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Review
. 2021 Sep 17;13(9):3244.
doi: 10.3390/nu13093244.

Dietary Glycaemic Index Labelling: A Global Perspective

Alan W Barclay  1 , Livia S A Augustin  2 , Furio Brighenti  3 , Elizabeth Delport  4 , C Jeyakumar Henry  5 , John L Sievenpiper  6   7   8   9   10 , Kathy Usic  11 , Yang Yuexin  12 , Andreea Zurbau  6   13 , Thomas M S Wolever  13 , Arne Astrup  14 , Mònica Bulló  15   16   17 , Anette Buyken  18 , Antonio Ceriello  19 , Peter R Ellis  20 , Marie-Ann Vanginkel  21 , Cyril W C Kendall  6 , Carlo La Vecchia  22 , Geoffrey Livesey  23 , Andrea Poli  24 , Gabriele Riccardi  25 , Jordi Salas-Salvadó  15   16   17 , Antonia Trichopoulou  26 , Kalpana Bhaskaran  27 , David J A Jenkins  6   7   8   9   10 , Walter C Willett  28 , Jennie C Brand-Miller  29
Affiliations
Review

Dietary Glycaemic Index Labelling: A Global Perspective

Alan W Barclay et al. Nutrients. .

Abstract

The glycaemic index (GI) is a food metric that ranks the acute impact of available (digestible) carbohydrates on blood glucose. At present, few countries regulate the inclusion of GI on food labels even though the information may assist consumers to manage blood glucose levels. Australia and New Zealand regulate GI claims as nutrition content claims and also recognize the GI Foundation's certified Low GI trademark as an endorsement. The GI Foundation of South Africa endorses foods with low, medium and high GI symbols. In Asia, Singapore's Healthier Choice Symbol has specific provisions for low GI claims. Low GI claims are also permitted on food labels in India. In China, there are no national regulations specific to GI; however, voluntary claims are permitted. In the USA, GI claims are not specifically regulated but are permitted, as they are deemed to fall under general food-labelling provisions. In Canada and the European Union, GI claims are not legal under current food law. Inconsistences in food regulation around the world undermine consumer and health professional confidence and call for harmonization. Global provisions for GI claims/endorsements in food standard codes would be in the best interests of people with diabetes and those at risk.

Keywords: diabetes; food labels; food regulation; glycaemic index.

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Conflict of interest statement

Alan W. Barclay is a founding member of the International Carbohydrate Quality Consortium (ICQC), is a consultant to the Glycemic Index Foundation, editor of the University of Sydney’s GI Newsletter and is an author/co-author of several books that make reference to the glycaemic index; Livia S. A. Augustin. is a founding member of the International Carbohydrate Quality Consortium (ICQC), has received honoraria from the Nutrition Foundation of Italy (NFI) and research grants from LILT (a non-profit organization for the fight against cancer). No funding that she has received has been involved in the current project; Furio Brighenti declares no conflicts of interest; Elizabeth Delport is an executive member and the research manager of GIFSA and is an author/co-author of several books that make reference to the glycaemic index; Anette Buyken is a member of the ILSI Europe Carbohydrate Task Force and a member of the Executive Committee of the German Nutrition Society; Antonio Ceriello declares the following Advisory Board, Consultancy and Lectures: Astra Zeneca, Berlin Chemie, Eli Lilly, Novo Nordisk, Mitsubishi, Roche Diagnostics and Theras; Peter R. Ellis declares no conflicts of interest; Marie-Ann Vanginkel declares no conflicts of interest; David J.A. Jenkins has received research grants from Saskatchewan & Alberta Pulse Growers Associations, the Agricultural Bioproducts Innovation Program through the Pulse Research Network, the Advanced Foods and Material Network, Loblaw Companies Ltd., Unilever Canada and Netherlands, Barilla, the Almond Board of California, Agriculture and Agri-food Canada, Pulse Canada, Kellogg’s Company, Canada, Quaker Oats, Canada, Procter & Gamble Technical Centre Ltd., Bayer Consumer Care, Springfield, NJ, Pepsi/Quaker, International Nut & Dried Fruit Council (INC), Soy Foods Association of North America, the Coca-Cola Company (investigator initiated, unrestricted grant), Solae, Haine Celestial, the Sanitarium Company, Orafti, the International Tree Nut Council Nutrition Research and Education Foundation, the Peanut Institute, Soy Nutrition Institute (SNI), the Canola and Flax Councils of Canada, the Calorie Control Council, the Canadian Institutes of Health Research (CIHR), the Canada Foundation for Innovation (CFI) and the Ontario Research Fund (ORF). He has received in-kind supplies for trials as a research support from the Almond board of California, Walnut Council of California, the Peanut Institute, Barilla, Unilever, Unico, Primo, Loblaw Companies, Quaker (PepsiCo), Pristine Gourmet, Bunge Limited, Kellogg Canada, WhiteWave Foods. He has been on the speaker’s panel, served on the scientific advisory board and/or received travel support and/or honoraria from 2020 China Glycemic Index (GI) International Conference, Atlantic Pain Conference, Academy of Life Long Learning, the Almond Board of California, Canadian Agriculture Policy Institute, Loblaw Companies Ltd., the Griffin Hospital (for the development of the NuVal scoring system), the Coca-Cola Company, Epicure, Danone, Diet Quality Photo Navigation (DQPN), Better Therapeutics (FareWell), Verywell, True Health Initiative (THI), Heali AI Corp, Institute of Food Technologists (IFT), Soy Nutrition Institute (SNI), Herbalife Nutrition Institute (HNI), Saskatchewan & Alberta Pulse Growers Associations, Sanitarium Company, Orafti, the International Tree Nut Council Nutrition Research and Education Foundation, the Peanut Institute, Herbalife International, Pacific Health Laboratories, Nutritional Fundamentals for Health (NFH), Barilla, Metagenics, Bayer Consumer Care, Unilever Canada and Netherlands, Solae, Kellogg, Quaker Oats, Procter & Gamble, Abbott Laboratories, Dean Foods, the California Strawberry Commission, Haine Celestial, PepsiCo, the Alpro Foundation, Pioneer Hi-Bred International, DuPont Nutrition and Health, Spherix Consulting and WhiteWave Foods, the Advanced Foods and Material Network, the Canola and Flax Councils of Canada, Agri-Culture and Agri-Food Canada, the Canadian Agri-Food Policy Institute, Pulse Canada, the Soy Foods Association of North America, the Nutrition Foundation of Italy (NFI), Nutra-Source Diagnostics, the McDougall Program, the Toronto Knowledge Translation Group (St. Michael’s Hospital), the Canadian College of Naturopathic Medicine, The Hospital for Sick Children, the Canadian Nutrition Society (CNS), the American Society of Nutrition (ASN), Arizona State University, Paolo Sorbini Foundation and the Institute of Nutrition, Metabolism and Diabetes. He received an honorarium from the United States Department of Agriculture to present the 2013 W.O. Atwater Memorial Lecture. He received the 2013 Award for Excellence in Research from the International Nut and Dried Fruit Council. He received funding and travel support from the Canadian Society of Endocrinology and Metabolism to produce mini cases for the Canadian Diabetes Association (CDA). He is a member of the International Carbohydrate Quality Consortium (ICQC). His wife, Alexandra L Jenkins, is a director and partner of INQUIS Clinical Research for the Food Industry. His two daughters, Wendy Jenkins and Amy Jenkins, have published a vegetarian book that promotes the use of the foods described here, The Portfolio Diet for Cardiovascular Risk Reduction (Academic Press/Elsevier 2020 ISBN:978-0-12-810510-8). His sister, Caroline Brydson, received funding through a grant from the St. Michael’s Hospital Foundation to develop a cookbook for one of his studies; C. Jeyakumar Henry declares that his Clinical Nutrition Research Centre conducts food and nutrition research for several companies including (but not limited to) Beneo, Roquette, Tate and Lyle, Wilmar and Nestle; Cyril W.C. Kendall has received grants/research support from Advanced Food Materials Network, Agriculture and Agri-Foods Canada (AAFC), Almond Board of California, Barilla, Canadian Institutes of Health Research (CIHR), Canola Council of Canada, International Nut and Dried Fruit Council, International Tree Nut Council Research and Education Foundation, Loblaw Brands Ltd., National Dried Fruit Trade Association, Pulse Canada and Unilever; in-kind research support from the Almond Board of California, the American Peanut Council, Barilla, the California Walnut Commission, Danone, Kellogg Canada, Loblaw Companies, Nutrartis, Quaker (Pepsico), Primo, Unico, Unilever and Upfield; travel support/honoraria from the American Peanut Council, the International Nut and Dried Fruit Council, the International Pasta Organization, Lantmannen, Oldways Preservation Trust and the Peanut Institute. He has served on the scientific advisory board for the International Pasta Organization, McCormick Science Institute, Oldways Preservation Trust. He is a member of the International Carbohydrate Quality Consortium (ICQC), Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD), is on the Clinical Practice Guidelines Expert Committee for Nutrition Therapy of the EASD and is a Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation; Carlo La Vecchia serves on the scientific board of the International Sweeteners Association (ISA) and has received grants from Soremartec; Andrea Poli is the President of the Nutrition Foundation of Italy (NFI) a not-for-profit organization partially supported by Italian and International Food Companies; John L. Sievenpiper has received research support from the Canadian Foundation for Innovation, Ontario Research Fund, Province of Ontario Ministry of Research and Innovation and Science, Canadian Institutes of health Research (CIHR), Diabetes Canada, PSI Foundation, Banting and Best Diabetes Centre (BBDC), American Society for Nutrition (ASN), INC International Nut and Dried Fruit Council Foundation, National Dried Fruit Trade Association, National Honey Board (the U.S. Department of Agriculture [USDA] honey “Checkoff” program), International Life Sciences Institute (ILSI), Pulse Canada, Quaker Oats Center of Excellence, The United Soybean Board (the USDA soy “Checkoff” program), The Tate and Lyle Nutritional Research Fund at the University of Toronto, The Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the University of Toronto (a fund established by the Alberta Pulse Growers) and The Nutrition Trialists Fund at the University of Toronto (a fund established by an inaugural donation from the Calorie Control Council). He has received in-kind food donations to support a randomized controlled trial from the Almond Board of California, California Walnut Commission, Peanut Institute, Barilla, Unilever/Upfield, Unico/Primo, Loblaw Companies, Quaker, Kellogg Canada, WhiteWave Foods/Danone and Nutrartis. He has received travel support, speaker fees and/or honoraria from Diabetes Canada, Dairy Farmers of Canada, FoodMinds LLC, International Sweeteners Association, Nestlé, Pulse Canada, Canadian Society for Endocrinology and Metabolism (CSEM), GI Foundation, Abbott, General Mills, Biofortis, ASN, Northern Ontario School of Medicine, INC Nutrition Research & Education Foundation, European Food Safety Authority (EFSA), Comité Européen des Fabricants de Sucre (CEFS), Nutrition Communications, International Food Information Council (IFIC), Calorie Control Council and Physicians Committee for Responsible Medicine. He has or has had ad hoc consulting arrangements with Perkins Coie LLP, Tate & Lyle, Wirtschaftliche Vereinigung Zucker e.V., Danone and Inquis Clinical Research. He is a member of the European Fruit Juice Association Scientific Expert Panel and Soy Nutrition Institute (SNI) Scientific Advisory Committee. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, European Association for the study of Diabetes (EASD), Canadian Cardiovascular Society (CCS) and Obesity Canada/Canadian Association of Bariatric Physicians and Surgeons. He serves or has served as an unpaid scientific advisor for the Food, Nutrition and Safety Program (FNSP) and the Technical Committee on Carbohydrates of ILSI North America. He is a member of the International Carbohydrate Quality Consortium (ICQC), Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD and Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His wife is an employee of AB InBev; Jordi Salas-Salvadó advises that he serves on the board of and has received grant support through his institution from the International Nut and Dried Fruit Council and Eroski Foundation. He reports serving in the Executive Committee of the Instituto Danone Spain. Has received research support from the Instituto de Salud Carlos III, Spain; Ministerio de Educación y Ciencia, Spain; Departament de Salut Pública de la Generalitat de Catalunya, Catalonia, Spain; European Commission. Has received research support from California Walnut Commission, Sacramento CA, USA; Patrimonio Comunal Olivarero, Spain; La Morella Nuts, Spain; and Borges S.A., Spain. He reports receiving consulting fees or travel expenses from Danone; California Walnut Commission, Eroski Foundation, Instituto Danone—Spain, Nuts for Life, Australian Nut Industry Council, Nestlé, Abbot Laboratories and Font Vella Lanjarón. He is on the Clinical Practice Guidelines Expert Committee of the European Association for the study of Diabetes (EASD) and served in the Scientific Committee of the Spanisch Food and Safety Agency and the Spanish Federation of the Scientific Societies of Food, Nutrition and Dietetics. He is a member of the International Carbohydrate Quality Consortium (ICQC) and Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD. Jordi Salas-Salvadó is partially supported by ICREA under the ICREA Academia programme; Antonia Trichopoulou declares no conflicts of interest; Kathy Usic is Chief Executive Officer of the Glycemic Index Foundation; Thomas M.S. Wolever: is a part owner of INQUIS Clinical Research, Ltd. (formerly GI Labs), a contract research organization in Toronto, Canada. He has authored or co-authored several books on the glycaemic index for which he has received royalties from Philippa Sandall Publishing Services and CABI Publishers. He has received research support, consultant fees or honoraria from or served on the scientific advisory board for Canadian Institutes of Health Research, Canadian Diabetes Association, Dairy Farmers of Canada, Agriculture Agri-Food Canada, Public Health Agency of Canada, GI Labs, GI Testing, Abbott, Proctor and Gamble, Mars Foods, McCain Foods, Bunge, Temasek Polytechnic Singapore, Northwestern University, Royal Society of London, Glycemic Index Foundation, CreaNutrition AG, McMaster University, University of Manitoba, University of Alberta, Canadian Society for Nutritional Sciences, National Sports and Conditioning Association, Faculty of Public Health and Nutrition and Autonomous University of Nuevo Leon and the Diabetes and Nutrition Study Group of the European Association for the Study of Diabetes (EASD); Yang Yuexin is a member of the International Carbohydrate Quality Consortium (ICQC) and has received honoraria from the Chinese Medical Association for the GI study. She has authored several books on the glycaemic index for which he has received contribution fees from Peking University Medical Press. The studies of GI was done at the national institute for nutrition and health, with seven local CDC collaborators China, research grants from National Natural Fund Committee and other research funds of China; Geoffrey Livesey holds shares in a consultancy company Independent Nutrition Logic Ltd. He and his wife have benefitted from research grants, travel funding, consultant fees and honoraria from the American Association for the Advancement of Science (USA), the All Party Parliamentary Group for Diabetes (London, UK), Almond Board of California (USA), BENEO GmbH (DE), Biotechnology and Biosciences Research Council (UK), British Nutrition Foundation(UK), Calorie Control Council (USA), Cantox (CA), Colloides Naturel International (FR), Coca Cola (UK), Danisco (UK & Singapore), Diabetes Nutrition Study Group (EASD, EU), DiabetesUK (UK), Elsevier Inc. (USA), European Commission (EU), European Polyol Association (Brussels), Eureka (UK), Food and Agricultural Organization (Rome), Granules India (Ind), General Mills (USA), Health Canada (CA), Institute of Food Research (UK), International Carbohydrate Quality Consortium (CA), Institute of Medicine (Washington, DC), International Life Sciences Institute (EU & USA), Life Sciences Research Office, FASEB (USA), Nutrition Society of Australia, Knights Fitness (UK), Leatherhead Food Research (UK), LitghterLife (UK), Matsutani (JPN), Medical Research Council (UK), MSL Group (UK), Porter Novelli (UK), Sudzuker (DE), Sugar Nutrition/WSRO (UK), Tate & Lyle (UK), The Food Group (USA), WeightWatchers (UK), Wiley-Blackwell (UK) and the World Health Organization (Geneva). He is a member of the EASD Nutrition Guidelines Committee; Gabriele Riccardi is a member of the scientific advisory board of Barilla Center for Food and Nutrition; Walter C. Willett declares no conflicts of interest; Andreea Zurbau is a part-time employee of INQUIS Clinical Research Ltd., a contract research organization. She has received research support from the Banting and Best Diabetes Centre and consulting fees from the Glycemic Index Foundation; Jennie C. Brand-Miller is President of the Glycemic Index Foundation, oversees a GI testing service at the University of Sydney and receives royalties from books about nutrition and the University of Sydney. She is on the Scientific Advisory Board of the Novo Foundation and Zoe Global Ltd.

Figures

Figure 1
Figure 1
Australia and New Zealand’s Glycaemic Index (GI) Symbol.
Figure 2
Figure 2
Glycaemic Index Foundation of South Africa’s GI Symbols.
Figure 3
Figure 3
Singapore’s Healthier Choice symbol with the low Glycaemic Index claim.
Figure 4
Figure 4
Temasek Polytechnic’s low GI tested logo.
See this image and copyright information in PMC

References

    1. Codex Alimentarius Nutrition and Labelling. 2020. [(accessed on 3 December 2020)]. Available online: http://www.fao.org/fao-who-codexalimentarius/thematic-areas/nutrition-la....
    1. Commonwealth of Australia . Australia New Zealand Food Standards Code. Commonwealth of Australia; Canberra, Australia: 2016. Food Standards Australia New.
    1. Feinman R.D., Pogozelski W.K., Astrup A., Bernstein R.K., Fine E.J., Westman E.C., Accurso A., Frassetto L., Gower B.A., McFarlane S.I., et al. Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base. Nutrition. 2015;31:1–13. doi: 10.1016/j.nut.2014.06.011. - DOI - PubMed
    1. Ewers B., Trolle E., Jacobsen S.S., Vististen D., Almdal T.P., Vilsbøll T., Bruun J.M. Dietary habits and adherence to dietary recommendations in patients with type 1 and type 2 diabetes compared with the general population in Denmark. Nutrition. 2019;61:49–55. doi: 10.1016/j.nut.2018.10.021. - DOI - PubMed
    1. Petersen K.S., Blanch N., Wepener R.H., Clifton P.M., Keogh J.B. Dietary quality in people with type 1 and type 2 diabetes compared to age, sex and BMI matched controls. Diabetes Res. Clin. Pract. 2015;107:e7–e10. doi: 10.1016/j.diabres.2014.12.001. - DOI - PubMed