A A C C   2 0 0 0   A n n u a l   M e e t i n g

High carbohydrate diets are considered by some to be deleterious for the treatment of diabetes and insulin resistance because they increase blood glucose and insulin and exacerbate blood lipid risk factors for cardiovascular disease. This view is based on short-term studies that do not take into account the glycemic index (GI) of different carbohydrate foods. Blood glucose and insulin responses depend on both the amount and GI of dietary carbohydrate. The results of a recent 6-month study in diabetic subjects suggest that the short-term metabolic effects of high carbohydrate diets may not persist in the long-term. The Nurses' Health and Health Professional studies showed that a high glycemic load is associated with increased risk for developing diabetes. Glycemic load can be reduced by reducing either the amount or the GI of dietary carbohydrate. However, these 2 maneuvers do not have the same acute metabolic effects. There is more evidence that reducing diet GI has a beneficial effect on blood glucose control and insulin sensitivity than lowering dietary carbohydrate. There is some evidence that a high carbohydrate, low GI diet is most beneficial for the treatment of insulin resistance. If this is the case, more appropriately processed cereal foods with a low GI need to be developed.