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The acute glycaemic response to digestible carbohydrates in foods has been associated with a range of medical conditions(1). Blood glucose is known to cause diffuse and progressive damage to tissues and control systems throughout the body in the processes of glycation and glycaemia-induced oxidation(2,3). Intense insulin demand evoked by rapid postprandial increases in blood glucose is also believed to be harmful, by placing a burden on the[...]-cells of the pancreas(4), and by the action of insulin as an active regulatory hormone. The intense production of insulin can lead to a hypoglycaemic overcompensation after the insulin-stimulated return of blood glucose to baseline. In the hypoglycaemic state, a number of physiological systems may be adversely affected, including appetite control and cognition(5).
With a growing global incidence of glucose intolerance, associated with obesity and ageing(6), there is an increasing demand for foods and approaches that can be used in the practical dietary management of postprandial glycaemia. One of the strategies that has been used in dietetic practice is to substitute highly glycaemic carbohydrates in the diet with less glycaemic carbohydrates using the 'carbohydrate exchange' system(7). However, rather than simply substitute one carbohydrate source for another, it would be beneficial if the exchange could be used as an opportunity to improve the nutrient profile of the diet by including nutrient-rich carbohydrate products such as fruit, particularly as many fruit constituents may have a role in ameliorating the effects of glycaemia-induced oxidative stress and inflammation(8). Even outside the context of carbohydrate exchange, it is valuable for consumers to be able to gauge the likely relative effect that fruit is likely to have on glycaemic response.
In a previous study (JA Monro, H Edwards, S Mishra, D Hedderley and J Podd, unpublished results) of the effects of kiwifruit on the blood glucose response to a glycaemic breakfast cereal, we found that breakfast cereal plus kiwifruit caused a lower glycaemic response than breakfast cereal plus the same amount of sugars, of the same monosaccharide composition, as in the kiwifruit. The kiwifruit was...