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The Glycemic Index: Physiological Significance

Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario
Clinical Nutrition & Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario
College of Pharmacy and Nutrition, University of Saskatchewan Saskatoon, Saskatchewan CANADA

Address correspondence to: David J.A Jenkins, M.D., Ph.D., Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, M5S 3E2 CANADA, E-mail: cyril.kendall{at}utoronto.ca

The glycemic index (GI) is a physiological assessment of a food's carbohydrate content through its effect on postprandial blood glucose concentrations. Evidence from trials and observational studies suggests that this physiological classification may have relevance to those chronic Western diseases associated with overconsumption and inactivity leading to central obesity and insulin resistance.

The glycemic index classification of foods has been used as a tool to assess potential prevention and treatment strategies for diseases where glycemic control is of importance, such as diabetes. Low GI diets have also been reported to improve the serum lipid profile, reduce C-reactive protein (CRP) concentrations, and aid in weight control. In cross-sectional studies, low GI or glycemic load diets (mean GI multiplied by total carbohydrate) have been associated with higher levels of high-density lipoprotein cholesterol (HDL-C), with reduced CRP concentrations, and, in cohort studies, with decreased risk of developing diabetes and cardiovascular disease. In addition, some case-control and cohort studies have found positive associations between dietary GI and risk of various cancers, including those of the colon, breast, and prostate.

Although inconsistencies in the current findings still need to be resolved, sufficient positive evidence, especially with respect to renewed interest in postprandial events, suggests that the glycemic index may have a role to play in the treatment and prevention of chronic diseases.

Key words: glycemic index, glycemic load, cardiovascular disease, diabetes, obesity, cancer