Formulating foods to slow rises in blood sugar and insulin; is this an opportunity?

New product success ultimately comes down to one variable: the consumer. Specifically, when a product makes a content statement or health claim, the consumer has to find value in it, understand it and believe in it. Unfortunately, according to an online November 2005 survey conducted by Cogent Research, Cambridge, Mass., for the Washington, D.C.-based International Food Information Council (IFIC) Foundation, only one-third of consumers say the food and health information they get from different sources is consistent.

For the time being, flagging sugar content reductions is more meaningful to consumers than discussing glycemic index.
When it comes to carbohydrates and sugars, the demise of the low-carb movement created some confusion in consumers' minds, which is likely why marketers are not discussing glycemic index . . . or at least just not yet.

"Our research suggests that consumers, for all the publicity concerning carbohydrates and health, are still confused about weight management and how to include carbohydrates in a healthful diet," says Susan Borra, president of the IFIC Foundation and past president of the American Dietetic Association (ADA). "Fads and quick fixes, though attractive, are not effective tools for getting to a healthful diet."

For the time being, flagging sugar content reductions is more meaningful to consumers than discussing glycemic index.

What is glycemic index?

Glycemic index (GI) is a measure of how carbohydrate-containing foods affect blood glucose levels. Originally a clinical tool, GI is determined by measuring the blood glucose values over two to three hours after eating 50g of a food and after 50g of either glucose or white bread. The value for the test food is then expressed as a percentage of the reference food, which is given a value of 100. High-GI foods, those with a value of 70 or higher, are quickly digested and absorbed, creating a higher spike in blood glucose, while low-GI foods, those having a value of 55 or less, are slowly digested and absorbed, resulting in a lower, prolonged glycemic response.

All carbohydrate-containing foods eventually raise or maintain blood sugar levels to some extent. High-fat and high-fiber foods typically have a lower GI because one must consume much larger amounts to ingest 50g of digestible carbohydrate. Both the fat and the fiber in these foods can slow the rate of gastric emptying and therefore reduce the rate of delivery of carbohydrate to the small intestine, where it is digested and glucose is absorbed. Fat actually delays gastric emptying, and many, but not all fibers increase the viscosity or increase the mass to slow the emptying rate.

Figure 1.
Some scientists say that GI has little relation to the way people eat, because it is not based on typical portions. It also measures glycemic response from individual foods versus complete meals.

It is difficult to use GI as a measure on which to base dietary recommendations for the general population, since a person's blood sugar response to eating a food can vary from day to day and also according to how a food was prepared. For example, even something as simple as ripeness in the case of bananas can affect GI. The riper the banana, the higher its GI.

Nevertheless, a diet built around low-GI is expected to increase in popularity over the next five years. A low-GI diet is thought to be a more moderate approach to weight loss because it has been shown to help control appetite and delay hunger using smarter carbohydrates.

Figure 2.

Do consumers get it?

According to the IFIC survey, consumers are quite confused about the role that carbohydrates play in their diet. On the other hand, consumers are responding to public health advice to consume more fiber and whole grains. One out of five (20%) of the 1,000 consumers surveyed (18 years or older) still think the calories contained in carbohydrates (as opposed to calories in and of themselves) are most likely to cause weight gain.

More than half (51%) say they are concerned with the amounts of carbohydrates they consume in the foods they eat. Slightly less-although nearly a majority-say they are concerned with the types of carbohydrates they consume. (See Figure 1.)

Consumers' concern with the amount and type of sugar they consume exceeds that of carbohydrates, particularly when it comes to the amounts of sugar they are consuming. As you can see in Figure 2, 63% of respondents are concerned with the amounts of sugars consumed, and 53% are concerned with the types of sugars consumed.

And, although a majority says they're trying to consume fewer sugars (69%) and refined carbohydrates (56%), only around one in six consumers say, on an unaided basis, they've actually reduced consumption of sugar.

Given the widespread publicity around the GI, including its inclusion in some recent fad diet books, IFIC surveyed consumers on their understanding of the GI as a weight management tool. Only one in three consumers has ever heard of GI and even fewer (15%) have heard of glycemic load. (See Figure 3.) Among those familiar with either term, very few (14%, or less than 5% of all consumers) say they consider it on a regular basis ("always" or "most of the time"). Consumers with a family history of diabetes are more likely to consider either term "most of the time" or "always." This finding echoes the 2005 Dietary Guidelines Advisory Committee report that stated, "Current evidence suggests that the GI and/or glycemic load are of little utility for providing dietary guidance for Americans."

Figure 3.

Where do you go from here?

In Australia, the GI is quite popular. In fact, in 2002, a non-profit company, Glycemic Index Limited, launched the Glycemic Index Symbol, a trademarked logo licensed for food packaging. The program aims to help consumers make informed food choices by encouraging food companies to communicate the GI and increase consumer understanding of GI.

Will GI labeling take off in the United States? A major consideration for companies targeting the low-GI diet consumer is that calculating a GI can be time-consuming and tricky. As with any new nutritional metric, consumers will need time to catch on. Informative labeling and advice will ease this trouble and encourage consumers to purchase products that make their life easier and shopping a less frustrating process.

There's no doubt that GI will become more important in driving specific consumer segment's diet and food choices. One of those important segments is diabetics. After all, the prevalence of diabetes is rising rapidly, up from 30 million globally in 1985 to a forecast 300 million in 2025. Currently it is estimated that 17.5 million Americans suffer from diabetes, with one million new cases reported every year. About 26 million Americans are classified as "pre-diabetes" for whom dietary intervention and exercise will play a major role in whether they develop full-blown diabetes. It has also been estimated that 30 to 80 million American suffer from insulin resistance.

In the meantime, because consumers appear to understand that they should be reducing sugar intake while increasing fiber and whole grain in their diet, it makes sense to tout those formulation tactics on product labels rather than getting into GI. There's potential for GI labeling in the future, but it must be approached sensibly.