Carbohydrate and the regulation of blood glucose and metabolism.

Classifying the glycemic responses of carbohydrate foods using the glycemic index (GI) requires standardized methodology for valid results. Dietary carbohydrates influence metabolism by at least four mechanisms: nature of the monosaccharides absorbed, amount of carbohydrate consumed, rate of absorption, and colonic fermentation. Reducing glycemic responses by reducing carbohydrate intake increases postprandial serum free-fatty acids (FFA) and does not improve overall glycemic control in diabetic subjects. By contrast, low-GI diets reduce serum FFA and improve glycemic control. Thus, current evidence supports FAO/WHO recommendations to maintain a high-carbohydrate diet and choose low-GI starchy foods.