Livesey Geoffrey, Taylor Richard, Hulshof Toine, Howlett John
Independent Nutrition Logic, Wymondham, Norfolk, United Kingdom.
Am J Clin Nutr. 2008 Jan;87(1):223S-236S. doi: 10.1093/ajcn/87.1.223S.
Reduction of dietary glycemic response has been proposed as a means of reducing the risk of diabetes and coronary heart disease. Its role in health maintenance and management, alongside unavailable carbohydrate (eg, fiber), is incompletely understood.
We aimed to assess the evidence relating the glycemic impact of foods to a role in health maintenance and management of disease.
We searched the literature for relevant controlled dietary intervention trials on glycemic index (GI) according to inclusion and exclusion criteria, extracted the data to a database, and synthesized the evidence via meta-analyses and meta-regression models.
Among literature to January 2005, 45 relevant publications were identified involving 972 subjects with good health or metabolic disease. With small reductions in GI (<10 units), increases in available carbohydrate, energy, and protein intakes were found in all studies combined. Falling trends in energy, available carbohydrate, and protein intakes then occurred with progressive reductions in GI. Fat intake was essentially unchanged. Unavailable carbohydrate intake was generally higher for intervention diets but showed no trend with GI (falling or rising). Among studies reporting on GI, variation in glycemic load was approximately equally explained by variation in GI and variation in available carbohydrate intake. An exchange of available and unavailable carbohydrate (approximately 1 g/g) was evident in these studies.
Among GI studies, observed reductions in glycemic load are most often not solely due to substitution of high for low glycemic carbohydrate foods. Available carbohydrate intake is a confounding factor. The role of unavailable carbohydrate remains to be accounted for.
降低饮食的血糖反应已被提议作为降低糖尿病和冠心病风险的一种手段。其在健康维持和管理中的作用，与不可利用碳水化合物（如膳食纤维）一起，尚未被完全理解。
我们旨在评估食物的血糖影响与健康维持和疾病管理作用之间关系的证据。
我们根据纳入和排除标准在文献中搜索有关血糖指数（GI）的相关对照饮食干预试验，将数据提取到数据库中，并通过荟萃分析和荟萃回归模型综合证据。
在截至2005年1月的文献中，确定了45篇相关出版物，涉及972名健康或患有代谢疾病的受试者。所有研究综合来看，随着GI小幅降低（<10个单位），可利用碳水化合物、能量和蛋白质摄入量增加。随着GI进一步降低，能量、可利用碳水化合物和蛋白质摄入量呈下降趋势。脂肪摄入量基本不变。干预饮食中不可利用碳水化合物摄入量通常较高，但与GI无趋势关系（下降或上升）。在报告GI的研究中，血糖负荷的变化大约同等程度地由GI变化和可利用碳水化合物摄入量变化所解释。在这些研究中，可利用和不可利用碳水化合物之间存在明显的交换（约1克/克）。
在GI研究中，观察到的血糖负荷降低通常并非仅仅由于高血糖碳水化合物食物被低血糖碳水化合物食物替代。可利用碳水化合物摄入量是一个混杂因素。不可利用碳水化合物的作用仍有待阐明。
