Different starchy foods produce different glycemic responses when fed individually, and there is some evidence that this also applies in the context of the mixed meal. A major reason appears to relate to the rate at which the foods are digested and the factors influencing this. A similar ranking in terms of glycemic response to specific foods is seen independent of the carbohydrate tolerance status of the groups tested. Potentially clinically useful starchy foods producing relatively flat glycemic responses have been identified. Many of these are considered ethnic or traditional and include legumes; pasta; grains such as barley, parboiled rice, and bulgur (cracked wheat); and whole-grain breads such as pumpernickel. Specific incorporation of these foods into diets has been associated with reductions in low-density lipoprotein cholesterol and triglyceride levels in hyperlipidemia and with improved blood glucose control in insulin-dependent diabetic patients. To facilitate identification of such foods, it has been suggested that the glycemic response should be indexed to a standard (e.g., white bread) to allow comparisons to be made between the glycemic index of foods tested in different groups of subjects. The scope of application of this principle is subject to further investigation. It may be used to expand the range of possibly useful starchy foods for trial in the diets of diabetic patients.

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