Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-28T07:37:27.288Z Has data issue: false hasContentIssue false

The glycaemic index: importance of dietary fibre and other food properties

Published online by Cambridge University Press:  05 March 2007

Inger Björck*
Affiliation:
Department of Applied Nutrition and Food Chemistry, Centre for Chemistry and Chemical Engineering, Lund University, PO Box 124, SE-221 00, Lund, Sweden
Helena Liljeberg Elmståhl
Affiliation:
Department of Applied Nutrition and Food Chemistry, Centre for Chemistry and Chemical Engineering, Lund University, PO Box 124, SE-221 00, Lund, Sweden
*
*Corresponding author: Professor Inger Björck, fax +46 46 222 4532, [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

An increasing body of evidence suggests that a low-glycaemic-index (GI) diet has a therapeutic as well as a preventive potential in relation to the insulin resistance syndrome. The implementation of a low-GI diet, however, will require an extended list of low-GI foods to be available on the market. The tailoring of low-GI bread products offers a particular challenge due to their generally high GI and abundance in the diet. Low-GI bread products can be tailored by, for example, enclosure of cereal kernels, sourdough fermentation and/or addition of organic acids, or use of cereal genotypes with elevated contents of amylose or β-glucans. Low-GI cereal foods appear to vary in effect on ‘second-meal’ glucose tolerance in healthy subjects. In addition to the slow release properties of such foods, the content of dietary fibre appears to play a role. The low glycaemia to starch in a pasta breakfast (GI 54) promoted a higher glucose tolerance and lowered triacylglycerol levels at a standardized lunch ingested 4 h later, compared with a white-wheat bread breakfast (GI 100). The metabolic benefits of the low GI properties per se have been demonstrated also in the longer term. Thus, a reduction in dietary GI improved glucose and lipid metabolism and normalized fibrinolytic activity in type 2 diabetics, while maintaining a similar amount and composition of dietary fibre. However, the higher dietary fibre content frequently associated with low-GI foods may add to the metabolic merits of a low-GI diet. Consequently, a low-GI barley meal rich in dietary fibre (GI 53) improved glucose tolerance from evening meal to breakfast, whereas an evening meal with pasta had no effect (GI 54). The exchange of common high-GI bread for low-GI high-fibre bread, as the only dietary modification, improved insulin economy in women at risk of type 2 diabetes. These results are in accordance with epidemiological evidence of a reduced risk of type 2 diabetes with a low-GI diet rich in cereal fibre. It is concluded that low-GI cereal foods developed should preferably be rich in dietary fibre.

Type
Session: Nutrients contributing to the fibre effect
Copyright
Copyright © The Nutrition Society 2003

References

Åkerberg, A, Liljeberg, H, Björck, I (1998) Effects of amylose/amylopectin ratio and baking conditions on resistant starch formation and glycaemic indices. Journal of Cereal Science 28, 7180.CrossRefGoogle Scholar
Björck, I, Liljeberg, H, Östman, E (2000) Low glycaemic-index foods. British Journal of Nutrition 83, 149S155S.CrossRefGoogle ScholarPubMed
Brand, J, Colagiuri, S, Crossman, S, Allen, A, Roberts, D, Truswell, S (1991) Low-glycemic index foods improve long term glycemic control in NIDDM. Diabetes Care 14, 95101.CrossRefGoogle ScholarPubMed
Brand Miller, JC (1994) Importance of glycemic index in diabetes. American Journal of Clinical Nutrition 59, 747S752S.CrossRefGoogle Scholar
Del Prato, S, Leonetti, F, Simonson, DC, Sheehan, P, Matsuda, M & DeFronzo, RA (1994) Effect of sustained physiologic hyperinsulinaemia and hyperglycaemia on insulin secretion and insulin sensitivity in man. Diabetologia 37, 10251035.CrossRefGoogle ScholarPubMed
Eerlingen, RC, Crombez, M, Delcour, JA (1993) Enzyme-resistant starch. I. Quantitative and qualitative influence of incubation time and temperature of autoclaved starch on resistant starch formation. Cereal Chemistry 70, 339344.Google Scholar
Food and Agriculture Organization/World Health Organization (1998) Carbohydrates in Human Nutrition: Report of a Joint FAO/WHO Expert Consultation Rome FAO FAO Food and Nutrition Paper no. 66 Rome: FAO.Google Scholar
Foster-Powell, K, Holt, S, Brand-Miller, J (2002) International table of glycemic index and glycemic load values: 2002. American Journal of Clinical Nutrition 76, 556.CrossRefGoogle ScholarPubMed
Frost, G, Leeds, AA, Doré, CJ, Madeiros, S, Brading, S, Dornhorst, A (1999) Glycaemic index as a determinant of serum HDLcholesterol concentration. Lancet 353, 10451048.CrossRefGoogle ScholarPubMed
Giacco, R, Parillo, M, Rivallese, A, Lasorella, G, Giacco, A, D'Episcopo, L, Riccardi, G (2000) Long-term dietary treatment with increased amount of fiber-rich low-glycemic index natural foods improves blood glucose control and reduces the number of hypoglycemic events in type 1 diabetic patients. Diabetes Care 23, 14611466.CrossRefGoogle ScholarPubMed
Gilbertsson, H, Brand Miller, J, Thorburn, A, Evans, S, Chondros, P & Werther, G (2001) The effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes. Diabetes Care 24, 11371143.CrossRefGoogle Scholar
Granfeldt, Y, Björck, I, Drews, A, Tovar, J (1992) An in vitro procedure based on chewing to predict metabolic response to starch in cereal and legume products. European Journal of Clinical Nutrition 46, 649660.Google Scholar
Järvi, AE, Karlström, BE, Granfeldt, YE, Björck, IME, Asp, N-G, Vessby, BOH (1999) Improved glycemic control and lipid profile and normalized fibrinolytic activity on a lowglycemic index diet in type 2 diabetic patients. Diabetes Care 22, 1018.CrossRefGoogle ScholarPubMed
Jenkins, DJ, Wolever, TM, Jenkins, AL, Giordano, C, Giudici, S, Thompson, LU, Kalmusky, J, Josse, RG, Wong, GS (1986) Low glycemic response to traditionally processed wheat and rye products: bulgur and pumpernickel bread. American Journal of Clinical Nutrition 43, 516520.CrossRefGoogle ScholarPubMed
Jenkins, DJ, Wolever, TM, Kalmusky, J, Guidici, S, Giordano, C, Patten, R, Wong, GS, Bird, JN, Hall, M, Buckley, G, Csima, A, Little, JA (1987) Low-glycemic index diet in hyperlipidemia: use of traditional starchy foods. American Journal of Clinical Nutrition 46, 6671.CrossRefGoogle ScholarPubMed
Jenkins, DJ, Wolever, TM, Nineham, R, Sarson, DL, Bloom, SR, Ahern, J, Alberti, KG, Hockaday, TD (1980) Improved glucose tolerance four hours after taking guar with glucose. Diabetologia 19, 2124.CrossRefGoogle ScholarPubMed
Jenkins, DJ, Wolever, TM, Ocana, AM, Vuksan, V, Cunnanen, SC, Jenkins, M, Wong, GS, Singer, W, Bloom, SR, Blendis, LM, Josse, RG (1990) Metabolic effects of reducing rate of glucose ingestion by single bolus versus continuous sipping. Diabetes 39, 775781.CrossRefGoogle ScholarPubMed
Jenkins, DJ, Wolever, TM, Taylor, RH, Griffiths, C, Krzeminska, K, Lawrie, JA, Bennett, CM, Goff, DV, Sarson, DL, Bloom, SR (1982) Slow release dietary carbohydrate improves second meal tolerance. American Journal of Clinical Nutrition 35, 13391346.CrossRefGoogle ScholarPubMed
Liljeberg, H, Björck, I (1994) Bioavailability of starch in bread products. Postprandial glucose and insulin responses in healthy subjects and in vitro resistant starch content. European Journal of Clinical Nutrition 48, 151163.Google ScholarPubMed
Liljeberg, H, Björck, I (1996) Delayed gastric emptying rate as a potential mechanism for lowered glycemia after eating sourdough bread: studies in humans and rats using test products with added organic acids or an organic salt. American Journal of Clinical Nutrition 64, 886893.CrossRefGoogle ScholarPubMed
Liljeberg, H, Björck, I (1998) Delayed gastric emptying rate may explain improved glycaemia in healthy subjects to a starchy meal with added vinegar. European Journal of Clinical Nutrition 52, 368371.CrossRefGoogle ScholarPubMed
Liljeberg, H, Björck, I (2000) Effects of a low-glycaemic index spaghetti meal on glucose tolerance and lipaemia at a subsequent meal in healthy subjects. European Journal of Clinical Nutrition 54, 2428.CrossRefGoogle Scholar
Liljeberg, H, Granfeldt, Y, Björck, I (1992) Metabolic responses to starch in bread containing intact kernels versus milled flour. European Journal of Clinical Nutrition 46, 561575.Google ScholarPubMed
Liljeberg, H, Lönner, C, Björck, I (1995) Sourdough fermentation or addition of organic acids or corresponding salts to bread improves nutritional properties of starch in healthy humans. Journal of Nutrition 125, 15031511.Google ScholarPubMed
Liljeberg, HGM, Åkerberg, AKE, Björck, IME (1999) Effect of the glycemic index and content of indigestible carbohydrates of cereal-based breakfast meals on glucose tolerance at lunch in healthy subjects. American Journal of Clinical Nutrition 69, 647655.CrossRefGoogle ScholarPubMed
Liu, S, Willett, W, Stampfer, M, Hu, F, Franz, M, Sampson, L, Hennekens, C, Manson, J (2000) A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. American Journal of Clinical Nutrition 71, 14551461.Google Scholar
Östman, EM, Nilsson, M, Liljeberg, Elmståhl, HGM, Molin, G, Björck IME (2002) On the effect of lactic acid on blood glucose and insulin responses to cereal products: mechanistic studies in healthy subjects and in vitro. Journal of Cereal Science 36, 335342.CrossRefGoogle Scholar
Salmerón, J, Ascherio, A, Rimm, EB, Colditz, GA, Spiegelman, D, Jenkins, DJ, Stampfer, MJ, Wing, AL, Willett, WC (1997a) Dietary fibre, glycemic load, and risk of NIDDM in men. Diabetes Care 20, 545550.CrossRefGoogle ScholarPubMed
Salmerón, J, Manson, JE, Stampfer, MJ, Colditz, GA, Wing, AL, Willett, WC (1997b) Dietary fibre, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. Journal of the American Medical Association 277, 472477.CrossRefGoogle ScholarPubMed
Scheppach, W, Sommer, H, Kirchner, T, Paganelli, G-M, Bartram, P, Cristl, S, Richterj, F, Dusel, G, Kasper, H (1992) Effect of butyrate enemas on the colonic mucosa in distal ulcerative colitis. Gastroenterology 103, 5156.CrossRefGoogle ScholarPubMed
Thorburn, A, Muir, J, Proitto, J (1993) Carbohydrate fermentation lowers hepatic glucose output in healthy subjects. Metabolism 42, 780785.CrossRefGoogle ScholarPubMed
Venter, CS, Vorster, HH, Cummings, JH (1990) Effects of dietary propionate on carbohydrate and lipid metabolism in healthy volunteers. American Journal of Gastroenterology 85, 549553.Google ScholarPubMed
Wolever, TM, Brighenti, F, Royall, D (1989) Effect of rectal infusion of short chain fatty acids in human subjects. American Journal of Gastroenterology 84, 10271037.Google ScholarPubMed
Wolever, TM, Jenkins, DJ, Jenkins, AL, Josse, RG (1991) The glycemic index: methodology and clinical implication. American Journal of Clinical Nutrition 54, 846854.CrossRefGoogle Scholar
Wolever, TM, Jenkins, DJ, Ocana, AM, Rao, VA, Collier, GR (1988) Second-meal effect: low-glycemic-index foods eaten at dinner improve subsequent breakfast glycemic response. American Journal of Clinical Nutrition 48, 10411047.CrossRefGoogle ScholarPubMed