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Glycemic index and glycemic load: measurement issues and their effect on diet–disease relationships

European Journal of Clinical Nutrition volume 61, pages S122–S131 (2007)Cite this article

Abstract

Glycemic index (GI) describes the blood glucose response after consumption of a carbohydrate containing test food relative to a carbohydrate containing reference food, typically glucose or white bread. GI was originally designed for people with diabetes as a guide to food selection, advice being given to select foods with a low GI. The amount of food consumed is a major determinant of postprandial hyperglycemia, and the concept of glycemic load (GL) takes account of the GI of a food and the amount eaten. More recent recommendations regarding the potential of low GI and GL diets to reduce the risk of chronic diseases and to treat conditions other than diabetes, should be interpreted in the light of the individual variation in blood glucose levels and other methodological issues relating to measurement of GI and GL. Several factors explain the large inter- and intra-individual variation in glycemic response to foods. More reliable measurements of GI and GL of individual foods than are currently available can be obtained by studying, under standard conditions, a larger number of subjects than has typically been the case in the past. Meta-analyses suggest that foods with a low GI or GL may confer benefit in terms of glycemic control in diabetes and lipid management. However, low GI and GL foods can be energy dense and contain substantial amounts of sugars or undesirable fats that contribute to a diminished glycemic response. Therefore, functionality in terms of a low glycemic response alone does not necessarily justify a health claim. Most studies, which have demonstrated health benefits of low GI or GL involved naturally occurring and minimally processed carbohydrate containing cereals, vegetables and fruit. These foods have qualities other than their immediate impact on postprandial glycemia as a basis to recommend their consumption. When the GI or GL concepts are used to guide food choice, this should be done in the context of other nutritional indicators and when values have been reliably measured in a large group of individuals.

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Acknowledgements

We wish to thank Dr Jennie Brand-Miller, Professor Gary Frost, Professor Philip James, Professor Simin Liu, Professor Jim Mann, Dr Gabriele Riccardi, Dr M Robertson and Professor HH Vorster for their valuable comments.

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Authors and Affiliations

  1. Department of Human Nutrition, University of Otago, Dunedin, New Zealand

    B J Venn & T J Green

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  1. B J Venn
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  2. T J Green
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Correspondence to B J Venn.

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Conflict of interest

During the preparation and peer-review of this paper in 2006, the authors and peer-reviewers declared the following interests.

Authors Dr Bernard J Venn: None declared.

Dr Tim Green: Affiliated with GI Otago, a commercial glycemic index testing service.

Peer-reviewers

Dr Jennie Brand-Miller: Publishing books in the popular press: ‘The New Glucose Revolution Series’; Director of a University-based service for GI testing; Director of a not-for-profit food-labelling programme based on the GI.

Professor Gary Frost: None declared.

Professor Philip James: None declared.

Professor Simin Liu: None declared.

Professor Jim Mann: None declared.

Dr Gabriele Riccardi: None declared.

Dr M Robertson: Research Grant from National Chemical and Starch.

Professor HH Vorster: Member and Director of the Africa Unit for Transdisciplinary health Research (AUTHeR), Research grant from the South African Sugar Association.

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Venn, B., Green, T. Glycemic index and glycemic load: measurement issues and their effect on diet–disease relationships. Eur J Clin Nutr 61 (Suppl 1), S122–S131 (2007). https://doi.org/10.1038/sj.ejcn.1602942

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