Concurrent management of postprandial glycaemia and nutrient intake using glycaemic glucose equivalents, food composition data and computer-assisted meal design.

A computer system, called SERVE-NZ Nutririon Management System, for use in diabetes management, addresses the problem of concurrently controlling postprandial glycaemic response and nutrient intake in meals containing a number of foods, is described. It converts the weight and relative glycaemic potency of each food to its content of glycaemic glucose equivalents (GGE) - the amount of glucose theoretically inducing the same blood glucose response as would the specified quantity of food. Glycaemic glucose equivalents in a meal can be simply obtained by adding the GGE content of all foods in the meal to give a figure for the maximal glycaemic impact of the meal. Glycaemic glucose equivalents may be calculated using food composition databases that include available carbohydrate, common standard measure weights and glycaemic index values. If GGE is treated as a nutrient, an output of the total nutrient profile of a food or meal, and its glycaemic impact as GGE, can be obtained simultaneously. Application of a nutritional software system incorporating GGE values to management of glycaemic loadings and nutrient intakes over five meals within a day is demonstrated. The system may be a useful aid in self-management of glycaemia, as it will identify quantities of foods that can be consumed without exceeding the predetermined glucose tolerances of individuals. The graphical presentation of GGE and nutrient composition of meals may be a useful visual aid in educating clients with diabetes. The GGE values on food labels would provide easily understood guidance, not obtained from glycaemic index values, to the maximum number of items or quantity of a food that an individual should eat at a time. In its present basic form the calculation of GGE is most likely to slightly overestimate glycaemic impact, so it presents a worst-case prediction.