Understanding the links between carbohydrates and health

Background

The Dietary Carbohydrates Task Force has spent more than a decade developing science which focuses on the relationships of carbohydrates with public health. The task force particularly puts emphasis on glycaemic control and the role of dietary fibres.

Objectives

The task force aims to understand the links between carbohydrates and health, particularly the relevance of controlling glycaemia, and the types and quantities of carbohydrates that should be consumed to optimise health.

Impact

  • Since its inception, the task force has produced a series of papers and concise monographs clarifying what existing science tells us about glycaemia and long-term health. The latest publication (E. Blaak et al., 2012) has been cited more than 80 times.
  • A new activity proposal on ‘Health Relevance of Lowering Post-Prandial Glycemia in Children and Adolescents’ is under review.

For more detailed information, please contact Dr Pierre Dussort at pdussort@ilsieurope.be

Task Force Members

* Scientific Advisor

Expert Groups

Workshop – Dietary Sweetness: Is It an Issue?

Objectives

Humans have an inborn liking and desire for sweetness that is persistent throughout all ethnic groups and cultures. Changes can be seen in the characteristics of liking and motivation for sweetness as we progress through life. However today human attraction to sweet sources of energy is seen as a potential risk factor for developing less healthy eating patterns. In this context, there is often a failure to distinguish between putative effects of exposure to sources of sweetness (e.g. free sugars in the diet) and the effects of exposure to sweetness itself. This workshop, jointly organised with the Eating Behaviour and Energy Balance Task Force, intends to assess the evidence base linking sweetness with health and dietary preferences throughout all life stages.

Activity

The workshop on ‘Dietary Sweetness: Is It an Issue?’ aims to encompass the great variety of scientific issues associated with this topic. It will, for instance, address the relationships of variation in sweetness perception and exposure with food preference, diet quality and energy balance.

Expected Output

This workshop will bring together experts from different fields to identify research gaps and needs. The outcomes of this event will be summarised in a scientific publication in a peer-reviewed journal. A follow-up expert group might be created to address workshop conclusions.

Characterisation of and Criteria for Glycaemic Exposure Markers in the Non-diabetic Population

Objectives

There is broad consensus that the maintenance of blood glucose concentrations within the normal range is beneficial for health. In particular, attention is given to the importance of minimising exposure to foods which produce a large glycaemic response. One accepted marker to evaluate the sustained maintenance of normal blood glucose concentrations is glycated hemoglobin A1c (HbA1c). However, the use of HbA1c as a marker may have drawbacks when applied to the non-diabetic population. The goal of this project is to reach evidence-based consensus on the relevance of and criteria for alternative markers and identify possible further research needs to establish these as accepted measures of diet-induced glycaemic exposures.

Activity

The expert group reviewed and characterised different markers for glycaemia. They identified research gaps for their further validation and wider endorsement for use in the non-diabetic population.

Expected Output

The review and dissemination of this scientific work will improve the recognition of alternative markers and stimulate greater consideration of their potential use in intervention studies of foods and diets, particularly in the general (non-diabetic) population. It will highlight the relevance of differentiating food effects in the non-diabetic population from medical monitoring of glycaemic control in diabetes patients. The acceptance of more feasible outcome measures would ultimately enhance the ability of researchers to test, develop and prove the potential beneficial effects of foods on glycaemic control. This consensus review could support the development of guidance on the evaluation of claims relating to maintenance of normal blood glucose concentrations.

Quantifying the Health Impact of Reduced Post-Prandial Glycaemia

Objectives

It is widely accepted that reductions in post-prandial glycaemic (PPG) and relative insulinaemic (PPI) responses are likely to be beneficial in reducing the risks of several non-communicable diseases (e.g. diabetes or cardiovascular diseases) in the general population. It should be possible to estimate quantitatively the potential health impact of reducing PPG and PPI through diet.

Activity

The expert group is reviewing the types of data available, identifying and collecting key variables which support this exercise. This includes chronic PPG / PPI data linked to disease endpoints for nutritional and relevant pharmaceutical interventions (e.g. using acarbose and α-glucosidase inhibitors), all in subjects with impaired glucose tolerance or diabetes, as well as in healthy individuals.

Expected Output

The output will clarify the impact of PPG and PPI in terms of quantitative risk reduction in the general population (a public health approach). It will also allow for differentiating the potential effects of food from pharmaceutical treatment of diagnosed individuals.

Carbohydrate-Based Recommendations as a Basis for Dietary Guidelines: A Scientific Review Completed

Objectives

Lifestyle-related diseases are the leading cause of death worldwide. Nutrition is seen as a major modifiable determinant of non-communicable diseases and changes in diet can have profound effects on health, both positive and negative. Although the process for dietary guidelines development has evolved and improved over the past 20 years and although many countries have already adopted public health interventions, non-communicable diseases still proliferate. This project will review the scientific basis and the processes by which current dietary guidelines related to carbohydrates (CHO) were developed. The activity will describe the methodology and the processes different authorities have used to derive dietary recommendations.

Activity

The expert group conducted a two-phase study. First, the experts developed an inventory of the methods that were applied for the establishment of current dietary guidelines related to CHOs. This includes the means of identifying scientific information (e.g. systematic reviews), types of studies included and the overall approach taken, such as deciding on how to communicate nutrient-based or food-based guidelines. It focuses on total carbohydrates, sugars and dietary fibres, also taking into consideration factors such as whole grains and glycaemic properties of the diet. Subsequently, consistencies and inconsistencies in approaches used by different authorities were evaluated, along with their potential implications for deriving recommendations.

Expected Output

This project is designed to bring improved clarity on how CHO-based dietary guidelines have been developed by various health and national authorities and what lessons can be learnt from the applied processes. More clarity could help in building harmonised guidelines and hence gaining the confidence of healthcare professionals to communicate understandable messages to consumers, leading to positive changes in dietary practices. A key deliverable will be a peer-reviewed publication summarising the methodology used to develop the guidelines, identifying consistencies and inconsistencies across the processes to support future efforts in this area. Harmonisation of the guideline development process will strengthen confidence and potentially lead to the development of more widely accepted (global) standards.

Expert Group Members

Workshop
Sweet Taste Perception, Food Preference and Eating Behaviour 

Characterisation of and Criteria for Glycaemic Exposure Markers in the Non-diabetic Population

Quantifying the Health Impact of Reduced Post-Prandial Glycaemia

Carbohydrate-Based Recommendations as a Basis for Dietary Guidelines: A Scientific Review  Completed

Poster

Impact of Postprandial Glycaemia on Health: Role in Body Weight Control and Diabetes Prevention

Publications

All Publications

Dietary Fibre

ILSI Europe Concise Monograph. Translations available in English, Portuguese, and Japanese.

Read more

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