Glycemic index in chronic disease: a review.
OBJECTIVE
The intent of this review is to critically analyze the scientific evidence on the role of the glycemic index in chronic Western disease and to discuss the utility of the glycemic index in the prevention and management of these disease states.


BACKGROUND
The glycemic index ranks foods based on their postprandial blood glucose response. Hyperinsulinemia and insulin resistance, as well as their determinants (eg high energy intake, obesity, lack of physical activity) have been implicated in the etiology of diabetes, coronary heart disease and cancer. Recently, among dietary factors, carbohydrates have attracted much attention as a significant culprit, however, different types of carbohydrate produce varying glycemic and insulinemic responses. Low glycemic index foods, characterized by slowly absorbed carbohydrates, have been shown in some studies to produce beneficial effects on glucose control, hyperinsulinemia, insulin resistance, blood lipids and satiety.


METHODS
Studies on the short and long-term metabolic effects of diets with different glycemic indices will be presented and discussed. The review will focus primarily on clinical and epidemiological data, and will briefly discuss in vitro and animal studies related to possible mechanisms by which the glycemic index may influence chronic disease.
Augustin
L S
LS
Servizio di Epidemiologia, Centro di Riferimento Oncologico, Istituto Nazionale Tumori, Aviano, Italy. livia.augustin@utoronto.ca
Franceschi
S
S
Jenkins
D J A
DJ
Kendall
C W C
CW
La Vecchia
C
C
D019540:Area Under Curve; D001786:Blood Glucose / Q000378:metabolism*; D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000209:etiology* / Q000517:prevention & control; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000145:classification / Q000378:metabolism; D015444:Exercise / Q000502:physiology; D005502:Food / Q000145:classification*; D038321:Glycemic Index; D006331:Heart Diseases / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology / Q000517:prevention & control; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D009369:Neoplasms / Q000209:etiology* / Q000517:prevention & control; D009765:Obesity / Q000378:metabolism; D019518:Postprandial Period
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007328:Insulin