced HbA 1c by 0.43% points (CI 0.72-0.13) over and above that produced by high-GI diets. Taking both HbA 1c and fructosamine data together and adjusting for baseline differences, glycated proteins were reduced 7.4% (8.8 -6.0) more on the low-GI diet than on the high-GI diet. This result was stable and changed little if the data were unadjusted for baseline levels or excluded studies of short duration. Systematically taking out each study from the meta-analysis did not change the CIs.CONCLUSIONS -Choosing low-GI foods in place of conventional or high-GI foods has a small but clinically useful effect on medium-term glycemic control in patients with diabetes. The incremental benefit is similar to that offered by pharmacological agents that also target postprandial hyperglycemia. Diabetes Care 26:2261-2267, 2003A long with obesity, prevalence of diabetes is increasing in all parts of the world. With it comes an urgent need to identify the most cost-effective strategies of management. The benefits of improving glycemic, blood pressure, and lipid control on risk of complications are now confirmed (1,2). Whereas pharmacological therapies are clearly effective, the diabetes prevention trials in Finland and the U.S. remind us that nutrition and lifestyle approaches can be more effective in delaying onset of the disease (3,4). For those already diagnosed, however, the optimal diet remains controversial, particularly with regard to the glycemic index (GI) of foods (5).Current dietary recommendations emphasize the quantity rather than the quality of carbohydrate, despite the fact that carbohydrate source and nature profoundly influence postprandial glycemia (6,7). Research on GI indicates that even when foods contain the same amount of carbohydrate (i.e., carbohydrate exchanges), there are up to fivefold differences in glycemic impact (8). In addition, several prospective observational studies have found that the overall GI and glycemic load (GI ϫ g carbohydrate) of the diet, but not total carbohydrate content, are independently related to the risk of developing type 2 diabetes (9,10), cardiovascular disease (11), and some cancers (12,13). However, not all studies are in agreement, and further research is needed (14)...

Given the high prevalence of diabetes and pre-diabetes worldwide and the consistency of the scientific evidence reviewed, the expert panel confirmed an urgent need to communicate information on GI and GL to the general public and health professionals, through channels such as national dietary guidelines, food composition tables and food labels.

BACKGROUNDContinuous glucose monitoring highlights the complexity of postprandial glucose patterns present in type 1 diabetes and points to the limitations of current approaches to mealtime insulin dosing based primarily on carbohydrate counting. METHODSA systematic review of all relevant biomedical databases, including MEDLINE, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials, was conducted to identify research on the effects of dietary fat, protein, and glycemic index (GI) on acute postprandial glucose control in type 1 diabetes and prandial insulin dosing strategies for these dietary factors. RESULTSAll studies examining the effect of fat (n = 7), protein (n = 7), and GI (n = 7) indicated that these dietary factors modify postprandial glycemia. Late postprandial hyperglycemia was the predominant effect of dietary fat; however, in some studies, glucose concentrations were reduced in the first 2-3 h, possibly due to delayed gastric emptying. Ten studies examining insulin bolus dose and delivery patterns required for high-fat and/or high-protein meals were identified. Because of methodological differences and limitations in experimental design, study findings were inconsistent regarding optimal bolus delivery pattern; however, the studies indicated that high-fat/protein meals require more insulin than lower-fat/protein meals with identical carbohydrate content. CONCLUSIONSThese studies have important implications for clinical practice and patient education and point to the need for research focused on the development of new insulin dosing algorithms based on meal composition rather than on carbohydrate content alone.

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Sialic acids are a family of nine-carbon acidic monosaccharides that occur naturally at the end of sugar chains attached to the surfaces of cells and soluble proteins. In the human body, the highest concentration of sialic acid (as N-acetylneuraminic acid) occurs in the brain where it participates as an integral part of ganglioside structure in synaptogenesis and neural transmission. Human milk also contains a high concentration of sialic acid attached to the terminal end of free oligosaccharides, but its metabolic fate and biological role are currently unknown. An important question is whether the sialic acid in human milk is a conditional nutrient and confers developmental advantages on breast-fed infants compared to those fed infant formula. In this review, we critically discuss the current state of knowledge of the biology and role of sialic acid in human milk and nervous tissue, and the link between sialic acid, breastfeeding and learning behaviour.

Background: Consumption of 3 g oat b-glucan/d is considered sufficient to lower serum LDL cholesterol, but some studies have shown no effect. LDL cholesterol lowering by oat b-glucan may depend on viscosity, which is controlled by the molecular weight (MW) and amount of oat b-glucan solubilized in the intestine (C). Objectives: Our 2 primary objectives were to determine whether consumption of 3 g high-MW oat b-glucan/d would reduce LDL cholesterol and whether LDL cholesterol lowering was related to the log(MW · C) of oat b-glucan. Design: In a double-blind, parallel-design, multicenter clinical trial, subjects with LDL cholesterol 3.0 and 5.0 mmol/L (n = 786 screened, n = 400 ineligible, n = 19 refused, n = 367 enrolled, and n = 345 completed) were randomly assigned to receive cereal containing wheat fiber (n = 87) or 3 g high-MW (2,210,000 g/mol, n = 86), 4 g medium-MW (850,000 g/mol, n = 67), 3 g medium-MW (530,000 g/mol, n = 64), or 4 g low-MW (210,000 g/mol, n = 63) oat b-glucan/d (divided doses, twice daily) for 4 wk. Results: LDL cholesterol was significantly less with 3 g high-MW, 4 g medium-MW, and 3 g medium-MW oat b-glucan cereals than with the wheat-fiber cereal by 0.21 (5.5%; 95% CI: 20.11, 20.30; P = 0.002), 0.26 (6.5%; 95% CI: 20.14, 20.37; P = 0.0007), and 0.19 (4.7%; 95% CI: 20.08, 20.30; P = 0.01) mmol/L, respectively. However, the effect of 4 g low-MW oat b-glucan/d (0.10 mmol/L) was not significant (2.3%; 95% CI: 0.02, 20.20). By analysis of covariance, log(MW · C) was a significant determinant of LDL cholesterol (P = 0.003). Treatment effects were not significantly influenced by age, sex, study center, or baseline LDL cholesterol. Conclusions: The physicochemical properties of oat b-glucan should be considered when assessing the cholesterol-lowering ability of oat-containing products; an extruded breakfast cereal containing 3 g oat b-glucan/d with a high-MW (2,210,000 g/mol) or a medium-MW (530,000 g/mol) lowered LDL cholesterol similarly by '0.2 mmol/L (5%), but efficacy was reduced by 50% when MW was reduced to 210,000 g/mol. This trial was registered at www.clinicaltrials.gov as NCT00981981.Am J Clin Nutr 2010;92:723-32.

Both high-protein and low-GI regimens increase body fat loss, but cardiovascular risk reduction is optimized by a high-carbohydrate, low-GI diet.