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Response to letter by Augustin et al

European Journal of Clinical Nutrition volume 58, page 561 (2004)Cite this article

I quite agree with Augustin et al that reducing the consumption of foods that cause large increases in blood glucose is desirable (ref. Willett's review), and that pasta has a lower glycemic index than does bread. Independent of the glycemic index of a diet, cereal fiber intake has consistently been associated with lower risk of coronary heart disease and type II diabetes, probably in part because whole grains are rich in many vitamins and minerals that are removed in the refining process along with the fiber (Hu & Willett 2000); (Hu et al, 2001). Thus, the intent of the alternative dietary pyramid that we have offered is to suggest the replacement of cereal products made from refined starch with whole-grain versions, and for this reason whole-grain foods were placed on the second level. This would include whole-grain pasta, which was traditionally consumed in Italy and is now again becoming available both there and in the US. The intent of the alternative pyramid was not to suggest that bread should replace pasta.

I certainly appreciate that pasta in Italy is served in more modest portions than typical in the US, and with a much higher ratio of olive oil, vegetables, and healthy sauce to starch. Still, because of its high consumption, pasta does contribute importantly to the glycemic load of the Italian diet. Thus, there is every reason to believe that the greater use of whole-grain pasta instead of the refined versions would contribute to improved health in Italy as elsewhere. If well prepared, I also suspect that my Italian colleagues would agree that this is not a culinary sacrifice because the texture and flavors of whole grains can be superior and highly satisfying. Because the quantity of carbohydrate-containing foods as well as their quality determines the glucose response, even this meal is best consumed in moderation and with a walk afterwards.

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References

  • Hu FB & Willett WC (2000): Optimal diets for prevention of coronary heart disease. JAMA 288, 2569–2578: (review). (PMID: 12444864 [PubMed - indexed for MEDLINE].).

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  1. Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA

    Walter Willett

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  1. Walter Willett
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Willett, W. Response to letter by Augustin et al. Eur J Clin Nutr 58, 561 (2004). https://doi.org/10.1038/sj.ejcn.1601911

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