International table of glycemic index and glycemic load

Reliable tables of glycemic index (GI) compiled from the scientific literature are instrumental in improving
the quality of research examining the relation between GI,
glycemic load, and health. The GI has proven to be a more useful nutritional concept than is the chemical classification of carbohydrate (as simple or complex, as sugars or starches, or as
available or unavailable), permitting new insights into the relation between the physiologic effects of carbohydrate-rich foods
and health. Several prospective observational studies have shown
that the chronic consumption of a diet with a high glycemic load
(GI ! dietary carbohydrate content) is independently associated
with an increased risk of developing type 2 diabetes, cardiovascular disease, and certain cancers. This revised table contains
almost 3 times the number of foods listed in the original table
(first published in this Journal in 1995) and contains nearly 1300
data entries derived from published and unpublished verified
sources, representing > 750 different types of foods tested with
the use of standard methods. The revised table also lists the
glycemic load associated with the consumption of specified
serving sizes of different foods. Am J Clin Nutr
2002;76:5–56.
KEY WORDS Glycemic index, carbohydrates, diabetes,
glycemic load
INTRODUCTION
Twenty years have passed since the first index of the relative
glycemic effects of carbohydrate exchanges from 51 foods was
published by Jenkins et al (1) in this Journal. Per gram of carbohydrate, foods with a high glycemic index (GI) produce a higher
peak in postprandial blood glucose and a greater overall blood glucose response during the first 2 h after consumption than do foods
with a low GI. Despite controversial beginnings, the GI is now
widely recognized as a reliable, physiologically based classification of foods according to their postprandial glycemic effect.
In 1997 a committee of experts was brought together by the
Food and Agriculture Organization (FAO) of the United Nations
and the World Health Organization (WHO) to review the available research evidence regarding the importance of carbohydrates in human nutrition and health (2). The committee
endorsed the use of the GI method for classifying carbohydraterich foods and recommended that the GI values of foods be used
in conjunction with information about food composition to guide
food choices. To promote good health, the committee advocated
the consumption of a high-carbohydrate diet (≥55% of energy
from carbohydrate), with the bulk of carbohydrate-containing
foods being rich in nonstarch polysaccharides with a low GI. In
Australia, official dietary guidelines for healthy elderly people
specifically recommend the consumption of low-GI cereal foods
for good health (3), and a GI trademark certification program is
in place to put GI values on food labels as a means of helping
consumers to select low-GI foods (4). Commercial GI testing of
foods for the food industry is currently conducted by many
laboratories around the world, including our own. Many recent
popular diet books contain extensive lists of the GI values of
individual foods or advocate the consumption of low-GI, carbohydrate-rich foods for weight control and good health (5).
Reliable tables of GI compiled from the scientific literature
are instrumental in improving the quality of research examining
the relation between the dietary glycemic effect and health. The
first edition of International Tables of Glycemic Index, published
in this Journal in 1995 with 565 entries (6), has been cited as a
reference in many scientific papers. In particular, these tables
provided the basis for the GI to be used a dietary epidemiologic
tool, allowing novel comparisons of the effects of different
carbohydrates on disease risk, separate from the traditional
classification of carbohydrates into starches and sugars. Several large-scale, observational studies from Harvard University
(Cambridge, MA) indicate that the long-term consumption of a
diet with a high glycemic load (GL; GI ! dietary carbohydrate
content) is a significant independent predictor of the risk of
developing type 2 diabetes (7, 8) and cardiovascular disease (9).
More recently, evidence has been accumulating that a low-GI
diet might also protect against the development of obesity (10,
11), colon cancer (12), and breast cancer (13). The EURODIAB
(Europe and Diabetes) study, involving >3000 subjects with type 1
diabetes in 31 clinics throughout Europe, showed that the GI rating of self-selected diets was independently related to blood
concentrations of glycated hemoglobin in men and women