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        Ways Of Reducing Glycaemic Load Vary In Effects

        A DGReview of :"Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance."
        American Journal of Clinical Nutrition

        03/10/2003
        By David Loshak


        Reduction in either dietary carbohydrate or glycaemic index reduces postprandial plasma glucose equally in patients with impaired glucose tolerance, although the two approaches vary in their effects.

        While both are beneficial for managing insulin because they reduce the glycaemic load, they influence postprandial plasma insulin, triacylglycerols and free fatty acids differently, say specialists at the University of Toronto and St. Michael's Hospital, Toronto, Canada. The researchers studied the effects of the two approaches in 34 patients with impaired glucose tolerance.

        The patients were randomised to three different diets over four months: one high in carbohydrate with high glycaemic index, another high in carbohydrate with low glycaemic index and the third low in carbohydrate and high in monounsaturated fatty acid.

        Plasma glucose, insulin and free fatty acids were measured from 0800 to 1600 hours at baseline in response to high glycaemic index meals (60% carbohydrate, with glycaemic index of 61 and glycaemic load of 63). Their responses to the study diets (breakfast and lunch combined) were measured four months later.

        In the high glycaemic index group, carbohydrate intake (percent of energy) was 60%, glycaemic index 61 and glycaemic load 63. In the low glycaemic index group, carbohydrate intake was 60%, glycaemic index 53 and glycaemic load 55. In the monounsaturated fatty acid group, carbohydrate intake was 49%, glycaemic index 61 and glycaemic load 52.

        Compared to the change with the high glycaemic index diet, the other two diets reduced 0 to 8 hour mean plasma glucose concentrations by 0.35 mmol/litre.

        Mean plasma insulin was about 20% higher and free fatty acids about 12% lower after the low glycaemic index diet than after the high glycaemic index diet. These changes were statistically significant but there was no significant effect with monounsaturated fatty acid.

        Changes in 0 to 8 hour mean plasma triacylglycerols in the three groups did differ significantly. They were -0.14 mmol/litre with the high glycaemic index diet, 0.04 mmol/litre with the monounsaturated fatty acid diet and 0.18 mmol/litre with the low glycaemic index diet.
        American Journal of Clinical Nutrition 2003;77:3:612-621. "Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance."

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