The glycemic index. A current controversy.

Area of Science:

• Nutritional Science
• Dietetics
• Public Health

Background:

• The Glycemic Index (GI) and Glycemic Load (GL) concepts are debated for their role in managing chronic diseases.
• Existing research highlights methodological issues such as poor standardization, reproducibility, and high variability in GI/GL.
• Factors influencing food GI and its variability require careful consideration.

Purpose of the Study:

• To define the concepts of GI and GL in food and diet.
• To analyze methodological problems associated with GI and GL.
• To discuss clinical and epidemiological evidence on the role of GI/GL in managing Diabetes Mellitus (DM) and preventing chronic diseases like obesity, insulin resistance (IR), cardiovascular diseases, and cancer.

Main Methods:

• Review and analysis of existing literature on GI and GL.
• Discussion of methodological challenges in GI and GL research.
• Evaluation of clinical and epidemiological evidence linking GI/GL to health outcomes.

Main Results:

• Insufficient evidence supports the use of GI/GL for preventing obesity, insulin resistance, cardiovascular diseases, and cancer.
• The American Diabetes Association (ADA) identifies carbohydrate reduction as primary for DM management but acknowledges potential GI benefits.
• GI has potential as a clinical tool, but caution is advised for dietary changes based solely on this concept.

Conclusions:

• Current evidence is insufficient to solely recommend GI/GL for preventing major chronic diseases.
• While not a primary tool, GI may offer supplementary benefits in Diabetes Mellitus management.
• Consumers are advised to focus on a plant-based diet rich in vegetables, fruits, whole grains, and legumes.