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June 1, 1984, Vol 251, No. 21 >
ARTICLE | June 1, 1984

Dietary Carbohydrates and Their Glycemic Responses FREE

David J. A. Jenkins, MD
JAMA. 1984;251(21):2829-2831. doi:10.1001/jama.1984.03340450045026
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References

Different carbohydrate foods produce different glycemic responses, as has been recognized for many years.1-5 However, in terms of dietary advice to diabetics, emphasis has remained on the relative virtue of "complex" carbohydrates (starch) over "simple sugars." The evidence has never been this clear-cut, as indicated by a report in the current issue of The Journal6 on the modest postprandial blood glucose response to ice cream.

Different Glycemic Responses to Different Foods  Studies by Crapo and colleagues2,5 demonstrated that the glycemic response to glucose was similar to certain starchy foods. Sucrose, with a lower blood glucose response than glucose,1,3,7-10 produced a rise in blood glucose levels similar to those produced by many commonly eaten starchy foods.1,3,7-9,11,12 In addition, the blood glucose and insulin responses seen in healthy volunteers were similar when a range of carbohydrates of differing complexity were compared; these included liquid starch, caloreen (a

REFERENCES

1 +
Otto H, Bieyer G, Pennartz M, et al:  Kohlenhydrataustausch nach biologischen aquivalenten , in Otto H, Spaethe R (eds): Diatetik bei Diabetes Mellitus . Bern, Verlag Hans Huber, 1973;, pp 41-50.
2 +
Crapo PA, Reaven GM, Olefsky J:  Post-prandial plasma glucose responses to different complex carbohydrates . Diabetes 1977;;26:1178-1183.
3 +
Schauberger G, Brinck UC, Suldner G, et al:  Exchange of carbohydrates according to their effect on blood glucose . Diabetes 1978;;26:415-417.
4 +
Crapo PA, Kolterman OE, Waldeck MA, et al:  Post-prandial hormonal responses to different types of complex carbohydrate in individuals with impaired glucose tolerance . Am J Clin Nutr 1980;;33:1723-1728.
5 +
Crapo PA, Insel J, Sperling M, et al:  Comparison of serum glucose, insulin and glucagon responses to different types of complex carbohydrate in non-insulin dependent diabetic patients . Am J Clin Nutr 1981;;34:184-190.
6 +
Nathan DM, Godine JE, Gauthier-Kelley C, et al:  Ice cream in the diet of insulin-dependent diabetic patients . JAMA 1984;;251:2825-2827.
7 +
Swan DC, Davidson P, Albrink MJ:  Effect of simpte and complex carbohydrates on plasma non-esterified fatty acids, plasma sugar, and plasma insulin during oral carbohydrate tolerance tests . Lancet 1966;;1:60-63.
8 +
Bohannon NV, Karum JH, Forsham PH:  Advantages of fructose ingestion (FTT) over sucrose (STT) and glucose (GTT) in humans . Diabetes 1978;;27( (suppl 2) ):438.
9 +
Jenkins DJA, Wolever TMS, Taylor RH, et al:  Glycemic index of foods: A physiological basis for carbohydrate exchange . Am J Clin Nutr 1981;;34:362-366.
10 +
Crapo PA, Scarlett JA, Kolterman OG, et al:  The effects of oral fructose, sucrose and glucose in subjects with reactive hypoglycemia . Diabetes Care 1982;;5:512-517.
11 +
Arvdsson-Lenner R:  Studies of glycemia and glycosuria in diabetes after breakfast meals of different compositions . Am J Clin Nutr 1976;;29:716-725.
12 +
Bantle JP, Laine DC, Castle GW, et al:  Postprandial glucose and insulin responses to meals containing different carbohydrates in normal and diabetic subjects . N Engl J Med 1983;;309:7-12.
13 +
Wahlqvist ML, Wilmshurtst EG, Murton CR, et al:  The effect of chain length on glucose absorption and the related metabolic response . Am J Clin Nutr 1978;;31:1998-2001.
14 +
Jenkins DJA, Wolever TMS, Jenkins AL, et al:  The glycemic response to carbohydrate foods . Lancet , in press.
15 +
Jenkins DJA, Wolever TMS, Jenkins AL, et al:  The glycaemic index of foods tested in diabetic patients. A new basis for carbohydrate exchange favouring the use of legumes . Diabetologia 1983;;24:257-264.
16 +
Coulston A, Greenfield MS, Kraemer FH, et al:  Effect of differences in source of dietary carbohydrate on plasma glucose and insulin responses to meals in patients with impaired glucose tolerance . Am J Clin Nutr 1981;;34:2716-2720.
17 +
Jenkins DJA, Wolever TMS, Taylor RH, et al:  Exceptionally low blood glucose response to dried beans: Comparison with other carbohydrate foods . Br Med J 1980;;281:578-580.
18 +
Potter JG, Coffman KP, Reid RL, et al:  Effect of test meals of varying dietary fiber content on plasma insulin and glucose response . Am J Clin Nutr 1981;;34:325-334.
19 +
Jenkins DJA, Wolever TMS, Jenkins AL, et al:  Glycemic response to wheat products: Reduced response to pasta but no effect of fiber . Diabetes Care 1983;;6:155-159.
20 +
Nuttall FQ, Mooradian AD, DeMarais R, et al:  The glycemic effect of different meals approximately isocaloric and similar in protein, carbohydrate, and fat content as calculated using the ADA exchange lists . Diabetes Care 1983;;6:432-435.
21 +
Crapo PA, Scarlett JA, Koltman OG:  Comparison of the metabolic responses to fructose and sucrose sweetened foods . Am J Clin Nutr 1980;;36:256-261.
22 +
Crapo PA, Olefsky JM:  Food fallacies and blood sugar . N Engl J Med 1983;;309:44-45.
23 +
Ginsberg H, Olefsky JM, Kimmerling G, et al:  Induction of hypertriglyceridemic by a low fat diet . J Clin Endocrinol Metabol 1976;;42:729-735.
24 +
Reiser S, Hallfrisch J, Michailir O, et al:  Isocaloric exchange of dietary starch and sucrose in humans: Effects on levels of fasting blood lipids . Am J Clin Nutr 1978;;32:1659-1669.
25 +
Coulston AM, Liu GC, Reaven GM:  Plasma glucose, insulin and lipid responses to high carbohydrate low fat diets in normal humans . Metabolism 1983;;32:52-56.
26 +
Grande F, Anderson JT, Keys A:  Sucrose and various carbohydrate-containing foods and serum lipids in man . Am J Clin Nutr 1974;;27:1043-1051.
27 +
Turner JL, Bierman EL, Brunzell JD, et al:  Effect of dietary fructose on triglyceride transport and glucoregulatory hormones in hypertriglyceridemic men . Am J Clin Nutr 1979;;32:1043-1050.
28 +
Antar MA, Little JA, Lucas C, et al:  Interrelationships between the kinds of dietary carbohydrate and fat in hyperlipoproteinemic patients: III. Synergistic effect of sucrose and animal fat on serum lipids . Atherosclerosis 1970;;11:191-201.
29 +
Holland WM:  The diabetes supplement of the National Health Survey 3: The patient reports on his diet . J Am Diet Assoc 1966;;52:387-390.
30 +
Tunbridge R, Wetherall JH:  Reliability and cost of diabetic diets . Br Med J 1970;;2:78-80.

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1 +
Otto H, Bieyer G, Pennartz M, et al:  Kohlenhydrataustausch nach biologischen aquivalenten , in Otto H, Spaethe R (eds): Diatetik bei Diabetes Mellitus . Bern, Verlag Hans Huber, 1973;, pp 41-50.
2 +
Crapo PA, Reaven GM, Olefsky J:  Post-prandial plasma glucose responses to different complex carbohydrates . Diabetes 1977;;26:1178-1183.
3 +
Schauberger G, Brinck UC, Suldner G, et al:  Exchange of carbohydrates according to their effect on blood glucose . Diabetes 1978;;26:415-417.
4 +
Crapo PA, Kolterman OE, Waldeck MA, et al:  Post-prandial hormonal responses to different types of complex carbohydrate in individuals with impaired glucose tolerance . Am J Clin Nutr 1980;;33:1723-1728.
5 +
Crapo PA, Insel J, Sperling M, et al:  Comparison of serum glucose, insulin and glucagon responses to different types of complex carbohydrate in non-insulin dependent diabetic patients . Am J Clin Nutr 1981;;34:184-190.
6 +
Nathan DM, Godine JE, Gauthier-Kelley C, et al:  Ice cream in the diet of insulin-dependent diabetic patients . JAMA 1984;;251:2825-2827.
7 +
Swan DC, Davidson P, Albrink MJ:  Effect of simpte and complex carbohydrates on plasma non-esterified fatty acids, plasma sugar, and plasma insulin during oral carbohydrate tolerance tests . Lancet 1966;;1:60-63.
8 +
Bohannon NV, Karum JH, Forsham PH:  Advantages of fructose ingestion (FTT) over sucrose (STT) and glucose (GTT) in humans . Diabetes 1978;;27( (suppl 2) ):438.
9 +
Jenkins DJA, Wolever TMS, Taylor RH, et al:  Glycemic index of foods: A physiological basis for carbohydrate exchange . Am J Clin Nutr 1981;;34:362-366.
10 +
Crapo PA, Scarlett JA, Kolterman OG, et al:  The effects of oral fructose, sucrose and glucose in subjects with reactive hypoglycemia . Diabetes Care 1982;;5:512-517.
11 +
Arvdsson-Lenner R:  Studies of glycemia and glycosuria in diabetes after breakfast meals of different compositions . Am J Clin Nutr 1976;;29:716-725.
12 +
Bantle JP, Laine DC, Castle GW, et al:  Postprandial glucose and insulin responses to meals containing different carbohydrates in normal and diabetic subjects . N Engl J Med 1983;;309:7-12.
13 +
Wahlqvist ML, Wilmshurtst EG, Murton CR, et al:  The effect of chain length on glucose absorption and the related metabolic response . Am J Clin Nutr 1978;;31:1998-2001.
14 +
Jenkins DJA, Wolever TMS, Jenkins AL, et al:  The glycemic response to carbohydrate foods . Lancet , in press.
15 +
Jenkins DJA, Wolever TMS, Jenkins AL, et al:  The glycaemic index of foods tested in diabetic patients. A new basis for carbohydrate exchange favouring the use of legumes . Diabetologia 1983;;24:257-264.
16 +
Coulston A, Greenfield MS, Kraemer FH, et al:  Effect of differences in source of dietary carbohydrate on plasma glucose and insulin responses to meals in patients with impaired glucose tolerance . Am J Clin Nutr 1981;;34:2716-2720.
17 +
Jenkins DJA, Wolever TMS, Taylor RH, et al:  Exceptionally low blood glucose response to dried beans: Comparison with other carbohydrate foods . Br Med J 1980;;281:578-580.
18 +
Potter JG, Coffman KP, Reid RL, et al:  Effect of test meals of varying dietary fiber content on plasma insulin and glucose response . Am J Clin Nutr 1981;;34:325-334.
19 +
Jenkins DJA, Wolever TMS, Jenkins AL, et al:  Glycemic response to wheat products: Reduced response to pasta but no effect of fiber . Diabetes Care 1983;;6:155-159.
20 +
Nuttall FQ, Mooradian AD, DeMarais R, et al:  The glycemic effect of different meals approximately isocaloric and similar in protein, carbohydrate, and fat content as calculated using the ADA exchange lists . Diabetes Care 1983;;6:432-435.
21 +
Crapo PA, Scarlett JA, Koltman OG:  Comparison of the metabolic responses to fructose and sucrose sweetened foods . Am J Clin Nutr 1980;;36:256-261.
22 +
Crapo PA, Olefsky JM:  Food fallacies and blood sugar . N Engl J Med 1983;;309:44-45.
23 +
Ginsberg H, Olefsky JM, Kimmerling G, et al:  Induction of hypertriglyceridemic by a low fat diet . J Clin Endocrinol Metabol 1976;;42:729-735.
24 +
Reiser S, Hallfrisch J, Michailir O, et al:  Isocaloric exchange of dietary starch and sucrose in humans: Effects on levels of fasting blood lipids . Am J Clin Nutr 1978;;32:1659-1669.
25 +
Coulston AM, Liu GC, Reaven GM:  Plasma glucose, insulin and lipid responses to high carbohydrate low fat diets in normal humans . Metabolism 1983;;32:52-56.
26 +
Grande F, Anderson JT, Keys A:  Sucrose and various carbohydrate-containing foods and serum lipids in man . Am J Clin Nutr 1974;;27:1043-1051.
27 +
Turner JL, Bierman EL, Brunzell JD, et al:  Effect of dietary fructose on triglyceride transport and glucoregulatory hormones in hypertriglyceridemic men . Am J Clin Nutr 1979;;32:1043-1050.
28 +
Antar MA, Little JA, Lucas C, et al:  Interrelationships between the kinds of dietary carbohydrate and fat in hyperlipoproteinemic patients: III. Synergistic effect of sucrose and animal fat on serum lipids . Atherosclerosis 1970;;11:191-201.
29 +
Holland WM:  The diabetes supplement of the National Health Survey 3: The patient reports on his diet . J Am Diet Assoc 1966;;52:387-390.
30 +
Tunbridge R, Wetherall JH:  Reliability and cost of diabetic diets . Br Med J 1970;;2:78-80.

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