Jenkins David J A, Kendall Cyril W C, Augustin Livia S A, Franceschi Silvia, Hamidi Maryam, Marchie Augustine, Jenkins Alexandra L, Axelsen Mette
Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital and Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Ontario, Canada.
Am J Clin Nutr. 2002 Jul;76(1):266S-73S. doi: 10.1093/ajcn/76/1.266S.
The glycemic index concept is an extension of the fiber hypothesis, suggesting that fiber consumption reduces the rate of nutrient influx from the gut. The glycemic index has particular relevance to those chronic Western diseases associated with central obesity and insulin resistance. Early studies showed that starchy carbohydrate foods have very different effects on postprandial blood glucose and insulin responses in healthy and diabetic subjects, depending on the rate of digestion. A range of factors associated with food consumption was later shown to alter the rate of glucose absorption and subsequent glycemia and insulinemia. At this stage, systematic documentation of the differences that exist among carbohydrate foods was considered essential. The resulting glycemic index classification of foods provided a numeric physiologic classification of relevant carbohydrate foods in the prevention and treatment of diseases such as diabetes. Since then, low-glycemic-index diets have been shown to lower urinary C-peptide excretion in healthy subjects, improve glycemic control in diabetic subjects, and reduce serum lipids in hyperlipidemic subjects. Furthermore, consumption of low-glycemicindex diets has been associated with higher HDL-cholesterol concentrations and, in large cohort studies, with decreased risk of developing diabetes and cardiovascular disease. Case-control studies have also shown positive associations between dietary glycemic index and the risk of colon and breast cancers. Despite inconsistencies in the data, sufficient, positive findings have emerged to suggest that the dietary glycemic index is of potential importance in the treatment and prevention of chronic diseases.
血糖生成指数的概念是纤维假说的延伸，表明食用纤维可降低营养物质从肠道流入的速率。血糖生成指数与那些与中心性肥胖和胰岛素抵抗相关的慢性西方疾病特别相关。早期研究表明，富含淀粉的碳水化合物食物对健康和糖尿病受试者餐后血糖和胰岛素反应的影响差异很大，这取决于消化速率。后来发现一系列与食物摄入相关的因素会改变葡萄糖吸收速率以及随后的血糖和胰岛素水平。在这个阶段，对碳水化合物食物之间存在的差异进行系统记录被认为至关重要。由此产生的食物血糖生成指数分类为糖尿病等疾病的预防和治疗中相关碳水化合物食物提供了一个数值生理分类。从那时起，低升糖指数饮食已被证明可降低健康受试者的尿C肽排泄，改善糖尿病受试者的血糖控制，并降低高脂血症受试者的血脂。此外，食用低升糖指数饮食与较高的高密度脂蛋白胆固醇浓度相关，并且在大型队列研究中，与患糖尿病和心血管疾病的风险降低相关。病例对照研究也表明饮食血糖生成指数与结肠癌和乳腺癌风险之间存在正相关。尽管数据存在不一致之处，但已出现足够多的阳性结果表明饮食血糖生成指数在慢性病的治疗和预防中具有潜在重要性。
