The glycemic index applications in practice

The GLYCEMIC INDEX Applications in Practice The GLYCEMIC INDEX Applications in Practice Edited by Elena Philippou Assistant Professor in Nutrition and Dietetics Department of Life and Health Sciences University of Nicosia Nicosia, Cyprus CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2017 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S Government works Printed on acid-free paper Version Date: 20160719 International Standard Book Number-13: 978-1-4987-0366-6 (Hardback) This book contains information obtained from authentic and highly regarded sources Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use The authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint Except as permitted under U.S Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400 CCC is a not-for-profit organization that provides licenses and registration for a variety of users For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Contents Foreword Preface Editor Contributors Chapter 1 Introduction to Dietary Carbohydrates and the Glycemic Index Elena Philippou and Ayesha Salem Al Dhaheri Chapter 2 Common Criticisms of the Glycemic Index Effie Viguiliouk, Viranda H Jayalath, Vanessa Ha, and Thomas M.S Wolever Chapter 3 Measuring the Glycemic Index of Foods Fiona S Atkinson, Kai Lin Ek, and Jennie C Brand-Miller Chapter 4 Glycemic Index and Diabetes Mellitus: Evidence on Prevention and Management and Implications on Insulin Resistance Laura Chiavaroli, Livia S.A Augustin, Cyril W.C Kendall, and David J.A Jenkins Chapter 5 Glycemic Index and Cardiovascular Disease Risk Prevention and Management Vanessa Ha, Effie Viguiliouk, Arash Mirrahimi, John L Sievenpiper, Russell J de Souza, Cyril W.C Kendall, David J.A Jenkins, and Thomas M.S Wolever Chapter 6 Glycemic Index in Preventing and Managing Obesity: Implications for Appetite and Body Weight Regulation Anne Raben, Signe Nyby, and Martí Juanola-Falgarona Chapter 7 Glycemic Index, Glycemic Load, and Cancer Prevention Livia S.A Augustin, Laura Chiavaroli, Stephanie Nishi, Arash Mirrahimi, Cyril W.C Kendall, and David J.A Jenkins Chapter 8 Manipulating Dietary Glycemic Index as a Means of Improving Exercise and Sports Performance Lars McNaughton, David Bentley, and S Andy Sparks Chapter 9 Dietary Glycemic Index Manipulation to Improve Cognitive Functioning: Is It Possible? Elena Philippou and Marios Constantinou Chapter 10 GIycemic Index and Women’s Health: Dietary GI in Management of Polycystic Ovary Syndrome and during Pregnancy Kate Marsh Chapter 11 Glycemic Index and Eye Health: Dietary Hyperglycemia and Metabolic Retinal Diseases Chung-Jung Chiu, Min-Lee Chang, and Allen Taylor Chapter 12 Glycemic Index Use on Food Labels: Informed Food Choice or Misuse? Alan W Barclay Chapter 13 Creating Food Products with a Lower Glycemic Index Sophie Vinoy, Aurélie Lesdéma, Gautier Cesbron-Lavau, Aurélie Goux, and Alexandra Meynier Appendix A: Glycemic Index of Some Commonly Consumed Foods Index Foreword By 1981, the United States was in the grip of the low-fat diet craze Based upon tenuous evidence, nutrition authorities began to recommend that everyone consume as little fat as possible to avoid obesity, diabetes, heart disease, and possibly cancer Instead, the public was advised to base their diet on carbohydrates Natural high-fat foods such as nuts, avocado, and whole milk yoghurt acquired a bad reputation, whereas highly processed carbohydrates inundated the food supply Amazingly, these products—including prepared breakfast, crackers, baked chips, breads, reduced fat cookies and cakes, and sugary beverages—were marketed as healthful or at least innocuous, even though they were composed primarily of refined grains and concentrated sugar Very soon, this low-fat message spread throughout the world The year 1981 also witnessed the introduction of the glycemic index (GI) by David Jenkins, Thomas Wolever, and colleagues at the University of Toronto At that time, the concept of the GI represented a radical departure from conventional thinking, by proposing that the health effects of carbohydrates differ according to how they affect blood glucose in the postprandial state On account of the brain’s critical dependence on this metabolic fuel under most conditions, the concentration of glucose in the blood is ordinarily tightly controlled However, most highly processed carbohydrates digest rapidly, raising blood glucose and insulin levels much more than traditionally consumed carbohydrates such as legumes, fruits, and minimally processed grains Early investigators in the field recognized that a high-GI diet stressed the body’s energy homeostasis mechanisms, with major implications not only to diabetes management but also to the prevention of type 2 diabetes, heart disease, obesity, and other modern chronic degenerative conditions Indeed, the science surrounding the GI helped explain why the conventional low-fat diet loaded with processed carbohydrates had actually contributed to many of the diseases it was intended to prevent Fortunately, the concept of the GI has also spread around the globe and is poised to outlast and supersede the low-fat diet craze A new scientific study on the topic is now being published at a rate of almost one a day, providing a wealth of new information about how diet affects hormones, metabolism, and health All fats are not the same, and neither are carbohydrates Thus, the GI leads us away from simplistic debates about nutrient “quantity,” to a critically important focus on food “quality.” Almost from its inception, the GI elicited controversy, perhaps precisely because it challenged an entrenched paradigm that implicitly considers all carbohydrates alike Some critics dismissed the GI, arguing that ostensibly unhealthful foods such as ice cream rate low on this scale But such arguments miss the point: No one dietary factor can ever define a healthful diet Others point to the existence of negative studies, neglecting the inherent complexity and heterogeneity of nutritional research and the large body of mechanistic, translational, interventional, and observational research supporting a critical role for the GI in human health In addition, the field is relatively young—many methodological issues have just recently been resolved The Glycemic Index: Applications in Practice is a wonderful birthday gift, 36 years after Jenkins, Wolever, and other visionaries brought the GI into the world In it, the reader will find chapters ranging from state-of-the-art science to clinical application, written by luminaries in the field I recommend this book with enthusiasm to everyone interested in improving public health through diet David S Ludwig Boston Children’s Hospital Harvard Medical School Harvard School of Public Health Preface It is already been 36 years since 1981 when David Jenkins, Thomas Wolever, and colleagues introduced the concept of glycemic index (GI) to differentiate carbohydrates based on the rate of blood glucose rise following their consumption Although GI was first used in the diet therapy of diabetes, since then, research evidence has accumulated to thousands of publications from all over the world with applications for prevention and/or management of metabolic syndrome, cardiovascular disease, obesity, polycystic ovary syndrome, certain types of cancer, effects on pregnancy outcomes, sports performance, eye health, and cognitive functioning As eloquently put by Professor David S Ludwig in his Foreword to this book, the GI concept has faced much controversy and criticism arising mainly from misconceptions on its use and application; nevertheless, it has led the way into understanding the importance of macronutrient quality rather than just quantity on metabolic pathways and diet–disease relationships The Glycemic Index: Applications in Practice has gathered in a systematic way all the up-to-date research in the field of GI It also provides a detailed explanation of how to correctly measure a food’s GI, how the GI of food products can be altered, and the use and misuse of GI labeling around the globe Additionally, it provides practical recommendations on how the GI concept can be applied in the dietary management of certain disease conditions It is a valuable source of information for healthcare professionals of various disciplines, such as nutritionists, dietitians, food scientists, medical doctors, sports scientists, psychologists, public health (nutrition) policy makers, and students in these fields, as well as an important addition to university libraries for reference purposes This book is a result of the combined effort of many experts, including pioneers in the area of GI research, and I wish to express my sincere gratitude to each one of them for making it such a valuable addition to the literature I also thank CRC Press and especially Dr Ira Wolinsky, who invited me to edit this book, Randy Brehm, senior editor of the nutrition program, and Kathryn Everett, production coordinator I hope you find this book stimulating and useful in your studies and practice Elena Philippou University of Nicosia Editor Dr Elena Philippou is an Assistant Professor in Nutrition and Dietetics at the University of Nicosia, Cyprus, and a Visiting Lecturer in Nutrition and Dietetics at King’s College London, United Kingdom As a registered dietitian, she also holds private consultations on diet-related issues, including obesity, cardiovascular disease, and diabetes She obtained a BSc degree in Nutrition and a postgraduate diploma in Dietetics from King’s College London, London, England, in 2001 and 2002, respectively She worked as a dietitian for the National Health Service in the United Kingdom and in parallel completed a postgraduate certificate in behavioral management of adult obesity awarded by the University of Central Lancashire, Preston, England In 2008, she completed her PhD studies at Imperial College London, focusing on the role of dietary carbohydrates and specifically dietary GI in weight maintenance and cardiovascular disease prevention Her research has been published in international peer-reviewed scientific journals and presented in scientific conferences In 2012, Dr Philippou obtained a postgraduate certificate in continuing professional academic development program in learning and teaching in higher education awarded by the University of Hertfordshire, Hatfield, England, and became a member of U.K.’s Higher Education Academy She lectures on various topics, including public health nutrition, nutritional assessment, and medical nutrition therapy of various diseases Dr Philippou’s current research interest is in the role of dietary GI manipulation and the Mediterranean diet on cognitive function including investigation of the potential underlying mechanisms Extrinsic pathway, 251 F FAO/WHO See Food and Agriculture Organization/World Health Organization (FAO/WHO) Farkas’ observation, 241 Fasting blood glucose (FBG), 79, 84, 97 Fat, 17, 305 impact on GI and II, 289t inverse effect, 289 FDA (U.S Food and Drug Administration), 47, 85, 91 Fermentation, 230, 306 colonic, 91, 300 sourdough, 288 Fermentative glycolytic pathway, 130 Fetal macrosomia, 205, 208 FFA See Free fatty acid (FFA) Fiber, 25, 32, 305 cellulose, 9, 17 prebiotic, 300, 306 soluble and insoluble, 8–9 viscous dietary, 8, 289–291 Fibrinogen, 85, 203 Flow-mediated dilation (FMD), 61 Food blood glucose response acidity, 17 curve, 14, 30 fiber, 17 preparation, 17 processing, 16 protein, fat, and carbohydrate, 17 starch type, 16 sugar, 17 total iAUC for, 38 CHO-rich, diversity of, 285–287 GI reduction in, 287–305 buccal phase, 287–288 enzymatic digestion of CHO, 291–296 food components effects on GI, 303–305, 304t gastric emptying, 288–291 glucose output enlargement, 300–302 glucose replacement with metabolized sugars, 297–300 long-term health impact for, 305–306 prebiotic fibers effects, 300 GI values, 30–31, 35–36, 38 labeling, 24 modeling, 279 purchasing decision making, 274 reference, 32–33 standards codes, GI, 276–278 Australia and New Zealand, 277–278 South Africa, 276–277 testing, GI, 33–34, 34t Food and Agriculture Organization of the United Nations, 23 Food and Agriculture Organization/World Health Organization (FAO/WHO), 2–4, 7–8, 10 Food frequency questionnaire (FFQ), 50, 64, 142–143 Food Standards Australia New Zealand’s (FSANZ), 277, 279 FoPL See Front-of-pack labeling (FoPL) Framingham Heart Study (FHS), 81–82 Free fatty acid (FFA), 163–164, 167 Free sugars, 4 health risks of consumption of, 11–13 Front-of-pack labeling (FoPL), 278–279, 278f schemes, 280–282, 281f Fructose, 3, 17, 24, 236, 297, 298t Fructose-6 phosphate (F-6-P), 240 G Ganglioside, 241 Gastric cancer, 140–141 cancer prevention, GI/GL, 140–141 Gastric emptying phase, 288–291 lipids effect, 288–289 organic acids effect, 288 soluble viscous dietary fiber effect, 289–291 Gastric inhibitory polypeptide (GIP), 63, 300 Gastrointestinal microbiota, 7 Gelatinization, 6 starch, 291–294 Geographic atrophy (GA), 224 Gestational diabetes (GDM), 35, 84, 204, 208 diagnostic criteria, 204t GI and, 209–210 tips for women with, 210 Gestational weight gain (GWG), 204–206 GI See Glycemic index (GI) GI Foundation of South Africa’s (GIFSA), 280–282, 281f GI/GL cancer/carcinoma risk, 130–142 breast, 131–133, 132f, 133f colorectal, 133–136, 135f, 136f endometrial, 137–138, 138f esophageal squamous cell, 141 gastric, 140–141 liver, 141–142 ovarian, 139–140 pancreatic, 136–137 prostate, 139 CF and dietary, 175–191, 176t–187t adults, effects of, 189–191 children, effects of, 189–190 effect of altering, 176t–187t effects, 188, 193–194 inconsistencies, 192–193 meal interventions, 188 results, 191–192 diabetes/diabetes mellitus, 56t limitations, 142–143 mechanisms, 143–145 cancer and IGF-1, 143–144 dietary and IGF-1, 144 oxidative stress, 145 overview, 128–130 diet and cancer, 128–129 glycemia and cancer, 129–130 GIP (gastric inhibitory polypeptide), 63, 300 GL See Glycemic load (GL) Glucagon-like peptide-1 (GLP-1), 63, 111, 300 Glucose, 3, 17, 219 concentration, 36 homeostasis, 220, 243 memory-enhancement effect, 193 output enlargement, 300–302 amino acid effects on insulin secretion, 302 protein quantity, 300, 301, 302 scale, 30 tolerance, 34–35, 193 Glucose-6 phosphate (G-6-P), 240 Glucose-enhancing effect, 175 Glucose transporter 1 (GLUT-1), 248 Glucose transporters (GLUTs), 248 GLUT-4 transporters, 164 Glutamine:fructose-6 phosphate amidotransferase (GFAT), 240 Glutathione (GSH), 236 Glycated hemoglobin (HbA1c), 58–59, 129 Glycemia and cancer, 129–130 Glycemic carbohydrates, 8–9 Glycemic control, 24, 58–62, 59f, 60f, 84–85, 95–98 macrovascular disease, 61–62 microvascular disease, 60 Glycemic index (GI), 29, 86, 128, 157, 219, 273, 276–277, 285–287 See also GI/GL and AMD, 222–225, 222t diabetes, 224–225 epidemiological studies, 222–224, 223f barriers, 275–276 blood collection and analysis, 36–38, 37f, 39t–40t lipids, dyslipidemia and, 87–91 pressure, hypertension and, 91–93 body weight, and obesity, 93–95 category claims, 276–277 on CF, 176t–180t classification, 15t, 30, 31t clinical utility, 38 and CVD, 98 effects on risk factors of, 87–98 defined, 9, 14–15, 47 diabetes prevention/treatment clinical trials, 50–54, 50f, 58–62 insulin, 54–55 observational evidence, 48–50, 48f, 49f, 56–57 overview, 47–48, 55–56, 56t dietary guidelines, 86–87 EPIC methodology, 56 factors, 24 influence of food, 40–41, 41t fat impact on, 289t food purchasing decision making, 274 standards codes, 276–278 FoPL, 278–279, 278f schemes, 280–282, 281f glycemic control, and diabetes, 95–98 in health and disease, 18 inaccuracy and imprecision, 23 interventions and exercise performance, 159t–161t recovery, 162t of isomaltulose, 295 long-term health impact for reduction, 305–309 component combinations relevance, 307–309 food components, 305–306 potential candidates, 306–307 low and high, 29, 30f mechanisms, 62–63, 62f meta-analysis, 48 methodology, 23–24 and mixed meals, 25, 34 pathogenesis of diabetes, 220, 221f and post-exercise recovery, 167–168 potential misuse, 274–275 as predictor, 24–25 preparation, 35–36 reduction in food, 287–305 buccal phase, 287–288 enzymatic digestion of CHO, 291–296 food components effects on GI, 303–305, 304t gastric emptying, 288–291 glucose output enlargement, 300–302 glucose replacement with metabolized sugars, 297–300 prebiotic fibers effects, 300 of some commonly consumed foods, 319t–322t standardized measurement, 274 standardized method, 23 symbol program, 279–280, 279f, 279t testing methodology, 31–32, 34, 36 carbohydrate, 32 food, 33–34, 34t reference food, 32–33 subjects, 34–35 value(s) accuracy/reliability, 30 application and uses, 38–40 food/beverage, 30–31, 35–36, 38 sweeteners, 32 viscous soluble fiber impact on, 290t Glycemic Index Foundation (GI Foundation), 276, 279 Glycemic load (GL), 15–16, 38, 47, 128, 174, 273 See also GI/GL; Glycemic index (GI) on CF, 181t–187t GI, 56t Glyceraldehyde-3 phosphate dehydrogenase (GAPDH), 229, 242 Glycogenolysis, 163, 166 Glycogen resynthesis, 167–168 Glycolytic pathway, 130, 227, 240 Glycosyltransferases, 241 GLYNDIET study, 90, 97, 113 Glyoxal (GO), 231, 233 Gold-standard euglycaemic hyperinsulinaemic clamp, 55 Gorging approach, 167 Group mean GI, 38 GSH-dependent glyoxalase complex, 233 Gut microbiota, 46, 300, 306 H Hazard ratio (HR), 61, 135 HDL-C See High-density lipoprotein-cholesterol (HDL-C) Healthier Choice Symbol (HCS) program, 281 Health Professionals Follow-up Study (HPFS), 202 Health star rating, 278, 278f Healthy foods and carbohydrate quality, poor predictor GI, 24–25 Heat shock proteins (HSPs), 246 HeLa cells, 248 Hemicelluloses, 6, 9 Hemorrhage, 226 Hepatocellular carcinomas (HCC), 141 Heterodimeric protein complex, 244 Hexosamine pathway, 229, 240–241, 240f Hexose (6C) sugars, 6 HGI See High GI (HGI) HIF See Hypoxia-inducible factor (HIF) HIF-1α, 244 proteins, 243 HIF-1β, 244 High-CHO meal, 167 High-density lipoprotein-cholesterol (HDL-C), 52, 81, 90 High-fructose corn syrup (HFCS), 3–4, 12 High GI (HGI), 157 food, 30 issue, 62 meals ingestion, exercise, 164–167 pre-exercise, 158, 159t–161t, 163–164 High-resistant starch (high-RS) content, 6 High sensitivity C-reactive protein (hsCRP), 203 Hirsutism, 200 HMG-CoA (3-Hydroxy-3-methylglutaryl-coenzyme A), 82, 91 HOMA-Beta cell function, 113 Homeostatic model assessment—insulin resistance (HOMA-IR), 55, 113, 203 Homocysteine, 85 Hormone-sensitive lipase, 163 hsCRP (high sensitivity C-reactive protein), 203 Human lens epithelial cells (HLEC), 248 Human RPE cells, 238 Hydrolysis index, 31, 294 of starch, 2 Hydrothermic parameter, 292 Hyperandrogenism syndrome, 200–201 Hyperglycemia(ic), 47, 63, 128–129 AGE pathway, 230–236, 233f advanced lipoxidation end products in retina, 235–236 and AMD, 232–235 and DR, 231–232 DR/AMD, mechanisms dietary, hypothesized, 227–250, 228f induces inflammation and apoptosis, 250–251 pathology, 225–227 hexosamine pathway, 240–241, 240f HIF pathway, 243–250, 244f–245f, 249f memory, 232 mitochondria-derived ROS, 241–243 pathogenesis, 230 PKC pathway, 238–240, 239f polyol pathway, 236–238, 237f unifying hypothesis, 242 vs euglycemia, 228f, 229 Hyperglycemia and adverse pregnancy outcomes (HAPOs), 204 Hyperglycemia-induced PKC activation, 238 Hyperglycemia-inducible factor, 248 Hyperinsulinemia/hyperinsulinaemia, 14, 47, 62–63, 128, 139 Hyperlipidemia, 62, 236 Hyperproliferative vascular disease, 250 Hypertriglyceridemia, 14 Hypocaloric diet, 203 Hypoglycemia/hypoglycaemia, 59–60, 63, 158, 174 Hypothalamic-pituitary-adrenal axis, 194 Hypoxia, 226, 228f, 230, 243, 246–247 Hypoxia-inducible factor (HIF) pathway, 243–250, 244f–245f ChREBP-mediated, 249f erythropoietin, 250 hyperglycemia, 246–249 hypoxia-inducible factor, 243–246 VEGF, 249–250 I iAUC See Incremental area under the curve (iAUC) iBRB See Inner blood–retinal barrier (iBRB) IGF (insulin-like growth factor), 140, 143–144 IGF-1 See Insulin-like growth factor 1 (IGF-1) IGF-binding protein (IGFBP), 139, 143–144 II See Insulin index (II) IL (interleukin)-1β, 251 Impaired glucose tolerance (IGT), 34, 47–48, 50, 145, 191, 295 Impaired glycemia, 47 Incremental area under the curve (iAUC), 15, 33, 35–36 baseline concentration, 37, 37f blood glucose, 38 Indigestible carbohydrates, 32 Infertility syndrome, 200 Inflammation, clinical trials GI, 53–54 Inflammatory cytokines, 145, 234–235, 250–251 Inner blood–retinal barrier (iBRB), 225, 231 breakdown, 239 dysfunction, 232 Institute of Medicine (IOM), 205 Insulin, 13, 62 amino acids effects on, 302 GI, 54–55 metabolic syndrome, 13–14, 13f resistance, 46, 63, 84, 134, 200 response, 142, 289, 298t exacerbated, 286, 288 maltitol effect on, 299t serum, 166f Insulin index (II), 15 fat impact on, 289t viscous soluble fiber impact on, 290t Insulin-like growth factor (IGF), 140, 143–144 Insulin-like growth factor 1 (IGF-1), 137, 248 bioavailability, 139 cancer, 143–144 dietary GI/GL and, 144 Insulin sensitivity index (ISI), 203 INTERHEART study, 82–84 Intermittent exercise, 166–167 International Association of Diabetes and Pregnancy Groups (IADPSG), 204 International GI tables, 132, 143 International Organization for Standardization (ISO), 23, 30, 32–33, 35–36, 40 26642:2010, 275, 279 Intracellular detoxifying enzymes, 233 Intrinsic pathway, 251 Iowa Women’s Health Study, 49 Ischemia(ic), 226, 243, 250 heart disease, 83 retinopathies, 239 ISO See International Organization for Standardization (ISO) Isocaloric energy-restricted diets, 113 Isoflavones, 307 Isomaltulose, 295, 303 Italian Society of Human Nutrition (SINU), 55, 56t, 60 K Kidney disease (nephropathy), 46, 57, 60 Kreb’s cycle, 226–227 L Lactate dehydrogenase A (LDH-A), 248 Lactate fermentation, 247 Lactose, 3–4, 297 Large-for-gestational age (LGA), 204 LDL-C See Low-density lipoprotein-cholesterol (LDL-C) LGI See Low GI (LGI) LGI/HGI meals exercise adaptations, 164–167 endurance exercise, 164–166, 165f, 166f intermittent exercise, 166–167 metabolic responses, 158–164, 159t–161t, 162t Lifestyle management, 108 Lipids, 235 effect on GI, 288–289 Lipofuscin, 227, 234 Lipolysis, 163–164 Liver cancer, 141–142 Loughborough Intermittent Shuttle Test (LIST), 167 Low- and middle-income countries (LMIC), 80, 83–84 Low-density lipoprotein-cholesterol (LDL-C), 51–52, 51f, 81–82 Low GI (LGI), 30, 113, 163 diet, 209, 286 benefit, 59, 64, 203 foods, 47 diet effect on, 97 meals ingestion, exercise, 164–167 pre-exercise, 158, 159t–161t, 163–164 M Macronutrients, 2, 286 Macrovascular disease, 61–62 diabetes, 55, 57 Macular degeneration, 57 Maculopathy, 227 Maillard products, 235 Maillard reaction, 230 Maltitol, 297, 306, 308 effect on glycemic and insulin responses, 299t Maltose, 4 Mediterranean diet, 61–62 Menopausal status, 131–132, 144 Menstrual abnormalities, 200 Meta-analysis(es), 48, 52, 79–80, 129–130 effect of pulses, 60f GI/GL and risk breast cancer, 132f, 133f colorectal cancer, 135f, 136f endometrial cancer, 138f GI/GL and type 2 diabetes, 48–49, 48f, 49f low GI diet, 59f low-vs high-GI dietary, 51f menopausal status, 131 RCTs, 86, 87, 91 sugar, 12 Metabolic syndrome (MetS), 200 Metabolism, 9, 12, 15, 35 glucose, 219, 229, 248 mitochondrial oxidative, 145 Methylglyoxal (MGO), 231, 233, 247 MetS (metabolic syndrome), 200 Microaneurysms, 226 Microvascular disease, 60 diabetes, 55, 57, 220 Mitochondria-derived ROS, 241–243 AMD, 243 DR, 242 pathway, 230 Mitochondrial biogenesis, 164 Mitochondrial oxidative metabolism, 145 MoCA (Montreal Cognitive Assessment), 195 Monitoring Trends and Determinants in Cardiovascular Disease study (MONICA), 112 Monosaccharides, 2–5, 297 Monounsaturated fatty acid (MUFA), 93, 97 Montreal Cognitive Assessment (MoCA), 195 Müller cells, 226, 242, 251 Muscle biopsy technique, 158 Myocardial infarctions (MIs), 82, 84, 98 N Nϵ-(carboxyl-methyl) lysine (CML), 231, 235 N-acetyl-glucosamine (GlcNAc), 241 NADPH-dependent reductases, 238 Na+-taurine cotransporter (TT), 165, 236, 238 National Health and Nutrition Examination Survey, 93, 117, 297 Natural sugars, 4 Neonatal anthropometry, 208 Neovascular AMD, 224–225 Neural tube defects (NTDs), 207 Neuronal cells, 242 Neurons NOS (nNOS), 246 Neuropsychological tests, 174–175 functions, 189 instruments, 195 Neurotransmitter, 193 Nibbling approach, 167 Nitric oxide (NO), 238, 246 Nitric oxide synthase (NOS), 246 Nonatherogenic lipids, 81 Nondigestible oligosaccharides, 5 Nonesterified fatty acid (NEFA), 203 Non-α-glucan oligosaccharides, 5 polysaccharides, 6 Nonglycemic carbohydrate, 8 Nonmilk extrinsic sugar, 4, 11 Nonneoplastic cells, 130 Nonstarch polysaccharides (NSPs), 2, 6–10 Normal glucose tolerance (NGT), 34–35, 48, 191 Normoxia, 228f, 230, 245, 247, 249f HIF, 244f–245f Nurses’ Health Study (NHS), 202, 222–223 Nurses’ Health Study II (NHS-II), 209 Nutrient profiling, 275 system, 281 Nutrition and Vision Project (NVP), 222 O O-acetylglucosaminylation (O-GlcNAcylation), 241 Obesity, 52, 83–84, 135, 273 GI in preventing and managing acute effects of dietary GI, 108–111 appetite regulation, 109–110 effects of dietary GI, 111–119 energy balance, 110–111 goals, 107 methodological and analytical flaws, 119–120 overview, 107–108 persistence, 108 serious complications, 107 and weight loss in adults, 111–117 weight maintenance after weight loss, 117–119 in pregnancy, 205 oBRB See Outer blood–retinl barrier (oBRB) Oligosaccharides, 2, 5 OmniCarb study, 90, 97 Oral digestion, 287–288 Oral glucose tolerance test (OGTT), 203 Organic acids, 3, 17, 306 effect on gastric emptying, 288 Outer blood–retinal barrier (oBRB), 226, 235, 238, 244 Ovarian cancer, 139–140 Overweight, 52, 62, 83–84, 97, 107, 119, 201 See also Obesity in pregnancy, 205 Oxidative stress, 63, 145, 238, 248 Oxygen homeostasis, 243 P P53 phosphorylation, 164 “Pair-testing,” 40 Pancreatic beta-cell function, 53 Pancreatic cancer, 136–137 etiology, 136 GI/GL cancer prevention, 136–137 risk factors, 136 PCOS See Polycystic ovary syndrome (PCOS) Pentose phosphate pathway, 248 Per-Arnt-Sim (PAS) domain, 246 Pericytes, 226, 231, 241 Peroxisome-proliferator-activated receptor-gamma coactivator-1alpha (PGC-α), 249 PHD (proline hydroxylase), 245–247 Photoreceptor cells, 226–227, 234, 250 PKC See Protein kinase C (PKC) PKC-β activation, 238–239 Placebo, 50–51, 173–174 Plant cell wall polysaccharides, 6, 8 Plasma, 36 F2-isoprostanes, 145 glucose, 165, 297 concentration, 300 insulin, 163 Plasminogen activator inhibitor-1 (PAI-1), 238, 240 Platelet-derived growth factor (PDGF), 235 Platelet-derived growth factor-B (PDGF-B), 232, 235 Poly(ADP-ribose) polymerase (PARP), 229, 242 Polycystic ovary syndrome (PCOS), 137, 199 diagnostic criteria, 200t dietary management, 201–202 health risks, 200 insulin resistance, 200 management, 200–201 Polyol(s), 297, 299t, 300, 304, 306 pathway, 229, 236–238 AMD, 237f, 238 DR, 236 with prebiotic fibers, 308 Polyphenol, 303 dietary, 296 potato, 296t side effects, 306–307 Polysaccharides, 2 nonstarch, 6 plant cell wall, 8 Polyunsaturated fatty acids (PUFAs), 235 Ponderal index, 208 Postmenopausal, 132, 140 Postpartum weight retention (PPWR), 206 Postprandial blood glucose, 29, 48, 167 Postprandial glycemia, 29, 36, 51, 286, 300 Postprandial hyperglycemia, 47, 61–62 Postprandial metabolic response, 301t Potential misuse, GI, 274–275 Prebiotic fibers, 300, 306, 308 Prebiotics, 7–8 Pregnancy and Glycemic Index Outcomes (PREGGIOs), 208 Pregnancy, dietary GI birth defects, 207 birth weight, 207–208 blood glucose concentration, 204–205 GDM, 209–210 outcomes, 208–209 overview, 204 postpartum diet, 210–211 tips, 210 weight gain, 206t weight management, 205–207 Pregnancy, infection, and nutrition (PIN) study, 206 Premenopausal, 131–132, 140, 144–145 Prevention and management, CVD, 85–86 medication, 85–86 physical activity and diet, 86 smoking, 86 PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World (PREVIEW) project, 119 Prognostic biomarker, 247 Proliferative DR, 226, 250 Proliferative retinopathy, 226, 231 Proline hydroxylase (PHD), 245–247 Prostate cancer, 139 Protein, 17, 108, 230 complex, 241, 244 dietary, 302 HIF, 246 quantity, 300–302 Protein-1 activation, 250 Protein kinase C (PKC), 246–247 βII, 229 pathway, 238–240, 239f AMD, 239–240 DR, 239 Protein phosphatase 2A (PP2A), 248 Pseudohypoxia, 243 Psychopathology, 189 Pyruvate dehydrogenase (PDH), 248 Pyruvate dehydrogenase kinase 1(PDK1), 247 R RAGE (receptor for AGEs), 231–232, 234 Randomization, clinical trials, 35–36 Randomized controlled trials (RCTs), 12, 52, 64, 83, 97 meta-analysis, 51f, 59f, 60f Randomized cOntrol trial of LOw (ROLO) study, 206, 208, 210 Randomized parallel design, 53 RCTs See Randomized controlled trials (RCTs) Reactive oxygen species (ROS), 227 mitochondrial, 229–230, 241–243 Reference food, GI, 32–33, 36 GI value, 30 starchy, 32 testing, 33 variety, 32 Refined sugars, 4 Relative risk (RR), 86, 131, 134–135, 209, 224 multivariate, 140 Resistant starch, 8, 32 Retinal capillary wall, 226 Retinal endothelial cells, 225, 239 Retinal hypoxia, 230 Retinal microvascular cells, 226 Retinal neovascularization (RNV), 226, 235 Retinal pericytes, 231, 241 Retinal photoreceptors, 250 Retinal pigment epithelium (RPE), 226–227, 234, 238, 241, 244 Retinopathy (eye diseases), 46, 57, 231 Risk factors, CVD blood lipids, dyslipidemia, 81–82 blood pressure, hypertension, 82–83 body weight, overweight/obesity, 83–84 glycemic control, diabetes mellitus, 84–85 other emerging risk factors, 85 ROS See Reactive oxygen species (ROS) RPE See Retinal pigment epithelium (RPE) RPE–Bruch’s membrane–choriocapillaris complex, 227 RR See Relative risk (RR) S Salivary amylase, 287–288 gene (AMY1), 32 SBP (systolic blood pressure), 82–83 SDS See Slowly digestible starch (SDS) Seguimiento Universidad de Navarra cohort, 93 Short-term memory, 189–190 Slowly digestible starch (SDS), 286, 305 method, 291–292 Small-for-gestational age (SGA) infant, 204 Soluble and insoluble fiber, 8–9 Soluble RAGE, 234 Soluble viscous fiber effect, gastric emptying, 289–291 Sorbitol, 3, 236 Spectrophotometric assays, 36 Squamous cell carcinoma, 141 Stable isotope method, 288 Standardized measurement, GI, 274 Starch, 5–6, 5f, 291, 305 amylopectin, 5–6, 5f, 16 amylose, 5–6, 16 gelatinization reduction, 291–294 hydrolysis, 2, 31 hydrothermic processing impact on, 292f interactions, 292 resistant, 8 types, 16 Starch–lipid complex, 295 Starchy reference food, 32 Stratification analysis, 224 Stress hormones, 194 The Study to Prevent Non-Insulin Dependent Diabetes Mellitus (STOP-NIDDM), 50, 98 Subgroup analysis(es), 52, 131–132, 134, 140 Sucrose, 3–4, 17, 32 Sugars, 2–5, 17 added, 4 alcohols, 3, 9 discretionary, 4 extrinsic and intrinsic, 4–5 free, 4 glucose replacement with metabolized, 297–300 hexose (6C), 6 natural, 4 nonmilk extrinsic, 4 pentose (5C), 6 refined, 4 total, 4 Sugar-sweetened foods and beverages (SSB), 12 Superoxide dismutase (SOD2), 243 Switching glucose metabolism, 229 Symbol program, GI, 279–280, 279f, 279t Synergistic effect, hypoxia and hyperglycemia, 247 Synthesized/modified CHOs, 294–295 Systolic blood pressure (SBP), 82–83 T T2DM See Type 2 diabetes (T2DM) Taurine, 238 Temperate climate fruits, 93, 97 TGF-β (transforming growth factor beta), 235, 240 Tight glycemic control, 60 Tissue aging, 227 Total carbohydrates, 2–3 Total cholesterol (TC), 87 Total sugars, 4 Trail Making Test, 195 Trehalose, 4, 295 Trial making test A & B (TMT A & B), 189 Tricarboxylic acid (TCA) cycle, 226–227, 230, 243, 248 Trowell defined dietary fiber, 8 Tumor necrosis factor α (TNF-α), 235 Type 1 diabetes/diabetes mellitus, 46, 84, 194 Type 2 diabetes (T2DM), 46–47, 54, 84, 107, 128–130, 191, 194 12-month clinical trial, 61 anti-diabetic medications, 58 CVD with, 56–57 develpoment, 63 diagnosis, 55 risks, 48–50, 48f, 49f U Ubiquitin-dependent proteasomal degradation pathway, 245 Ubiquitin (Ub) proteasome pathway, 232–233, 247 Ub-protein ligase, 245 UDPGlcNAc (uridine diphosphate N-acetyl glucosamine), 240 UK Pregnancies Better Eating and Activity Trial (UPBEAT), 206, 208–209 Unavailable carbohydrates, 9 Uncoupling proteins (UCPs), 242 Uridine diphosphate N-acetyl glucosamine (UDPGlcNAc), 240 U.S Department of Agriculture, 2 U.S Food and Drug Administration (FDA), 47, 85, 91 V VADT, 47 V-amylose, 295 Vascular endothelial growth factor (VEGF), 230, 232, 234, 238–239, 249–250 Venous system, 36 Verbal episodic memory, 174 Verbal memory, 191 Very-low-density lipoprotein (VLDL), 203 Visceral adipose tissue, 14 Viscous fiber, 17, 25 Viscous soluble fibers, 290–291, 303 Volume-sensitive taurine efflux pathway, 238 Von Hippel–Lindau (VHL) mutations, 243 W Warburg effect, 130 Waxes, 3 Waxy starches, 294 Wechsler memory scale-IV (WMS-IV), 189 Weight, body, 83–84, 93–95 Weight gain, 10 Weight loss, GI, 52–53, 111–117 definition, 111–117 hypocaloric design, 116 intervention trials, 113–117 isocaloric design, 116 prospective cohort studies, 111–112 Weight maintenance, dietary GI, 117–119 Weight management, 210 GI and, 206–207 in pregnancy, 205–206 Weight watcher plan, 113 Whole grain, 10, 25 Working memory, 175 World Health Organization (WHO), 11–12, 95, 139, 204 .. .The GLYCEMIC INDEX Applications in Practice The GLYCEMIC INDEX Applications in Practice Edited by Elena Philippou Assistant Professor in Nutrition and Dietetics Department of Life and Health Sciences... Jenkins, Wolever, and other visionaries brought the GI into the world In it, the reader will find chapters ranging from state-of -the- art science to clinical application, written by luminaries in. .. However, Cumming and Stephen rightly pointed out that because the type of grain contributing to whole grains varies from country to country, with most of the wholegrain intake being wheat in the United Kingdom and oats in