Abstract
BackgroundGlycemic load (GL) is used to quantify the glycemic impact of high-carbohydrate (CHO) foods, but cannot be used for low-CHO foods. Therefore, we evaluated the accuracy of equivalent-glycemic-load (EGL), a measure of the glycemic impact of low-CHO foods defined as the amount of CHO from white-bread (WB) with the same glycemic impact as one serving of food.MethodsSeveral randomized, cross-over trials were performed by a contract research organization using overnight-fasted healthy subjects drawn from a pool of 63 recruited from the general population by newspaper advertisement. Incremental blood-glucose response area-under-the-curve (AUC) elicited by 0, 5, 10, 20, 35 and 50 g CHO portions of WB (WB-CHO) and 3, 5, 10 and 20 g glucose were measured. EGL values of the different doses of glucose and WB and 4 low-CHO foods were determined as: EGL = (F-B)/M, where F is AUC after food and B is y-intercept and M slope of the regression of AUC on grams WB-CHO. The dose-response curves of WB and glucose were used to derive an equation to estimate GL from EGL, and the resulting values compared to GL calculated from the glucose dose-response curve. The accuracy of EGL was assessed by comparing the GL (estimated from EGL) values of the 4 doses of oral-glucose with the amounts actually consumed.ResultsOver 0–50 g WB-CHO (n = 10), the dose-response curve was non-linear, but over the range 0–20 g the curve was indistinguishable from linear, with AUC after 0, 5, 10 and 20 g WB-CHO, 10 ± 1, 28 ± 2, 58 ± 5 and 100 ± 6 mmol × min/L, differing significantly from each other (n = 48). The difference between GL values estimated from EGL and those calculated from the dose-response curve was 0 g (95% confidence-interval, ± 0.5 g). The difference between the GL values of the 4 doses of glucose estimated from EGL, and the amounts of glucose actually consumed was 0.2 g (95% confidence-interval, ± 1 g).ConclusionEGL, a measure of the glycemic impact of low-carbohydrate foods, is valid across the range of 0–20 g CHO, accurate to within 1 g, and at least sensitive enough to detect a glycemic response equivalent to that produced by 3 g oral-glucose in 10 subjects.
Highlights
Glycemic load (GL) is used to quantify the glycemic impact of high-carbohydrate (CHO) foods, but cannot be used for low-CHO foods
The results of the glycemic responses elicited by different doses of white bread showed that, for doses of bread containing between 0 and 20 g avCHO, the areas under the curve (AUC) of blood glucose was a linear function of the amount of avCHO consumed as follows: If we consider a serving of a low carbohydrate food which elicits an AUC of AUCf, the grams of avCHO from white bread which elicits a glycemic response equal to AUCf would be the EGL of that food
Repeated measures analysis of variance was used to examine for the significance of differences in AUC between different doses of white bead and glucose
Summary
Glycemic load (GL) is used to quantify the glycemic impact of high-carbohydrate (CHO) foods, but cannot be used for low-CHO foods. If the portion of food contains g grams of available carbohydrate (avCHO), GL is defined as g × GI/100 [4,13], where GI is the glycemic index of the food. Only high carbohydrate foods were tested because, to determine GI, subjects need to be able to eat a portion of food containing at least 25 g avCHO [15]. Since portions of low-carbohydrate foods containing even 5–10 g avCHO may be too large for subjects to eat, it is not possible to determine their GI, and it is not possible to determine their GL
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