(PO13-10-22) Comparison of Different Approaches to Assess Carbohydrate Quality of Grain Foods: Glycemic Index Versus Carbohydrate Metrics

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Presenting Author(s)

Mariane M. Fontanelli, PhD
– Postdoctoral fellow, School of Arts, Sciences and Humanities (EACH), University of São Paulo, São Paulo, Sao Paulo, Brazil

Co-Author(s)

LB

Lais D. Batista
– School of Public Health, University of Sao Paulo
MR

Marcelo M. Rogero, PhD
– Professor, School of Public Health, University of São Paulo, Sao Paulo, Sao Paulo, Brazil
RM

Renata Micha, PhD, RD
– Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States
Dariush Mozaffarian, MD, DrPH
– Dean, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States
RF

Regina M. Fisberg, PhD
– Professor, School of Public Health, University of São Paulo, Sao Paulo, Sao Paulo, Brazil
FS

Flavia M. Sarti, PhD
– Professor, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil

Disclosure(s):

Mariane M. Fontanelli, PhD: Cereal Partner Worldwide (CPW): Consultant (Terminated)
ILSI-Brazil: Consultant (Terminated)

Objectives: Carbohydrate quality remains a concept under development in the field of Nutrition, and different methods have been proposed to assess healthfulness of carbohydrate-providing foods. The study investigated the relationships between carbohydrate metrics and glycemic index (GI) of grain foods.

Methods: The investigation was based on data from the population-based study 2015 Health Survey of Sao Paulo, including a probabilistic sample of residents in Sao Paulo, Brazil. Foods reported by 1741 participants in 24h recalls were categorized according to USDA food groups, and grain foods were identified using the grain products group. The following metrics were applied per 10g of carbohydrate: 1) ≥1g fiber (10:1), 2) ≥1g fiber and < 1g free sugars (10:1:1), 3) ≥1g fiber and < 2g free sugars (10:1:2); and 4) ≥1g fiber and per 1 g of fiber < 2g free sugars (10:1|1:2). We used kappa statistics to assess agreement between metrics, Mann-Whitney test to compare GI values (glucose reference) across metrics, and chi-squared test to compare proportions of foods meeting the metrics and GI categories.

Results: A total of 244 grain foods were identified and the highest number of foods met the 10:1 (15.6%), followed by 10:1|1:2 (13.1%), 10:1:2 (12.3%), and 10:1:1 (9.8%) [kappa=0.86]. The median (IQR) GI of grain foods was 66.6 (5.4), and foods meeting the 10:1 had lower median GI than those not meeting this metric (61.4 vs 66.8, p=0.043), as well as grain foods meeting the 10:1:1 (50.7 vs 66.7, p=0.020). Grain foods were classified in low (13.9%), medium (70.9%), and high GI (15.2%). The highest proportion of low GI foods was identified by the 10:1:1 (54.2%), followed by 10:1|1:2 (46.9%), 10:1:2 (43.3%) and 10:1 (42.1%), and foods not meeting the metrics identified 9.7%-10.7%. Regarding high GI foods, the highest proportion was identified by the 10:1:2 (36.7%), 10:1|1:2 (34.4%), 10:1 (28.9%), and 10:1:1(25%), while foods not meeting the metrics identified 12.3-14.1%.

Conclusions: The 10:1 and 10:1:1 metrics identified lower GI grain foods, although a higher proportion of high GI foods was observed among foods meeting the metrics, especially the 10:1:2 and the 10:1|1:2. Considering the perspective of postprandial glycemic response, findings support the use of the 10:1 and 10:1:1 to identify higher carbohydrate-quality grain foods.

Funding Sources: São Paulo Research Foundation