Abstract
This study aimed to perform a systematic review and meta-analysis of the glycemic index (GI) of gluten-free bread (GFB) and its main ingredients. The systematic review followed PRISMA guidelines, using seven electronic databases (PubMed, EMBASE, Scopus, Science Direct, Web of Science, gray literature research with Google Scholar, and patents with Google Patent tool), from inception to November 2020. Eighteen studies met the inclusion criteria evaluating 132 GFB samples. Five articles tested GI in vivo, eleven in vitro; and two studies tested both methods. The analysis showed that 60.7% (95% CI: 40.2–78.1%) of the samples presented high glycemic indexes, evidencing a high glycemic profile for GFB. Only 18.2% (95% CI: 11.7–27.2%) of the bread samples presented in the studies were classified as a low GI. Meta-analysis presented moderate/low heterogenicity between studies (I2 = 61% and <1% for both high and low GIs) and reinforced the proportion of high GIs. Lower GIs were found in formulations based on Colocasia esculenta flour or enriched with fiber, yogurt and curd cheese, sourdough, psyllium, hydrocolloids, enzymes, fructans, and resistant starch, highlighting the efficacy of these ingredients to lower GFBs’ GI. GFB tends to present high GI, impacting the development of chronic diseases when consumed.
Highlights
The gluten-free diet (GFD) has become more popular since it is the only treatment for individuals with gluten-related disorders (GRD) [1,2]
This study aimed to perform a systematic review of the glycemic index of gluten-free bread and the main ingredients used in their formulations following PRISMA guidelines
The pooled analysis estimates an overall percentage of 60.7% of high glycemic index (GI) (≥70) (Table 2, Figure 2)
Summary
The gluten-free diet (GFD) has become more popular since it is the only treatment for individuals with gluten-related disorders (GRD) [1,2]. Unbalanced GFD is correlated to an increase in chronic diseases, highlighting the importance of improving the nutritional quality of gluten-free (GF) products [1]. Gluten-free starches and flours are traditionally low in fiber, micronutrients, protein, and, usually, present a higher glycemic index (GI) [3,4]. The GI is an essential tool in the evaluation of the nutritional quality of food since high or upper-limit moderate GI is related to the increasing prevalence of diabetes, being overweight, and cardiovascular diseases [5,6]. Dietary guidelines suggest a diet with low GI foods (
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