Glycemic Index and Glycemic Load - Linus Pauling Institute

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Measuringtheglycemicindexoffoods Todeterminetheglycemicindex(GI)ofafood,healthyvolunteersaretypicallygivenatestfoodthatprovides50grams(g)ofcarbohydrateandacontrolfood(white,wheatbreadorpureglucose)thatprovidesthesameamountofcarbohydrate,ondifferentdays(4).Bloodsamplesforthedeterminationofglucoseconcentrationsaretakenpriortoeating,andatregularintervalsforafewhoursaftereating.Thechangesinbloodglucoseconcentrationovertimeareplottedasacurve.TheGIiscalculatedastheincrementalareaundertheglucosecurve(iAUC)afterthetestfoodiseaten,dividedbythecorrespondingiAUCafterthecontrolfood(pureglucose)iseaten.Thevalueismultipliedby100torepresentapercentageofthecontrolfood(5): GI= (iAUCtestfood/iAUCglucose)x100 Forexample,aboiledwhitepotatohasanaverageGIof82relativetoglucoseand116relativetowhitebread,whichmeansthatthebloodglucoseresponsetothecarbohydrateinabakedpotatois82%ofthebloodglucoseresponsetothesameamountofcarbohydrateinpureglucoseand116%ofthebloodglucoseresponsetothesameamountofcarbohydrateinwhitebread.Incontrast,cookedbrownricehasanaverageGIof50relativetoglucoseand69relativetowhitebread.Inthetraditionalsystemofclassifyingcarbohydrates,bothbrownriceandpotatowouldbeclassifiedascomplexcarbohydratesdespitethedifferenceintheireffectsonbloodglucoseconcentrations. WhiletheGIshouldpreferablybeexpressedrelativetoglucose,otherreferencefoods(e.g.,whitebread)canbeusedforpracticalreasonsaslongastheirpreparationhasbeenstandardizedandtheyhavebeencalibratedagainstglucose(2).AdditionalrecommendationshavebeensuggestedtoimprovethereliabilityofGIvaluesforresearch,publichealth,andcommercialapplicationpurposes(2,6). Physiologicalresponsestohigh-versuslow-glycemicindexfoods Bydefinition,theconsumptionofhigh-GIfoodsresultsinhigherandmorerapidincreasesinbloodglucoseconcentrationsthantheconsumptionoflow-GIfoods.Rapidincreasesinbloodglucose(resultinginhyperglycemia)arepotentsignalstotheβ-cellsofthepancreastoincreaseinsulinsecretion(7).Overthenextfewhours,theincreaseinbloodinsulinconcentration(hyperinsulinemia)inducedbytheconsumptionofhigh-GIfoodsmaycauseasharpdecreaseintheconcentrationofglucoseinblood(resultinginhypoglycemia).Incontrast,theconsumptionoflow-GIfoodsresultsinlowerbutmoresustainedincreasesinbloodglucoseandlowerinsulindemandsonpancreaticβ-cells(8). Glycemicindexofamixedmealordiet ManyobservationalstudieshaveexaminedtheassociationbetweenGIandriskofchronicdisease,relyingonpublishedGIvaluesofindividualfoodsandusingthefollowingformulatocalculatemeal(ordiet)GI(9): MealGI=[(GIxamountofavailablecarbohydrate)FoodA+(GIxamountofavailablecarbohydrate)FoodB+…]/totalamountofavailablecarbohydrate Yet,theuseofpublishedGIvaluesofindividualfoodstoestimatetheaverageGIvalueofamealordietmaybeinappropriatebecausefactorssuchasfoodvariety,ripeness,processing,andcookingareknowntomodifyGIvalues.InastudybyDoddetal.,theestimationofmealGIsusingpublishedGIvaluesofindividualfoodswasoverestimatedby22to50%comparedtodirectmeasuresofmealGIs(9). BesidestheGIofindividualfoods,variousfoodfactorsareknowntoinfluencethepostprandialglucoseandinsulinresponsestoacarbohydrate-containingmixeddiet.Arecentcross-over,randomizedtrialin14subjectswithtype2diabetesmellitusexaminedtheacuteeffectsoffourtypesofbreakfastswithhigh-orlow-GIandhigh-orlow-fibercontentonpostprandialglucoseconcentrations.Plasmaglucosewasfoundtobesignificantlyhigherfollowingconsumptionofahigh-GIandlow-fiberbreakfastthanfollowingalow-GIandhigh-fiberbreakfast.However,therewasnosignificantdifferenceinpostprandialglycemicresponsesbetweenhigh-GIandlow-GIbreakfastsofsimilarfibercontent(10).Inthisstudy,mealGIvalues(derivedfrompublisheddata)failedtocorrectlypredictpostprandialglucoseresponse,whichappearedtobeessentiallyinfluencedbythefibercontentofmeals.Sincetheamountsandtypesofcarbohydrate,fat,protein,andotherdietaryfactorsinamixedmealmodifytheglycemicimpactofcarbohydrateGIvalues,theGIofamixedmealcalculatedusingtheabove-mentionedformulaisunlikelytoaccuratelypredictthepostprandialglucoseresponsetothismeal(3).Moreover,theGIisapropertyofagivenfoodcarbohydratesuchthatitdoesnottakeintoaccountindividuals’characteristicslikeethnicity,metabolicstatus,oreatinghabits(e.g.,thedegreetowhichwemasticate)whichmight,toalimitedextent,alsoinfluencetheglycemicresponsetoagivencarbohydrate-containingmeal(11-14). UsingdirectmeasuresofmealGIsinfuturetrials—ratherthanestimatesderivedfromGItables—wouldincreasetheaccuracyandpredictivevalueoftheGImethod(2,6).Inaddition,inarecentmeta-analysisof28studiesexaminingtheeffectoflow-versushigh-GIdietsonserumlipids,Goffetal.indicatedthatthemeanGIoflow-GIdietsvariedfrom21to57acrossstudies,whilethemeanGIofhigh-GIdietsrangedfrom51to75(15).Therefore,astricteruseofGIcutoffvaluesmayalsobewarrantedtoprovidemorereliableinformationaboutcarbohydrate-containingfoods. GlycemicLoad Theglycemicindex(GI)comparesthepotentialoffoodscontainingthesameamountofcarbohydratetoraisebloodglucose.However,theamountofcarbohydratecontainedinafoodservingalsoaffectsbloodglucoseconcentrationsandinsulinresponses.Forexample,themeanGIofwatermelonis76,whichisashighastheGIofadoughnut(seeTable1).Yet,oneservingofwatermelonprovides11gofavailablecarbohydrate,whileamediumdoughnutprovides23gofavailablecarbohydrate. Theconceptofglycemicload(GL)wasdevelopedbyscientiststosimultaneouslydescribethequality(GI)andquantityofcarbohydrateinafoodserving,meal,ordiet.TheGLofasinglefoodiscalculatedbymultiplyingtheGIbytheamountofcarbohydrateingrams(g)providedbyafoodservingandthendividingthetotalby100(4): GLFood=(GIFoodxamount(g)ofavailablecarbohydrateFoodperserving)/100 Foratypicalservingofafood,GLwouldbeconsideredhighwithGL≥20,intermediatewithGLof11-19,andlowwithGL≤10.Usingtheabove-mentionedexample,despitesimilarGIs,oneservingofwatermelonhasaGLof8,whileamedium-sizeddoughnuthasaGLof17.DietaryGListhesumoftheGLsforallfoodsconsumedinthediet. Itshouldbenotedthatwhilehealthyfoodchoicesgenerallyincludelow-GIfoods,thisisnotalwaysthecase.Forexample,intermediate-to-high-GIfoodslikeparsnip,watermelon,banana,andpineapple,havelow-to-intermediateGLs(seeTable1). DiseasePrevention Type2diabetesmellitus Theconsumptionofhigh-GIand-GLdietsforseveralyearsmightresultinhigherpostprandialbloodglucoseconcentrationandexcessiveinsulinsecretion.Thismightcontributetothelossoftheinsulin-secretingfunctionofpancreaticβ-cellsandleadtoirreversibletype2diabetesmellitus(16). AUSecologicstudyofnationaldatafrom1909to1997foundthattheincreasedconsumptionofrefinedcarbohydratesintheformofcornsyrup,coupledwiththedecliningintakeofdietaryfiber,hasparalleledtheincreasedprevalenceoftype2diabetes(17).Inaddition,high-GIand-GLdietshavebeenassociatedwithanincreasedriskoftype2diabetesinseverallargeprospectivecohortstudies.ArecentupdatedanalysisofthreelargeUScohortsindicatedconsumptionoffoodswiththehighestversuslowestGIwasassociatedwithariskofdevelopingtype2diabetesthatwasincreasedby44%intheNurses’HealthStudy(NHS)I,20%intheNHSII,and30%intheHealthProfessionalsFollow-upStudy(HPFS).High-GLdietswereassociatedwithanincreasedriskoftype2diabetes(+18%)onlyintheNHSIandinthepooledanalysisofthethreestudies(+10%)(18).Additionally,theconsumptionofhigh-GIfoodsthatarelowincerealfiberwasassociatedwitha59%increaseindiabetesriskcomparedtolow-GIandhigh-cereal-fiberfoods.High-GLandlow-cereal-fiberdietswereassociatedwitha47%increaseinriskcomparedtolow-GLandhigh-cereal-fiberdiets.Moreover,obeseparticipantswhoconsumedfoodswithhigh-GIor-GLvalueshadariskofdevelopingtype2diabetesthatwasmorethan10-foldgreaterthanleansubjectsconsuminglow-GIor-GLdiets(18). However,anumberofprospectivecohortstudieshavereportedalackofassociationbetweenGIorGLandtype2diabetes(19-24).TheuseofGIfoodclassificationtablesbasedpredominantlyonAustralianandAmericanfoodproductsmightbeasourceofGIvaluemisassignmentandpartlyexplainnullassociationsreportedinmanyprospectivestudiesofEuropeanandAsiancohorts. Nevertheless,conclusionsfromseveralrecentmeta-analysesofprospectivestudies(includingtheabove-mentionedstudies)suggestthatlow-GIand-GLdietsmighthaveamodestbutsignificanteffectinthepreventionoftype2diabetes(18,25,26).OrganizationslikeDiabetesUK(27)andtheEuropeanAssociationfortheStudyofDiabetes(28)haveincludedtheuseofdietsoflowGI/GLandhighindietaryfiberandwholegrainsintheirrecommendationsfordiabetespreventioninhigh-riskindividuals.TheuseofGIandGLiscurrentlynotimplementedinUSdietaryguidelines(29). Cardiovasculardisease Observationalstudies NumerousobservationalstudieshaveexaminedtherelationshipbetweendietaryGI/GLandtheincidenceofcardiovascularevents,especiallycoronaryheartdisease(CHD)andstroke.Ameta-analysisof14prospectivecohortstudies(229,213participants;meanfollow-upof11.5years)founda13%and23%increasedriskofcardiovasculardisease(CVD)withhighversuslowdietaryGIandGL,respectively(30).Threeindependentmeta-analysesofprospectivestudiesalsoreportedthathigherGIorGLwasassociatedwithincreasedriskofCHDinwomenbutnotinmen(31-33).ArecentanalysisoftheEuropeanProspectiveInvestigationintoCancerandNutrition(EPIC)studyin20,275Greekparticipants,followedforamedianof10.4years,showedasignificantincreaseinCHDincidenceandmortalitywithhighdietaryGLspecificallyinthosewithhighBMI(≥28kg/m2)(34).ThisisinlinewithearlierfindingsintheNurses’HealthStudy(NHS)showingthatahighdietaryGLwasassociatedwithadoublingoftheriskofCHDover10yearsinwomenwithhigher(≥23kg/m2)vs.lowerBMI(35).Asimilarfindingwasreportedinacohortofmiddle-agedDutchwomenfollowedfornineyears(36). Additionally,highdietaryGL(butnotGI)wasassociatedwitha19%increasedriskofstrokeinpooledanalysesofprospectivecohortstudies(32,37).Ameta-analysisofsevenprospectivestudies(242,132participants;3,255strokecases)foundthatdietaryGLwasassociatedwithanoverall23%increaseinriskofstrokeandaspecific35%increaseinriskofischemicstroke;GLwasnotfoundtoberelatedtohemorrhagicstroke(38). Overall,observationalstudieshavefoundthathigherglycemicloaddietsareassociatedwithincreasedriskofcardiovasculardisease,especiallyinwomenandinthosewithhigherBMIs. GI/GLandcardiometabolicmarkers TheGI/GLofcarbohydratefoodsmaymodifycardiometabolicmarkersassociatedwithCVDrisk.Ameta-analysisof27randomizedcontrolledtrials(publishedbetween1991and2008)examiningtheeffectoflow-GIdietsonserumlipidprofilereportedasignificantreductionintotalandLDL-cholesterolindependentofweightloss(15).Yet,furtheranalysissuggestedsignificantreductionsinserumlipidsonlywiththeconsumptionoflow-GIdietswithhighfibercontent.Inathree-month,randomizedcontrolledstudy,anincreaseinthevaluesofflow-mediateddilation(FMD)ofthebrachialartery,asurrogatemarkerofvascularhealth,wasobservedfollowingtheconsumptionofalow-versushigh-GIhypocaloricdietinobesesubjects(39). HighdietaryGLshavebeenassociatedwithincreasedconcentrationsofmarkersofsystemicinflammation,suchasC-reactiveprotein(CRP),interleukin-6,andtumornecrosisfactor-α(TNF-α)(40,41).Inasmall12-weekdietaryinterventionstudy,theconsumptionofaMediterranean-style,low-GLdiet(withoutcaloricrestriction)significantlyreducedwaistcircumference,insulinresistance,systolicbloodpressure,aswellasplasmafastinginsulin,triglycerides,LDL-cholesterol,andTNF-αinwomenwithmetabolicsyndrome.Areductionintheexpressionofthegenecodingfor3-hydroxy-3-methylglutaryl(HMG)-CoAreductase,therate-limitingenzymeincholesterolsynthesis,inbloodcellsfurtherconfirmedaneffectforthelow-GIdietoncholesterolhomeostasis(42).Well-controlled,long-terminterventionstudiesareneededtoconfirmthepotentialcardiometabolicbenefitsoflowGI/GLdietsinpeopleatriskforCVD.  Cancer Evidencethathigh-GIor-GLdietsarerelatedtocancerisinconsistent.Arecentmeta-analysisof32case-controlstudiesand20prospectivecohortstudiesfoundmodestandnonsignificantincreasedrisksofhormone-relatedcancers(breast,prostate,ovarian,andendometrialcancers)anddigestivetractcancers(esophageal,gastric,pancreas,andlivercancers)withhighversuslowdietaryGIandGL(43).AsignificantpositiveassociationwasfoundonlybetweenahighdietaryGIandcolorectalcancer(43).Yet,earliermeta-analysesofprospectivecohortstudiesfailedtofindalinkbetweenhigh-GIor-GLdietsandcolorectalcancer(44-46).Anotherrecentmeta-analysisofprospectivestudiessuggestedaborderlineincreaseinbreastcancerriskwithhighdietaryGIandGL.AdjustmentforconfoundingfactorsacrossstudiesfoundnomodificationofmenopausalstatusorBMIontheassociation(47).FurtherinvestigationsareneededtoverifywhetherGIandGLareassociatedwithvariouscancers. Gallbladderdisease ResultsoftwostudiesindicateGIandGLmayberelatedtogallbladderdisease:ahigherdietaryGIandGLwereassociatedwithsignificantlyincreasedrisksofdevelopinggallstonesinacohortofmenparticipatingintheHealthProfessionalsFollow-upStudy(48)andinacohortofwomenparticipatingintheNurses’HealthStudy(49).However,moreepidemiologicalresearchisneededtodetermineanassociationbetweendietaryglycemicindex/loadandgallbladderdisease. DiseaseTreatment Diabetesmellitus Whetherlow-GIfoodscouldimproveoverallbloodglucosecontrolinpeoplewithtype1ortype2diabetesmellitushasbeeninvestigatedinanumberofinterventionstudies.Ameta-analysisof19randomizedcontrolledtrialsthatincluded840diabeticpatients(191withtype1diabetesand649withtype2diabetes)foundthatconsumptionoflow-GIfoodsimprovedshort-termandlong-termcontrolofbloodglucoseconcentrations,reflectedbysignificantdecreasesinfructosamineandglycatedhemoglobin(HbA1c)levels(50).However,theseresultsneedtobecautiouslyinterpretedbecauseofsignificantheterogeneityamongtheincludedstudies.TheAmericanDiabetesAssociationhasratedpoorlythecurrentevidencesupportingthesubstitutionoflow-GLfoodsforhigh-GLfoodstoimproveglycemiccontrolinadultswithtype1ortype2diabetes(51,52).Well-controlledstudiesareneededtofurtherassesswhethertheuseoflow-GI/GLdietscouldsignificantlyimprovelong-termglycemiccontrolandthequalityoflifeofsubjectswithdiabetes. Arandomizedcontrolledstudyin92pregnantwomen(20-32weeks)diagnosedwithgestationaldiabetesfoundnosignificanteffectsofalow-GIdietonmaternalmetabolicprofile(e.g.,bloodconcentrationsofglucose,insulin,fructosamine,HbA1c;insulinresistance)andpregnancyoutcomes(i.e.,maternalweightgainandneonatalanthropometricmeasures)comparedtoaconventionalhigh-fiber,moderate-GIdiet(53).Thelow-GIdietconsumedduringthepregnancyalsofailedtoimprovematernalglucosetolerance,insulinsensitivity,andothercardiovascularriskfactors,ormaternalandinfantanthropometricdatainathree-monthpostpartumfollow-upstudyof55ofthemother-infantpairs(54).Inaddition,anothertrialin139pregnantwomen(12-20weeks’gestation)athighriskforgestationaldiabetesshowednostatisticaldifferencesregardingthediagnosisofgestationaldiabetesduringthesecondandthirdtrimesterofpregnancy,therequirementforinsulintherapy,andpregnancyoutcomesandneonatalanthropometrywhetherwomenfollowedalow-GIdietorahigh-fiber,moderate-GIdiet(55).Atpresent,thereisnoevidencethatalow-GIdietprovidesbenefitsbeyondthoseofahealthy,moderate-GIdietinwomenathighriskoraffectedbygestationaldiabetes. Obesity Obesityisoftenassociatedwithmetabolicdisorders,suchashyperglycemia,insulinresistance,dyslipidemia,andhypertension,whichplaceindividualsatincreasedriskfortype2diabetesmellitus,cardiovasculardisease,andearlydeath(56,57).Traditionally,weight-lossstrategieshaveincludedenergy-restricted,low-fat,high-carbohydratedietswith>50%ofcaloriesfromcarbohydrates,≤30%fromfat,andtheremainderfromprotein.However,arecentmeta-analysisofrandomizedcontrolledinterventionstudies(≥6months’duration)hasreportedthatlow-ormoderate-carbohydratediets(4%-45%carbohydrate)andlow-fatdiets(10%-30%fat)wereequallyeffectiveatreducingbodyweightandwaistcircumferenceinoverweightorobesesubjects(58). Low-GI/GLdietversusmoderate-GI/GL,low-fatdiet Severaldietaryinterventionstudieshaveexaminedhowlow-GI/GLdietscomparedwithconventionallow-fatdietstopromoteweightloss.LoweringtheGIofconventionalenergy-restricted,low-fatdietswasproventobemoreeffectivetoreducepostpartumbodyweightandwaistandhipcircumferencesandpreventtype2diabetesmellitusinwomenwithpriorgestationaldiabetesmellitus(59).Inasix-monthdietaryinterventionstudyin73obeseadults,nodifferencesinweightlosswerereportedinsubjectsfollowingeitheralow-GLdiet(40%carbohydrateand35%fat)oralow-fatdiet(55%carbohydrateand20%fat).Yet,theconsumptionofalow-GLdietincreasedHDL-cholesterolanddecreasedtriglycerideconcentrationssignificantlymorethanthelow-fatdiet,butLDL-cholesterolconcentrationwassignificantlymorereducedwiththelow-fatthanlow-GIdiet(60). Aone-yearrandomizedcontrolledstudyof202individualswithabodymassindex(BMI)≥28andatleastanothermetabolicdisordercomparedtheeffectoftwodietarycounseling-basedinterventionsadvocatingeitherforalow-GLdiet(30%-35%ofcaloriesfromlow-GIcarbohydrates)oralow-fatdiet(<30%ofcaloriesfromfat)(61).Weightlosswitheachdietwasequivalent(~4kg).Bothinterventionssimilarlyreducedtriglycerides,C-reactiveprotein(CRP),andfastinginsulin,andincreasedHDL-cholesterol.Yet,thereductioninwaistandhipcircumferenceswasgreaterwiththelow-fatdiet,whilebloodpressurewassignificantlymorereducedwiththelow-GLdiet(61).IntheGLYNDIETstudy,asix-monthrandomizeddietaryinterventiontrial,thecomparisonoftwomoderate-carbohydratediets(42%ofcaloriesfromcarbohydrates)withdifferentGIs(GIof34orGIof62)andalow-fatdiet(30%ofcaloriesfromfat;GIof65)onweightlossindicatedthatthelow-GIdietreducedbodyweightmoreeffectivelythanthelow-fatdiet.Additionally,thelow-GIdietimprovedfastinginsulinconcentration,β-cellfunction,andinsulinresistancebetterthanthelow-fatdiet.Noneofthedietsmodulatedhungerorsatietyoraffectedbiomarkersofendothelialfunctionorinflammation.Finally,nosignificantdifferenceswereobservedinlow-comparedtohigh-GLdietsregardingweightlossandinsulinmetabolism(62). Low-GI/GLdietversushigh-GI/GLdiet Inameta-analysisof14randomizedcontrolledtrialspublishedbetween2005and2011,neitherhigh-norlow-GI/GLdietaryinterventionsconductedfor6to17monthshadanysignificanteffectonbodyweightandwaistcircumferenceinatotalof2,344overweightandobesesubjects(63).Low-GI/GLdietswerefoundtosignificantlyreduceC-reactiveproteinandfastinginsulinbuthadnoeffectonbloodlipidprofile,fastingglucoseconcentration,orHbA1cconcentrationcomparedtohigh-GI/GLdiets. Ithasbeensuggestedthattheconsumptionoflow-GIfoodsdelayedthereturnofhunger,decreasedsubsequentfoodintake,andincreasedsatietywhencomparedtohigh-GIfoods(64).Theeffectofisocaloriclow-andhigh-GItestmealsontheactivityofbrainregionscontrollingappetiteandeatingbehaviorwasevaluatedinasmallrandomized,blinded,cross-overstudyin12overweightorobesemen(65).Duringthepostprandialperiod,bloodglucoseandinsulinrosehigherafterthehigh-GImealthanafterthelow-GImeal.Inaddition,inresponsetotheexcessinsulinsecretion,bloodglucosedroppedbelowfastingconcentrationsthreetofivehoursafterhigh-GImealconsumption.Cerebralbloodflowwassignificantlyhigherfourhoursafteringestionofthehigh-GImeal(comparedtoalow-GImeal)inaspecificregionofthestriatum(rightnucleusaccumbens)associatedwithfoodintakerewardandcraving.Ifthedatasuggestedthatconsuminglow-ratherthanhigh-GIfoodsmayhelprestrainovereatingandprotectagainstweightgain,thishasnotyetbeenconfirmedinlong-termrandomizedcontrolledtrials.Intherecentmulticenter,randomizedcontrolledDiet,Obesity,andGenes(DiOGenes)studyin256overweightandobeseindividualswholost≥8%ofbodyweightfollowinganeight-weekcalorie-restricteddiet,consumptionofadlibitumdietswithdifferentproteinandGIcontentfor12monthsshowedthatonlyhigh-proteindiets—regardlessoftheirGI—couldmitigateweightregain(66).However,thedietaryinterventionsonlyachievedamodestdifferenceinGI(~5units)betweenhigh-andlow-GIdietssuchthattheeffectofGIinweightmaintenanceremainedunknown. Lifestylemodificationprogramsdonotcurrentlyincludethereductionofcaloriesfromcarbohydrateasanalternativetostandardprescriptionoflow-fatdiets,nordotheysuggesttheuseofGI/GLasaguidetohealthierdietarychoices(67). LoweringDietaryGlycemicLoad SomestrategiesforloweringdietaryGLinclude: •Increasingtheconsumptionofwholegrains,nuts,legumes,fruit,andnon-starchyvegetables •Decreasingtheconsumptionofstarchy,moderate-andhigh-GIfoodslikepotatoes,whiterice,andwhitebread •Decreasingtheconsumptionofsugaryfoodslikecookies,cakes,candy,andsoftdrinks Table1includesGIandGLvaluesofselectedfoodsrelativetopureglucose(68).FoodsarerankedindescendingorderoftheirGIvalues,withhigh-GIfoods(GI≥70)atthetopandfoodswithlow-GIvalues(≤55)atthebottomofthetable.TolookuptheGIvaluesforotherfoods,visittheUniversityofSydney’sGIwebsite. Table1.GIandGLValuesforSelectedFoods Food GI (Glucose=100) ServingSize Carbohydrate*perServing(g) GLperServing Russetpotato,baked 111 1medium 30 33 Potato,white,boiled(average) 82 1medium 30 25 Puffedricecakes 82 3cakes 21 17 Cornflakes 79 1cup 26 20 Jellybeans 78 1oz 28 22 Doughnut 76 1medium 23 17 Watermelon 76 1cup 11 8 Sodacrackers 74 4crackers 17 12 Bread,white-wheatflour 71 1largeslice 14 10 Pancake 67 6"diameter 58 39 Rice,white,boiled 66 1cup 53 35 Tablesugar(sucrose) 63 2tsp 10 6 Dates,dried 62 2oz 40 25 Spaghetti,white,boiled(20min) 58 1cup 44 25 Honey,pure 58 1Tbsp 17 10 Pineapple,raw 58 ½cup 19 11 Banana,raw 55 1cup 24 13 Maplesyrup,Canadian 54 1Tbsp 14 7 Parsnips,peeled,boiled 52 ½ cup 10 5 Rice,brown,boiled 50 1cup 42 20 Spaghetti,white,boiled(average) 46 1cup 44 20 Whole-grainpumpernickelbread 46 1largeslice 12 5 All-Bran™cereal 45 1cup 21 10 Spaghetti,whole-meal,boiled 32 1cup 37 14 Orange,raw 42 1medium 11 5 Apple,raw 39 1medium 15 6 Pear,raw 38 1medium 11 4 Skimmilk 33 8floz 13 4 Carrots,boiled 33 ½ cup 4 1 Lentils,dried,boiled 29 1cup 24 7 Kidneybeans,dried,boiled 28 1cup 29 8 Pearledbarley,boiled 28 1cup 38 11 Cashews 25 1oz 9 2 Peanuts 18 1oz 6 1 *Amountofavailablecarbohydratesinafoodservingthatexcludesindigestiblecarbohydrates,i.e.,dietaryfiber. AuthorsandReviewers Originallywrittenin2003by: JaneHigdon,Ph.D. LinusPaulingInstitute OregonStateUniversity UpdatedinDecember2005by: JaneHigdon,Ph.D. LinusPaulingInstitute OregonStateUniversity UpdatedinFebruary2009by: VictoriaJ.Drake,Ph.D. LinusPaulingInstitute OregonStateUniversity UpdatedinMarch2016by: BarbaraDelage,Ph.D. LinusPaulingInstitute OregonStateUniversity ReviewedinMarch2016by: SiminLiu,M.D.,M.S.,M.P.H.,Sc.D. 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