Glycemic index is as reliable as macronutrients on food labels

Wolever, Thomas M. S.; Augustin, Livia S. A.; Brand-Miller, Jennie; Delport, Elizabeth; Livesey, Geoffrey; Ludwig, David S.; Sievenpiper, John L.

doi:10.3945/ajcn.116.146092

Cited by 15 publications

(8 citation statements)

References 10 publications

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“…(2) Health Canada was correct in asserting that the glycaemic response depends both on GI and the amount of carbohydrate consumed, but failed to recognize that the relationship between the glycaemic response (GR–In this context, GR is the incremental area below the glycaemic response curve over 2 h) and the amount of available carbohydrate (avCHO) consumed is not linear, but falls off as carbohydrate intake increases [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

Dietary Glycaemic Index Labelling: A Global Perspective

Barclay¹,

Augustin

Brighenti

et al. 2021

Nutrients

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The glycaemic index (GI) is a food metric that ranks the acute impact of available (digestible) carbohydrates on blood glucose. At present, few countries regulate the inclusion of GI on food labels even though the information may assist consumers to manage blood glucose levels. Australia and New Zealand regulate GI claims as nutrition content claims and also recognize the GI Foundation’s certified Low GI trademark as an endorsement. The GI Foundation of South Africa endorses foods with low, medium and high GI symbols. In Asia, Singapore’s Healthier Choice Symbol has specific provisions for low GI claims. Low GI claims are also permitted on food labels in India. In China, there are no national regulations specific to GI; however, voluntary claims are permitted. In the USA, GI claims are not specifically regulated but are permitted, as they are deemed to fall under general food-labelling provisions. In Canada and the European Union, GI claims are not legal under current food law. Inconsistences in food regulation around the world undermine consumer and health professional confidence and call for harmonization. Global provisions for GI claims/endorsements in food standard codes would be in the best interests of people with diabetes and those at risk.

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Section: Resultsmentioning

confidence: 99%

Dietary Glycaemic Index Labelling: A Global Perspective

Barclay¹,

Augustin

Brighenti

et al. 2021

Nutrients

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“…Another weakness is that the application of GI and GL values to foods has been of concern. In epidemiology, there is now no concern about the analytical accuracy of food GI and GL values [82]. More concern exists about the accuracy of the assignment of GI values to local foods eaten when attempting to match them to foods in the international tables of GI and GL [83].…”

Section: Discussionmentioning

confidence: 99%

Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies

et al. 2019

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Published meta-analyses indicate significant but inconsistent incident type-2 diabetes (T2D)-dietary glycemic index (GI) and glycemic load (GL) risk ratios or risk relations (RR). It is now over a decade ago that a published meta-analysis used a predefined standard to identify valid studies. Considering valid studies only, and using random effects dose–response meta-analysis (DRM) while withdrawing spurious results (p < 0.05), we ascertained whether these relations would support nutrition guidance, specifically for an RR > 1.20 with a lower 95% confidence limit >1.10 across typical intakes (approximately 10th to 90th percentiles of population intakes). The combined T2D–GI RR was 1.27 (1.15–1.40) (p < 0.001, n = 10 studies) per 10 units GI, while that for the T2D–GL RR was 1.26 (1.15–1.37) (p < 0.001, n = 15) per 80 g/d GL in a 2000 kcal (8400 kJ) diet. The corresponding global DRM using restricted cubic splines were 1.87 (1.56–2.25) (p < 0.001, n = 10) and 1.89 (1.66–2.16) (p < 0.001, n = 15) from 47.6 to 76.1 units GI and 73 to 257 g/d GL in a 2000 kcal diet, respectively. In conclusion, among adults initially in good health, diets higher in GI or GL were robustly associated with incident T2D. Together with mechanistic and other data, this supports that consideration should be given to these dietary risk factors in nutrition advice. Concerning the public health relevance at the global level, our evidence indicates that GI and GL are substantial food markers predicting the development of T2D worldwide, for persons of European ancestry and of East Asian ancestry.

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“…However, there is no universally accepted definition for a wholegrain product [ 26 ], and some products that feature a front-of-package wholegrain claim can include a range of wholegrain and refined grain contents in conjunction with higher calories and added sugars [ 21 ]. The GI metric has a physiological basis and may offer a simpler alternative to reading nutrition information on packaging; however, there is controversy surrounding the effectiveness of using GI to guide food choices [ 27 , 28 ], as low GI foods may be high in fructose and/or saturated fat (e.g. fruit muffin) and conversely, high GI foods may also be rich in micronutrients (e.g.…”

Section: Introductionmentioning

confidence: 99%

Balanced carbohydrate ratios are associated with improved diet quality in Australia: A nationally representative cross-sectional study

Blumfield

McConnell

Cassettari³

et al. 2021

PLoS ONE

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Background Carbohydrate quality influences major health outcomes; however, the best criteria to assess carbohydrate quality remain unknown. Objective The objectives were to: i) evaluate whether a diet that meets a carbohydrate ratio (simple, modified or dual ratio) is associated with higher nutrient intakes and diet quality, and ii) model the impact of substituting carbohydrate foods that meet the proposed ratios in place of foods that do not, on nutrient intakes. Design A secondary analysis of cross-sectional data from the 2011–12 Australian National Nutrition and Physical Activity Survey. Participants/Setting National data from participants aged 2 years and older (n = 12,153). Main outcome measures Ratios were defined as (i) simple ratio, 10:1 (10g carbohydrate:≥1g dietary fiber); (ii) modified ratio, 10:1:2 (10g carbohydrate:≥1g dietary fiber:≤2g free sugars); and (iii) dual ratio, 10:1 & 1:2 (10g carbohydrate:≥1g dietary fiber & ≤2g free sugars per 1g dietary fiber). Ratios were compared to nutrient intakes obtained via automated multiple-pass 24-hour dietary recall and diet quality calculated using the Australian Healthy Eating Index. Statistical analyses performed Substitution dietary modelling was performed. Data were analyzed using paired and independent sample t-tests. Results Ratio adherence was highest for simple (50.2% adults; 28.6% children), followed by dual (40.6% adults; 21.7% children), then modified (32.7% adults; 18.6% children) ratios. Participants who met any ratio reported higher nutrient intake and diet quality compared to those who failed to meet the respective ratio (P < .001 for all), with the greatest nutrient intakes found for those who met modified or dual ratios. Dietary modelling improved nutrient intakes for all ratios, with the greatest improvement found for the dual ratio. Conclusions All carbohydrate ratios were associated with higher diet quality, with a free sugars constraint in the dual ratio providing the greatest improvements.

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Glycemic index is as reliable as macronutrients on food labels

Cited by 15 publications

References 10 publications

Dietary Glycaemic Index Labelling: A Global Perspective

Dietary Glycaemic Index Labelling: A Global Perspective

Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies

Balanced carbohydrate ratios are associated with improved diet quality in Australia: A nationally representative cross-sectional study

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