Glycemic Index: Use with caution

Go Lean rolls were created around the aspect of glycemic load (GL), the relation of GI to grams of carbohydrate. Many nutritionists feel GL gives a more realistic picture than GI because we eat mixtures of ingredients, all of which affect blood glucose. Others point out foods with the same GL may vary significantly in glycemic response.

"Desired" GI numbers often are achieved by the use of novel sweeteners with a very low GI. For example, Danisco offers a line of sugar alcohols and "randomly bonded glucose polymers" that are incompletely broken down in the small intestines.

Another strategy used to lower GI in foods is to replace sugars with non-digestible fructose polymers, which also act as prebiotics. Two examples, Raftiline and Raftilose by Orafti (www.orafti.com), Malvern, Pa., are prebiotic ingredients used in a wide range of food and beverage products.

Because of the complexity and the controversy that has accompanied GI, some manufacturers feel it's confusing to place GI numbers on the label. "Glycemic index is a tool that can be used in the present-day struggle with being overweight and obese, but it's just one tool,” says Gerry Amantea, vice president of technical service for Hain Celestial Group Inc. (www.hain-celestial.com), Melville, N.Y. "If a low-glycemic snack can help a person sustain energy between meals so that at the end of the day fewer calories are consumed, the snack is a beneficial addition to the diet. In the end, it's 'calories in,  calories out' that counts."

The Hain Celestial Group has developed a new line of low-GI products, called "Low G," in its Estee brand of sugar-free foods and snacks. The company spent decades creating foods that have been ahead of the trends in "healthy" carbohydrates and fats. "Although the Low G products all have been stringently tested for glycemic load, they will not carry glycemic index numbers, which at this point we feel overcomplicates a simple concept," says Amantea.

Some manufacturers find the rapid move toward GI mania troubling. Lara Merriken, CEO and founder of Humm Foods Inc. (www.larabar.com), Denver, worries about the message sent by placing glycemic index on the food label. Creator of the Lärabar line of organic raw food bars made with whole fruits and nuts, Humm Foods plays up the products, not the numbers.

"While I understand GI is trying to give people a measure, I also believe GI can steer consumers toward following a diet regimen that only focuses on GI and not on the quality of the ingredients in the product," Merriken says.

Rhonda Witwer, business development manager-nutrition at National Starch Food Innovation (www.foodinnovation.com), Bridgewater, N.J., agrees. "The quality of carbohydrates in our diet does matter, but focusing on glycemic index instead of the food components, such as dietary fiber or natural resistant starch, is a step in the wrong direction," she explains. "GI tells only part of the story. It does not indicate the effect of foods on insulin — the critical biomarker for maintaining healthy blood-sugar levels. Studies show glycemic index and glycemic load do not increase insulin sensitivity. In contrast, increasing dietary fiber and natural resistant starch are proven strategies for improving insulin sensitivity, which is the underlying biomarker for metabolic syndrome."

Mixed reviews

Can glycemic index deliver on its promise to stem the tide of obesity and type II diabetes? Or is it simply so seductively plausible it's been prematurely deemed the wave of the future? Both the Food and Agriculture Organization of the United Nations and the World Health Organization have endorsed glycemic index for use in classifying carbohydrate-rich foods and in guiding dietary choices.

However, U.S. health organizations are not so mesmerized. "Despite the increasing popularity of GI, its validity and practicality remain controversial, especially in the U.S.,” writes Katherine Beals, nutrition professor at the University of Utah and consultant for the U.S. Potato Board, in a critical review of the glycemic index. “Currently, the American Diabetes Assn., the American Heart Assn. and American Dietetic Assn. do not recognize the GI as a useful dietary planning tool for weight management or disease."

A statement by the American Diabetes Assn. published in September 2004 concluded that observing GI along with total carbohydrate can provide additional benefit for blood sugar control, but the role of low-GI foods in preventing the development of type II diabetes was unclear. Here, preventing obesity was the most important factor.

As reasonable as the connection between high-GI foods and obesity seems, there is as yet no definitive evidence that this theory is correct. There are studies that appear to support both sides, but most show that using glycemic index as a weight-loss strategy is not more effective than simply consuming fewer calories.

Strictly following a glycemic index table suggests choosing chocolate fudge cake (with a glycemic index of 39) over watermelon (with a GI of 72).

Proponents of GI point to studies suggesting health benefits from eating naturally low-GI foods, such as fruits, vegetables, beans and whole grains. Yet mixed messages riddle GI charts. There are numerous anomalous values on a GI table — foods that are healthy by any standard, yet have a high GI. Carrots and watermelon are examples.