Franz M J
Nutrition Concepts by Franz, Inc., 6635 Limerick Drive, Minneapolis, MN 55439, USA.
Curr Diab Rep. 2001 Oct;1(2):177-86. doi: 10.1007/s11892-001-0031-9.
There have been two approaches to examining the effects of carbohydrate on postprandial glycemia: 1) studies designed to determine the glycemic response of foods containing carbohydrate, regardless of the source, i.e., starch, sugar, or fiber (glycemic index [GI] of carbohydrates), and 2) studies comparing the glycemic response to equivalent amounts of starches or sugars. A number of food factors determine the glycemic response to carbohydrates: food form, digestibility, cooking, sugars, type of starch, presence of antinutrients, and second meal or lente effect. In people with diabetes, the severity of glucose intolerance and premeal glucose concentrations also influence the glycemic response. The GI attempts to classify individual foods (50-g portions) by the extent to which they raise blood glucose levels compared with a standard (reference carbohydrate), initially glucose and in later studies bread. Acute glycemic responses differ, however, when meals containing low GI foods are compared to meals containing high GI foods long term (measured by fructosamine or hemoglobin A1c), the outcomes are mixed. If there is an effect from the GI of foods on glycemia, it is modest at best. In other studies, when sucrose is substituted for a variety of starches--in meals or snacks and both acutely and for up to 6 weeks--the glycemic response is similar if the total amount of carbohydrate is similar. Therefore, the recommendation for persons with diabetes in regard to the glycemic effect of carbohydrates is that the total amount of carbohydrate in meals or snacks is more important than the source or type and is the first priority in the planning of meals or snacks. This has led to the implementation of carbohydrate counting, in which foods are listed as carbohydrate choices based on the amount and not the source of the carbohydrate.
1）旨在确定含碳水化合物食物（无论其来源，即淀粉、糖或纤维，也就是碳水化合物的血糖生成指数[GI]）的血糖反应的研究；2）比较等量淀粉或糖的血糖反应的研究。许多食物因素决定了碳水化合物的血糖反应：食物形态、消化率、烹饪方式、糖、淀粉类型、抗营养物质的存在以及第二餐或缓释效应。在糖尿病患者中，葡萄糖不耐受的严重程度和餐前血糖浓度也会影响血糖反应。血糖生成指数试图根据个体食物（50克份量）与标准（参考碳水化合物，最初是葡萄糖，后来的研究中是面包）相比升高血糖水平的程度对其进行分类。然而，当长期比较含低血糖生成指数食物的餐食与含高血糖生成指数食物的餐食时（通过果糖胺或糖化血红蛋白A1c测量），急性血糖反应有所不同，结果也不一致。如果食物的血糖生成指数对血糖有影响，充其量也很微小。在其他研究中，当用蔗糖替代各种淀粉——用于餐食或零食，无论是急性还是长达6周——如果碳水化合物总量相似，血糖反应也相似。因此，对于糖尿病患者关于碳水化合物血糖效应的建议是，餐食或零食中碳水化合物的总量比其来源或类型更重要，并且是餐食或零食规划中的首要考虑因素。这导致了碳水化合物计数法的实施，即根据碳水化合物的量而非来源将食物列为碳水化合物选择项。
