Glycemic Index Helpful in Food Selection

May 07, 2002

NEW YORK (MedscapeWire) May 08 - A systematic review of studies using the glycemic index to classify foods suggests that the approach can help select foods that decrease risk of obesity, type 2 diabetes, and heart disease. Another article describes improvements in total fat mass and lipid profile in healthy, overweight men on a 5-week low-glycemic index diet.

"The rate of carbohydrate absorption after a meal, as quantified by glycemic index, has significant effects on postprandial hormonal and metabolic responses," writes David S. Ludwig, MD, PhD, from Children's Hospital in Boston. "Despite areas of continuing controversy, clinical use of glycemic index as a qualitative guide to food selection would seem to be prudent in view of the preponderance of evidence suggesting benefit and absence of adverse effects."

Ludwig recommends increased consumption of fruits, vegetables, legumes, and grains processed by traditional rather than modern methods, and limited intake of potatoes and concentrated sugar.

His findings are published in the May 8 issue of The Journal of the American Medical Association.

In the separate study from INSERM in Paris and Lyon, France, 11 healthy men were randomly allocated to 5 weeks of a low- or high-glycemic index (LGI or HGI) diet separated by a 5-week washout period in a crossover design. Compared with the HGI diet, the LGI diet resulted in lower postprandial plasma glucose and insulin profiles and areas under the curve, lower plasma triacylglycerol excursion after lunch, decreased total fat mass by approximately 700 g, and a tendency to increase lean body mass without changing body weight. Decreased leptin, lipoprotein lipase, and hormone-sensitive lipase mRNA quantities in the subcutaneous abdominal adipose tissue accompanied decreased fat mass.

The report appears in the May issue of Diabetes Care.

"Five weeks of an LGI diet ameliorates some plasma lipid parameters, decreases total fat mass, and tends to increase lean body mass without changing body weight," write Clara Bouche, MD, and colleagues. "These changes were accompanied by a decrease in the expression of some genes implicated in lipid metabolism. Such a diet could be of benefit to healthy, slightly overweight subjects and might play a role in the prevention of metabolic diseases and their cardiovascular complications."

JAMA. 2002;287(18):2414-2423

Diabetes Care. 2002;25(5):822-828

Reviewed by Gary D. Vogin, MD

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