2/25/2014 What is the Glycemic Index?

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What is the Glycemic Index?
Topics
What Is the Glycemic Index (GI)?
Why Is GI Important?
How Is GI Measured?
Why Do Some GI Values Seem Surprising?
Where Can I Find Out More About GI?
References
Discussion
What Is the Glycemic Index (GI)?
Glycemic Index (GI) is a measurement carried out on carbohydrate-containing foods and their impact on our blood sugar. GI is a
relatively new way of analyzing foods. Previously, most meal plans designed to improve blood sugar analyzed the total amount of
carbohydrates (including sugars and starches) in the foods themselves. GI goes beyond this approach, looking at the impact of foods on
our actual blood sugar. In other words, instead of counting the total amount of carbohydrates in foods in their unconsumed state, GI
measures the actual impact of these foods on our blood sugar. We rank our WHFoods as being very low, low, medium, or high in their
GI value. You can find a GI value for each individual food in its food profile. Just go to any food profile and take a look at the
DRI%/DV% bar chart that is located towards the beginning of the article. At the top right-hand side of the chart you will find the food's
GI value.
Why Is GI Important?
Over the past 15 years, low-GI diets have been associated with decreased risk of cardiovascular disease, type 2 diabetes, metabolic
syndrome, stroke, depression, chronic kidney disease, formation of gall stones, neural tube defects, formation of uterine fibroids, and
cancers of the breast, colon, prostate, and pancreas. Taking advantage of these potential health benefits can be as simple as sticking
with whole, natural foods that are either low or very low in their GI value. We've ranking all of our WHFoods as being either high GI,
medium GI, low GI, or very low GI to make it easier for you to focus on foods whose GI values fall into the low or very low range
(we've also done this for the herbs and spices we include on the website).
How Is GI Measured?
Typically, a food is consumed in whatever serving size will provide 50 grams (about 1.8 ounces) of available carbohydrates. Available
carbohydrates (or avCHOs) are carbohydrates that get readily digested, absorbed, and metabolized by our body. These carbohydrates
have a much greater impact on our blood sugar level than carbohydrates in general because carbohydrates in general include substances
that aren't readily digested, absorbed, and metabolized. Insoluble fibers, for example, are carbohydrates that do not have an immediate
impact on our blood sugar level because they cannot be readily digested. As a very general way of estimating available carbohydrates in
a serving of food, researchers take the total amount of carbohydrates and subtract out the total amount of fiber. Available carbohydrates
are what's left.
After 50 grams of available carbohydrates have been consumed, blood sugar levels are measured over a period of 2 hours. The results
are plotted on a graph and summarized in what is called glucose AUC, or "area under the curve." Glucose AUC shows the immediate
impact of the food on our blood sugar.
Measuring GI also requires a second step. In this second step, 50 grams of available carbohydrate are consumed, but this time the food
involved is one of two reference foods: either white bread or pure sugar (glucose). Once again, blood sugar levels are measured over a
period of 2 hours, and the glucose AUC is calculated. At this point, it is possible to compare the two results. The impact of the first food
on our blood sugar is compared to the impact of either white bread or glucose itself. When these two results are compared, the impact
of the white bread or glucose is arbitrarily given a value of 100 to make the comparison easier. As an example, let's say that researchers
are trying to establish a GI for green peas and they decide to compare the impact of green peas on blood sugar to the impact of white
bread. And in this example, let's say that a person consumes a starchy vegetable like green peas, and the glucose AUC (area under the
curve) is 48% as large the glucose AUC when white bread is consumed. In this case, the GI for green peas would be established at
48% of 100, or 48. (In fact, this is precisely the GI that we use for green peas at WHFoods.)
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WHFoods GI Rating System
Most healthcare organizations use a "high," medium" and "low" rating system for GI. Using this system, foods get classified in the
following way:
Low GI Medium GI High GI
0-55 56-69 70 or greater
We like this rating system. It's also the one we used as the foundation for our own rating system at WHFoods. We kept each of these
same categories (low, medium, and high). But we used the concept of avCHO (available carbohydrate) to establish a fourth category
called "very low" as well as to rank some of our WHFoods as "low" even though they did not have a published GI value. Since over
one-third of our WHFoods are vegetables that often contain very small amounts of avCHO, we thought that the addition of a "very low
GI" category would be helpful for sorting out our vegetables in terms of their GI value. To qualify as "very low" our foods needed to
have an avCHO of less than 5 grams. (We calculated avCHO by setting a standardized food serving size of 100 grams, recording the
food's total carbohydrate content in grams, and subtracting out its total fiber in grams.) To qualify as "low" our foods needed to have an
avCHO of 5 grams or more but less than 12 grams. Finally, we ended up classifying a few of our foods as low-GI even when they did
not meet our avCHO criterion. While researching the GI values for our foods, we came across research evidence for some particular
foods that showed those foods to have a beneficial impact on blood sugar. When the preponderance of research studies for any food
showed a beneficial impact on blood sugar, we classified that food as low-GI even if it did not meet our avCHO criterion. Here is a
summary chart showing our WHFoods rating system criteria.
WHFoods Glycemic Index Rating System
Very Low GI Low GI
Medium
GI
High GI
Criteria for
Classification
No established GI value and an
available carbohydrate (avCHO) of
less than 5 grams OR an established
GI of less than 20 and an avCHO of
less than 7 grams
Either an established GI value of 55 or less OR an
available carbohydrate (avCHO) value greater or more
than 5 grams but less than or equal to 12 grams OR a
beneficial impact on blood sugar in a preponderance of
research studies
An
established
GI vale of
56-69
An
established
GI value
of 70 or
greater
Why Do Some GI Values Seem Surprising?
One of the most interesting aspects of GI involves its relationship to the unique features of carbohydrates. Carbohydrates are definitely
not the same with respect to their immediate impact on our blood sugar. For example, non-whole grain breads and pasta noodles both
contain similar amounts of starch, and their starches are similarly composed of long chains of the simple sugar, glucose. But the 3-
dimensional structure of bread allows more of the starch to be exposed to enzymes in our saliva and in our digestive tract. This greater
exposure to enzymes allows more of the starch to be broken down into sugar and gives non-whole grain breads a generally higher GI
value than non-whole grain pastas. Similarly, two basic types of starch found in many foods - amylose and amylopectin - also influence
their GI values, even if the foods have identical amounts of total starch.
With respect to their GI, foods are also differently impacted by cooking. Many legumes, for example, have cell structures that are fairly
resistant to disruption and help prevent breakdown of the starches inside their cells. For this reason, legumes tend to have lower-than-
expected GI values, provided that they have not been overcooked. Before they have been ground into flour, whole grains also tend to
have lower GI values due to the sturdiness of their cell structures. But after being ground into flour, their starches become more
susceptible to breakdown and their GI value tends to increase. Of course, these descriptions are generalizations and can be different for
specific legumes, specific grains, and specific flours. Still, they reflect a general pattern and principle: namely, that for a carbohydrate-
containing food, the more its natural integrity becomes disrupted by processing or overcooking, the more its GI value is likely to be
increased. Minimal disruption of whole foods from their natural, unprocessed state is one of our key principles at WHFoods, and it is a
principle 100% aligned with promotion of lower GI values.
GI Ratings for the World's Healthiest Foods
Food Group Very Low GI Low GI Medium GI High GI
World's Healthiest Foods
Vegetables asparagus carrots beets potatoes
avocados eggplant corn
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beet greens garlic leeks
bell peppers green peas sweet potatoes
bok choy onions
broccoli sea vegetables
Brussels sprouts winter squash
cabbage
cauliflower
celery
collard greens
cucumbers
fennel (bulb)
green beans
kale
mushrooms, crimini
mustard greens
olives
olive oil
Romaine and other lettuce
spinach
summer squash
Swiss chard
tomatoes
turnip greens
Fruits apples apricots
bananas cantaloupe
blueberries figs
cranberries kiwifruit
grapefruit papaya
grapes pineapple
lemons/limes raisins
oranges watermelon
pears
plums
prunes
raspberries
strawberries
Nuts & Seeds flaxseeds almonds
sesame seeds cashews
peanuts
pumpkin seeds
sunflower seeds
walnuts
Beans & Legumes soybeans black beans
tofu dried peas
tempeh garbanzo beans
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kidney beans
lentils
lima beans
navy beans
pinto beans
Seafood cod scallops
salmon
sardines
shrimp
tuna
Meats beef, grass-fed
chicken-pasture-raised
lamb, grass-fed
turkey, pasture-raised
Dairy cheese, grass-fed
eggs, pasture-raised
cow's milk, grass-fed
yogurt, grass-fed
Grains barley millet
brown rice
buckwheat
oats
quinoa
rye
whole wheat
World's Healthiest Spices and Herbs black pepper
cayenne & chili pepper
cilantro & coriander seeds
cinnamon
cloves
cumin seeds
dill
ginger
mustard seeds
oregano
parsley
peppermint
rosemary
sage
thyme
turmeric
Where Can I Find Out More About GI?
Much of the pioneering work on glycemic index was carried out by Professor Jennie Brand-Miller,PhD, Personal Chair in Human
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Nutrition in the Human Nutrition Unit, School of Molecular and Microbial Biosciences at the University of Sydney in Sydney, Australia.
The glycemic index website at the University of Sydney provides extensive information about her work as well as a searchable database
for GI values.
Another resource we like is the website established by medical writer David Mendosa and devoted to issues involving glycemic index,
glycemic load, and diabetes management. The Mendosa site also provides comprehensive lists of foods and their GI values.
References
For Established Glycemic Index values, We Used the Following Databases and Publications
Atkinson FS, Foster-Powell K, Brand-Miller JC. International Tables of Glycemic Index and Glycemic Load Values: 2008. Diabetes
Care 2008; 31(12).
Foster-Powell K, Holt HA, and Brand-Miller JC. International table of glycemic index and glycemic load values: 2002. Am J Clin
Nutr2002;76:556.
Human Nutrition Unit, School of Molecular Biosciences, University of Sydney, Sydney, Australia. (2013). GI Foods Advanced Search
Database. Online at http://www.glycemicindex.com/foodSearch.php.
National Cancer Institute (NCI). DHQ Nutrient Database. Applied Research: Cancer Control and Populations Sciences. National
Institutes of Health, Bethesda, MD. Available online at: http://appliedresearch.cancer.gov/DHQ/database/
In Addition We Used the Following Non-Database References
Castro-Quezada I, Sanchez-Villegas A, Diaz-Gonzalez V, et al. Relationship between dietary glycemic index, dietary glycemic load and
major cardiovascular events in the PREDIMED study. European Geriatric Medicine, Volume 4, Supplement 1, September 2013, Pages
S128-S129.
Frost G and Dornhorst A. Glycemic Index. Encyclopedia of Human Nutrition (Third Edition), 2013, Pages 393-398.
Kumar SB and Prabhansankar P. Low glycemic index ingredients and modified starches in wheat based food processing: A review
Review. Trends in Food Science & Technology, Volume 35, Issue 1, January 2014, Pages 32-41.
Lin CS, Kimokoti RW, Brown LS, et al. Methodology for Adding Glycemic Index to the National Health and Nutrition Examination
Survey Nutrient Database. Journal of the Academy of Nutrition and Dietetics, Volume 112, Issue 11, November 2012, Pages 1843-
1851.
Ma XY, Liu JP, and Song ZY. Glycemic load, glycemic index and risk of cardiovascular diseases: Meta-analyses of prospective
studies. Atherosclerosis, Volume 223, Issue 2, August 2012, Pages 491-496.
O'Reilly J, Wong SH, and Chen Y. Glycaemic index, glycaemic load and exercise performance. Sports Med. 2010 Jan 1;40(1):27-39.
Wolever TM. Is glycaemic index (GI) a valid measure of carbohydrate quality? Eur J Clin Nutr. 2013 May;67(5):522-31. doi:
10.1038/ejcn.2013.27. Epub 2013 Feb 13.
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