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Open Access
Review Article
Abstract
This article reviews some traditional Saudi foods in terms of their nutritive values, glycaemic index (GI) and
insulinaemic index (II). The relationship between the consumption of these foods and the prevalence of diabetes
in Saudi Arabia has been discussed. This review reveals that traditional Saudi foods are good source of healthy
carbohydrates that are consumed in forms of whole grains where they will be rich in fibre, some vitamins and
minerals. For example, 26 % and 16 % of the requirements of iron and fibre for adults can be provided from
consuming a serving size of Harees. Moreover, the GI value of most traditional Saudi foods has fallen within low
range. The II value of some traditional Saudi foods such as Hassawi rice and Khalas dates also reported which was
56 and 63, respectively. The lower GI and II for most traditional Saudi foods suggest that these foods may have
benefits on postprandial glycaemic and insulinaemic levels. These important features of traditional Saudi foods could
provide substantial contribution to the improvement of Saudi diets in the management and prevention of diabetes
mellitus (DM) where there is a high rate of prevalence of DM in Saudi Arabia. The recent dramatic modification in
Saudi diet in particular modifying the type of carbohydrates content of the diet was behind the most health problem.
Dietary advice should be given and good strategies should be taken in order to diminishing the occurrence of health
problem escalation.
Introduction
Lifestyle and nutrition play a crucial role in the development
or prevention of chronic conditions such as obesity, coronary heart
disease and diabetes mellitus. It is well documented that the prevalence
of diabetes is increasing dramatically worldwide at an alarming rate
and the number of people with diabetes is projected to grow from 366
million in 2011 to 552 million in 2030 [1]. Diabetes and in particular
type 2 diabetes mellitus (T2DM) has shown to be associated with
obesity and an inactive lifestyle. In Saudi Arabia, there is a particularly
high rate of prevalence of diabetes (24 %) and this may be due to the
rapid socioeconomic changes which has led to increase rate of obesity
over the last 3 decades [2,3].
Dietary carbohydrates (CHOs) have an important role in the
management of diabetes. They are digested and absorbed at different
rates and to different extents in human small intestine [4]. The glycaemic
index has been introduced by Jenkins et al. [5] to aid our understanding
of the metabolic impact of different types of CHO containing foods [6].
The effect of consumption of high GI foods and its associations with the
progression to DM has been studied in large prospective cohort studies
[7,8]. Reducing glucose response and subsequently insulin demand is
the one target for the prevention and treatment of T2DM. It has been
suggested that the high intake of low GI foods and dietary fibre are
associated with a lower risk of T2DM [9]. However, the great health
benefit of low GI foods remains to be fully elucidated.
This review will summarise the prevalence of diabetes in Saudi
Arabia and the changes in Saudi eating patterns. Traditional Saudi foods
and their nutritive values will be briefly discussed, with particular focus
on the type of their CHO contents. The GI and insulinaemic index (II)
concepts and their values for some Saudi foods will be also reviewed.
Citation: Al-Mssallem MQ (2014) The Association between the Glycaemic Index of Some Traditional Saudi Foods and the Prevalence of Diabetes in
Saudi Arabia: A Review Article. J Diabetes Metab 5: 452 doi:10.4172/2155-6156.1000452
Page 2 of 7
A large number of Saudi patients with diabetes are at a high risk
for diabetic complications (nephropathy, neuropathy and retinopathy).
Risk factors include their blood glucose, blood pressure and lipid are
not achieving recommended levels. Also about a third of patients had
undiagnosed hypertension and 17.6% of patients having low density
lipoprotein (LDL) cholesterol values of more than 3.38 mmol/l, a level
that suggests the need for lipid-lowering therapy [20,21].
T2DM accounts for 90-95 % of those with diabetes and results from
progressive insulin secretory defect. The cause of T2DM is thought to
be due to a combination of environmental and genetic factors. Most of
individuals with T2DM are obese and they do not usually need insulin
treatment to survive. The risk of developing this form of diabetes
increases with age, lack of physical activity, and obesity. Obesity itself or
having an increased percentage of body fat distributed predominantly in
the abdominal region causes some degree of insulin resistance. Insulin
resistance may improve with weight reduction and/or hypoglycaemic
treatment [10].
Serving
size
Moisture
(g)
Energy
(cal)
CHO (g)
Protein
(g)
Fat (g)
Fibre (g)
B1 (mg)
B2
(mg)
Fe
(mg)
Ca
(mg)
Na
(mg)
Arabic coffee
25
24.7
0.15
0.03
Aseeda
75
49.43
99
18.6
3.6
1.13
1.5
0.03
0.07
0.06
219
150
97.1
213
43.2
4.2
2.5
1.2
0.06
0.96
0.3
1.5
301.5
Briani
150
89.4
252
48.1
5.1
4.3
1.5
0.03
0.03
1.35
1.5
378
Bukhary
150
98.2
207
39.3
4.8
3.4
1.6
0.05
0.05
1.2
7.5
465
Dates
60
12
183
43.8
1.32
0.36
1.44
0.05
0.06
1.26
43.2
90
12.78
369.9
45.9
7.68
17.37
3.69
0.09
0.23
2.19
115.2
85
36.7
184.6
43.9
1.35
0.36
1.44
0.05
0.06
1.26
43.2
185
122.1
257.3
50.5
5.3
3.6
1.44
0.05
0.06
1.26
193.2
Harees
150
119.2
105
43.2
3.6
0.6
4.05
0.06
0.06
2.7
165
150
94.5
202.6
24.2
12.5
6.2
1.2
0.10
0.92
2.60
17.16
88.5
Klaija
30
2.6
114.6
15.03
2.58
4.92
1.8
0.69
1.5
28.2
Loqaimat
50
8.35
189
33.6
1.95
5.15
0.8
0.25
10.5
8.5
Maamool Tamer
40
2.6
187.6
24.48
2.68
8.56
1.32
Mahalbia
75
46.2
114
23.85
2.85
0.75
0.6
0.03
0.06
0.53
12
105.75
Mandi
150
92.8
235
45.7
5.1
3.6
0.9
0.03
0.03
1.2
1.5
Marassia
150
73.9
309
47.1
10.05
6.9
0.04
1.41
3.15
1.95
285
Marqooq
150
121.8
99
15.6
4.65
1.95
3.9
0.08
0.54
2.1
457.5
Mataziz
150
114.9
142.5
20.85
5.55
4.05
2.55
0.05
0.29
1.65
52.5
190.5
Moaddas
150
104.7
198
29.5
6.3
6.1
0.6
0.12
1.37
3.3
40.5
885
Qors Tamer
65
19.75
216.45
31.21
3.02
8.51
1.38
0.1
0.08
1.23
28.8
15.75
Qorsan
150
115.05
18.75
6.45
3.45
3.75
4.05
0.09
0.78
1.35
1.5
390
Saleeq
150
115.3
141
25
5.8
1.9
0.3
1.05
64.5
483
Siyadiyeh
150
99.1
223
30.6
9.9
6.9
1.6
0.03
0.14
0.6
375
125
110.1
73.7
6.7
3.25
0.23
150
J Diabetes Metab
ISSN: 2155-6156 JDM, an open access journal
Citation: Al-Mssallem MQ (2014) The Association between the Glycaemic Index of Some Traditional Saudi Foods and the Prevalence of Diabetes in
Saudi Arabia: A Review Article. J Diabetes Metab 5: 452 doi:10.4172/2155-6156.1000452
Page 3 of 7
Another traditional food which is also important in Saudi culture
is palm dates. Dates are mostly consumed in the Rutab or Tamer stage
of development [25,26]. The highest consumption of Rutab or dates
reaches its top in Ramadhan when all Saudi people prefer to break their
fast with eating Rutab or dates. The most expensive variety of dates is
called Ajwa from Al-Maddina which is cultivated in the North West of
the Kingdom of Saudi Arabia. However, the most popular date variety
is called Khalas which is grown in Al-Hassa in the Eastern Province of
Saudi Arabia [25]. Dates are usually consumed with sour milk (plain
yoghurt drink) at lunch time or with Arabic coffee as a snack during
the day [27,28]. In addition, dates is stuffed with nuts or chocolate and
customarily served as a dessert along with Arabic coffee. Dates can
also be used for bakery products such as bread, varieties of cakes and
biscuits.
GI
Baked Motabbaq
56
II
-
63
62
29
55
64
Foul (mashed)
55
Foul (whole)
45
Fried Motabbaq
52
Gerish
89
Harees
52
59
56
Kabsa
60
Klaija eneazaa
58
Klaija malakee
51
Mahalbia
56
Marassia
51
Qorsan
61
Saleeq
52
Siyadiyeh
14
30
Table 2:The glycaemic index (GI) and insulinaemic index (II) for some Saudi foods.
Citation: Al-Mssallem MQ (2014) The Association between the Glycaemic Index of Some Traditional Saudi Foods and the Prevalence of Diabetes in
Saudi Arabia: A Review Article. J Diabetes Metab 5: 452 doi:10.4172/2155-6156.1000452
Page 4 of 7
Dates variety
GI value
Original
Reference
[51]
Birhi
64
Saudi Arabia
Birhi
50
[47]
31- 46
[47,50]
Dabbas
49
[50]
Farad
54
[50]
Khalas
55
[27,50]
Khudhary
58
Saudi Arabia
[51]
Lulu
53
[50]
Nabut Seif
64
Saudi Arabia
[51]
Nabut Sultan
51
Saudi Arabia
[51]
Rabiea
55
Saudi Arabia
[51]
Rothana
54
Saudi Arabia
[51]
45- 47
[28]
Sukkary
47
Saudi Arabia
[51]
Sullaj
56
Saudi Arabia
[51]
Suqai
59
Saudi Arabia
[51]
Bo maan
Rutab Khalas
Table 3. The glycaemic index (GI) for some varieties of dates grown in Saudi
Arabia and United Arab Emirates.
low GI diet might reduce frequent and rapid rise in blood glucose levels
and increase the bodys sensitivity to insulin. Studies on the postprandial
glucose response to CHO-containing foods have demonstrated that the
low GI foods decrease the insulin and glucose response compared with
high GI foods, suggesting an increase in insulin sensitivity in normal
volunteers and in obese insulin resistant subjects [58]. It has been
found that a reduction of the fasting plasma glucose concentration in
subjects on low GI diets was significantly more pronounced than in
those on the high GI diet [59]. It has also been found that the final
values of glycosylated serum proteins (fructosamine) has shown a 7%
fall (p<0.01) on the low GI diet and a non-significant fall of 2.2% on the
high GI diet [55]. Similarly, Frost et al. [60] have found that a significant
fall in fasting blood glucose and fructosamine occurred in type 2
diabetic patients treated only by giving advice to lower the GI of the
CHO in their diet for 3 months [60]. These results demonstrated greater
improvements in glucose control with a low GI diet as compared to a
high GI diet occurred. In addition, the effect of consumption of low GI
diet was also shown an improvement in glycated haemoglobin (HbA1c).
A study on subjects with diabetes found that significantly better HbA1c
levels in subjects consuming a low GI diet compared to the high GI diet
group [42]. In fact, each 1 % decrease in HbA1c was associated with 21%
reduction in the risk of diabetic complications [41].
Indeed, the joint Food and Agriculture Organization (FAO) and
World Health Organization (WHO) Expert Consultation Committee
advocated the use of low GI diets in the management of individuals
at risk of developing diabetes and diabetes-related complications [61].
However, the great health benefit of the low GI foods remains to be fully
elucidated.
Citation: Al-Mssallem MQ (2014) The Association between the Glycaemic Index of Some Traditional Saudi Foods and the Prevalence of Diabetes in
Saudi Arabia: A Review Article. J Diabetes Metab 5: 452 doi:10.4172/2155-6156.1000452
Page 5 of 7
these foods tend to have a high GI compared to whole grain containing
foods [38]. For example, Harees as a traditional Saudi food had a low
GI with a value of 52 [66]. The low GI value in Harees refers to the fact
that Harees is digested more slowly and its CHO is probably converted
into glucose at a slower rate, producing a lower postprandial glucose
concentration and subsequently lower insulin response [4,67]. As
mentioned above, consumption such Harees in the form of a whole
grains can provide a substantial contribution to the improvement of
the Saudi diets.
Saudi patients with diabetes are commonly advised without a sound
scientific basis, to avoid the consumption of dates [68]. This is mainly
due to the fact that the main sugar in dates is glucose [69] which can
be readily absorbed in the human small intestine and thus influence
diabetic control. However, the GI for most different varieties of dates as
shown in Table 3 is generally in the low range [27,51].
It is important to consider both the GI and II of foods in the
dietary management of an individual with diabetes because there are
some foods with a low GI but their II is high. Interestingly, the first
documentation of the II for Saudi foods was for Hassawi rice and Khalas
dates. Khalas dates had a medium II with value of 64 [27], while the II
vaule of Hassawi rice was 56 [29]. There was a low insulin response to
Hassawi rice which could be due to its higher content of dietary fibre.
It is evident that consumption of high fibre diet is associated with a
favourable effect on insulin sensitivity and may protect against the
development of DM [70,71]. Several studies have included measures
of II values because the role of insulin in glucose homeostasis is
well known and because of the association between the large insulin
demand with a high GI food which has been proposed to be involved in
the aetiology of diabetes [8,72-74]. Incorporating the use of GI and II
values should be considered in planning the optimal dietary CHOs for
people with diabetes.
Conclusion
One of the greatest health problems associated with excess
morbidity and mortality around the worldwide is DM. Saudi Arabia
is a country with a population of approximately 27 million. Its people
have experienced great changes in the last 7 decades because of the
discovery of oil. This has resulted in large social changes and now the
population is experiencing a high prevalence of DM that is increasing
at an alarming rate. One of the main causes for this phenomenon is due
to rapid changes in habitual eating patterns, in particular the quantity
and quality of dietary CHOs. Several strategies have been investigated
to prevent or alleviate the acuteness of this problem. A modification
in the type and amount of the dietary CHOs intakes is known to alter
the impact of dietary CHOs on the plasma glucose and insulin profiles
and this presents a useful strategy to alleviate some of the problems
associated with DM.
Despite of the dramatic changes in Saudi habitual dietary patterns,
there is still some common place traditional practice that remains,
such as the consumption of some traditional foods. It is obvious that
traditional Saudi foods produce more favourable metabolic profiles.
The traditional foods may have a beneficial effect on plasma glucose and
insulin levels owing to the fact that their CHO may be slowly hydrolysed
and thus absorbed at a slower rate in the small intestine. These features
of staple foods may be important for people with diabetes in Saudi
Arabia. A greater understanding of the effects of traditional Saudi foods
on blood glucose and insulin levels may lead to more effective lifestyle
prevention strategies for DM.
J Diabetes Metab
ISSN: 2155-6156 JDM, an open access journal
The lower GI and II for most traditional Saudi foods suggest that
these foods may have a role to play in the management and prevention
of DM. In addition, most traditional Saudi foods contain high level
of dietary fibre. It is well documented that dietary fibre has beneficial
effects in improving insulin sensitivity and therefore reducing the risk
of developing DM. As diabetes is becoming more common in Saudi
Arabia, steps need to be taken to address this problem. Nutritional
advice, including the use of traditional foods, such as Harees, Marqooq,
dates and Hassawi rice on a regular basis, could be given to the general
public and in particular individuals with diabetes to overcome this
disease. The major practical implication from this review is to encourage
the consumption of healthy Saudi traditional foods. Further studies are
needed to confirm the impact of long term consumption of traditional
Saudi foods on blood glucose and insulin levels in healthy people and
those with diabetes.
References
1. Whiting DR, Guariguata L, Weil C, Shaw JE (2011) IDF diabetes atlas: global
estimates of the prevalence of diabetes for 2011 and 2013. Diabetes Res Clin
Pr 94: 311-321.
2. Musaiger AO, Al-Hazzaa HM (2012) Prevalence and risk factors associated
with nutrition-related noncommunicable diseases in the Eastern Mediterranean
region. Int J Gen Med 5: 199-217.
3. Alhadd TA, Al-Amoudi AA, Alzahrani AS (2007) Epidemiology, Clinical and
Complications Profile of Diabetes in Saudi Arabia: A Review. Ann Saudi Med
27: 241-250.
4. Al-Mssallem MQ, Frost GS, Brown JE (2014) The metabolic effects of two
meals with the same glycaemic index but different slowly available glucose
parameters determined in vitro: a pilot study. Ann Nutr Disorders & Therapy
1: 1-5.
5. Jenkins DJ, Wolever TM, Taylor RH, Barker H, Fielden H, et al. (1981) Glycemic
index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr
34: 362-366.
6. Zhang G, Hamaker BR (2009) Slowly Digestible Starch: Concept, Mechanism,
and Proposed Extended Glycemic Index. Crit Rev Food Sci Nutr 49: 852-867.
7. Schulze M B, Liu S, Rimm EB, Manson JE, Willett WC, et al. (2004) Glycemic
index, glycemic load, and dietary fiber intake and incidence of type 2 diabetes
in young and middle-aged women. Am J Clin Nutr 80: 348-356.
8. Salmeron J, Ascherio A, Rimm EB, Colditz GA, Spieqelman D, et al. (1997)
Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care 20: 545550.
9. Willett W, Manson J, Liu S (2002) Glycemic index, glycemic load, and risk of
type 2 diabetes. Am J Clin Nutr 76: S274-S280.
10. American Diabetes Association (2014) Standards of medical care in
diabetes-2014. Diabetes Care 37: S14-S80.
11. Shaw JE, Sicree RA, Zimmet PZ (2009) Global estimates of the prevalence of
diabetes for 2010 and 2013. Diabetes Res Clin Pract 87: 4-14.
12. Wild S, Sicree R, Roglic G, King H (2004) Global Prevalence of Diabetes:
Estimates for the year 2000 and projections for 2030. Diabetes Care 27: 10471053.
13. Central Department of Statistics (2011) Censuses statistics. Kingdom of Saudi
Arabia.
14. Adam A, Osama S, Muhammad K (2014) Nutrition and Food Consumption
Patterns in the Kingdom of Saudi Arabia. Pakistan J Nutr 13: 181-190.
15. Alissa EM, Bahijri SM, Ferns GA (2005) Dietary macronutrient intake of Saudi
meals and its relationship to classical coronary risk factors. Saudi Med J 26:
201-207.
16. Al-Nozha MM, Al-Maatouq MA, Al-Mazrou YY, Al-Harthi SS, Arafah MR, et al.
(2004) Diabetes mellitus in Saudi Arabia. Saudi Med J 25: 1603-1610.
17. Al-Nuaim AR, Al-Rubeaan K, Al-Mazrou Y, Al-Attas O, Al-Daghari N, et al.
(1996) High prevalence of overweight and obesity in Saudi Arabia. Int J Obes
Relat Metab Disord 20: 547-552.
Citation: Al-Mssallem MQ (2014) The Association between the Glycaemic Index of Some Traditional Saudi Foods and the Prevalence of Diabetes in
Saudi Arabia: A Review Article. J Diabetes Metab 5: 452 doi:10.4172/2155-6156.1000452
Page 6 of 7
18. El-Hazmi MA, Warsy AS, Al-Swailem AM, Sulaimani R, Al-Meshari A (1998)
Diabetes mellitus and impaired glucose tolerance in Saudi Arabia. Ann Saudi
Med 4: 381-385.
19. Fatani HH, Mira SA, El-Zubier AG (1987) Prevalence of diabetes mellitus in
rural Saudi Arabia. Diabetes Care 10: 180-183.
20. Eledrisi M, Alhaj B, Rehmani R (2007) Quality of diabetes care in Saudi Arabia.
Diabetes Res Clin Pract 78: 145-146.
21. American Diabetes Association (2008) Nutrition Recommendations and
Interventions for Diabetes. Diabetes Care 31: S61-S78.
22. Musaiger AO (1987) The state of food and nutrition in the Arabian Gulf
countries. World Rev Nutr Diet 54: 105-173.
23. Al-Kanhal MA, Al-Mohizea IS, Al-Othaimeen AI, Khan MA (1994) Nutritive value
of some wheat based dishes consumed in the Kingdom of Saudi Arabia. Ecol
Food Nutr 32: 219-226.
24. Al-Kanhal MA, Al-Mohizea IS, Al-Othaimeen AI, Khan MA (1999) Nutritive value
of various rice based dishes in Saudi Arabia. Ecol Food Nutr 38: 223-235.
25. Ministry of Agriculture (2011) Most popular date varieties in the Kingdom of
Saudi Arabia. Ministry of Agriculture, second edition, Riyadh, Saudi Arabia.
26. Ali A, Al-Kindi YS, Al-Said F (2009) Chemical composition and glycemic index
of three varieties of Omani dates. Int JFood Sci Nutr 60: 51-62.
27. Al-Mssallem MQ, Brown JE (2013) Arabic coffee increases the glycemic index
but not insulinemic index of dates. Saudi Med J 34: 923-928.
28. Miller CJ, Dunn EV, Hashim IB (2003) The glycaemic index of dates and dates/
yoghurt mixed meals. Are dates the candy that grows on trees? Eur J Clin
Nutr 57: 427-430.
29. Al-Mssallem MQ, Hampton SM, Frost GS, Brown JE (2011) A study of Hassawi
rice (Oryza sativa L.) in terms of its carbohydrate hydrolysis in vitro and
glycaemic and insulinaemic indices in vivo. Eur J Clin Nutr 65: 627-634.
30. Al-Mssallem IS, Al-Mssallem M Q (1997) Study of Glutelin Storage Proteins in
AI-Hassawi Rice (Oryza sativa). Arab Gulf J Sci Res 15: 633- 646.
31. Musaiger AO (2012) The Food Dome: dietary guidelines for Arab countries.
Nutr Hosp 27: 109-115.
32. Al-Shahib W, Marshall RJ (2002) Dietary fibre content of dates from 13 varieties
of date palm Phoenix dactylifera L. Int J Food Sci Tech 37: 719-721.
33. Al-Farsi M, Alasalvar C, Al-Abid M, Al-Shoaily K, Al-Amry M, et al. (2007)
Compositional and functional characteristics of dates, syrups, and their byproducts. Food Chem 104: 943-947.
34. Wolever TM, Brand-Miller J, Abernethy J, Astrup A, Atkinson F, et al. (2008)
Measuring the glycemic index of foods: interlaboratory study. Am J Clin Nutr
87: S247- S257.
35. Wolever TM, Jenkins DJ, Jenkins AL, Josse RG (1991) The Glycemic index:
methodology and clinical implications. Am J Clin Nutr 54: 846-854.
36. Liu S, Willett WC, Stampfer MJ, Hu FB, Franz M, et al. (2000) A prospective
study of dietary glycemic load, carbohydrate intake, and risk of coronary heart
disease in US women. Am J Clin Nutr 71: 1455-1461.
37. Jenkins DJ, Kendall CW, Marchie A, Augustin LS (2004) The glycemic index: an
overview of its possible role in the prevention and treatment of chronic disease.
Blackwell Publishing Ltd. Int J Clin Pract 58: 3-7.
38. Schulze MB, Hoffmann K, Manson JE, Willett WC, Meigs IB, et al. (2005)
Dietary pattern, inflammation, and incidence of type 2 diabetes in women. Am
J Clin Nutr 82: 675-684.
39. Kalergis M, De Grandpre E, Andersons C (2005) The Role of the Glycemic Index
in the Prevention and Management of Diabetes: A Review and Discussion.
Canadian J Diabet 29: 27-38.
40. Granfeldt Y, Wu X, Bjorck I (2006) Determination of glycaemic index; some
methodological aspects related to the analysis of carbohydrate load and
characteristics of the previous evening meal. Eur J Clin Nutr 60: 104-112.
41. Thomas DE, Elliott EJ (2010) The use of low-glycaemic index diets in diabetes
control. Br J Nutr 104: 1-6.
42. Heilbronn LK, Noakes M, Clifton PM (2002) The Effect of High- and LowGlycemic Index Energy Restricted Diets on Plasma Lipid and Glucose Profiles
in Type 2 Diabetic Subjects with Varying Glycemic Control. J Am Coll Nutr 21:
120-127.
J Diabetes Metab
ISSN: 2155-6156 JDM, an open access journal
43. Wolever TM, Yang M, Zeng X, Atkinson F, Brand-Miller J (2006) Food glycemic
index, as given in Glycemic Index tables, is a significant determinant of
glycemic responses elicited by composite breakfast meals. Am J Clin Nutr 83:
1306-1312.
44. Frost G, Leeds AA, Dore CJ, Madeiros S, Brading S, et al. (1999) Glycaemic
index as a determinant of serum HDL-cholesterol concentration. Lancet 353:
1045-1048.
45. Garsetti M, Vinoy S, Lang V, Holt S, Loyer S, Brand-Miller J (2005) The
Glycemic and Insulinemic Index of Plain Sweet Biscuits: Relationships to in
Vitro Starch Digestibility. J Am Coll Nutr 24: 441-447.
46. Nilsson M, Stenberg M, Frid AH, Holst JJ, Bjorck ME (2004) Glycemia and
insulinemia in healthy subjects after lactose-equivalent meals of milk and other
food proteins: the role of plasma amino acids and incretins. Am J Clin Nutr 80:
1246-1253.
47. Atkinson FS, Foster-Powell K, Brand-Miller JC (2008) International tables of
glycemic index and glycemic load values: 2008. Diabetes care 31: 2281-2283.
48. Ba-Jaber AS (1997) Glycemic Indexes of Some Popular Saudi Arabian Foods.
Agriculture Research Center, King Saud University, Research Bullet 66: 5-17.
49. Farhat AG, Moukarzel SR, El-Said RJ, Daher CF (2010) Glycemic index of
commonly consumed Lebanese mixed meals and desserts. Asian J Clin Nutr
2: 48-57.
50. Alkaabi JM, Al-Dabbagh B, Ahmad S, Saadi HF, Gariballa S, et al. (2011)
Glycemic indices of five varieties of dates in healthy and diabetic subjects. Nutr
J 10: 59-68.
51. Ba-Jaber AS, Fares E, Al-Rakban M, Al-Kahtani H, Dafallah A (2006) Glycemic
Index (GI) of some popular Saudi Dates and the effect of their composition on
the GI. Arabic J Foods Nutr 15: 6-13.
52. Alkaabi JM, Al-Dabbagh B, Saadi HF, Gariballa S, Yasin J (2013) Effect of
traditional Arabic coffee consumption on the glycemic index of Khalas dates
tested in healthy and diabetic subjects. Asia Pac J Clin Nutr 22: 565-573.
53. Frost G, Leeds A, Trew G, Margara R, Dornhorst A (1998) Insulin sensitivity in
women at risk of coronary heart disease and the effect of a low glycemic index
diet. Metabolism 47: 1245-1251.
54. Brand-Miller J C (1994) Importance of glycaemic index in diabetes. The
American Journal of Clinical Nutrition 60: 48-50.
55. Jenkins DJ, Wolever TM, Collier GR, Ocana A, Rao AV, et al. (1987) Metabolic
effects of a low- glycemic- index diet. Am J Clin Nutr 47: 968-975.
56. Sluijs I, van der Schouw YT, van der A DL, Spijkerman AM, Grobbee DE, et
al. (2010) Carbohydrate quantity and quality and risk of type 2 diabetes in the
European Prospective Investigation into Cancer and NutritionNetherlands
(EPIC-NL) study. Am J Clin Nutr 92: 905-911.
57. Wilkin TJ, Metcalf BS, Murphy MJ, Kirkby J, Jeffery AN, et al. (2002). The
Relative Contributions of Birth Weight, Weight Change, and Current Weight
to Insulin Resistance in Contemporary 5-Year-Olds. Diabetes 51: 3468-3472.
58. Frost G, Keogh B, Smith D, Akinsanya K, Leeds A (1996) The effect of lowglycemic carbohydrate on insulin and glucose response in vitro and in vivo in
patients with coronary heart disease. Metabolism 45: 669-672.
59. Jarvi AE, Karlstrom BE, Granfeldt YE, Bjorck IE, Asp NG, et al. (1999) Improved
Glycemic Control and Lipid Profile and Normalized Fibrinolytic Activity and a
Low-Glycemic Index Diet in Type 2 Diabetic Patients. Diabetes Care 22: 10-18.
60. Frost G, Wilding J, Beecham J (1994) Dietary Advice Based on the Glycaemic
Index Improves Dietary Profile and Metabolic Control in Type 2 Diabetic
Patients. Diabetic Med 11: 397-401.
61. FAO/WHO (1998) Carbohydrates in human nutrition. Report of a Joint FAO/
WHO Expert Consultation, 14-18 April, 1997, FAO food and Nutrition paper
66: 1-140.
62. Frost G, Dornhorst A (2000) The relevance of the glycaemic index to our
understanding of dietary carbohydrates. Diabetic Med 17: 336-345.
63. Meyer KA, Kushi LH, Jacobs DR, Slavin JJ, Sellers TA, et al. (2000)
Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. Am
J Clin Nutr 71: 921-930.
64. Stevens J, Ahn K, Juhaeri, Houston D, Steffan L, et al. (2002) Dietary Fiber
Intake and Glycemic Index and Incidence of Diabetes in African-Amrican and
White Adults. Diabetes Care 25: 1715-1721.
Citation: Al-Mssallem MQ (2014) The Association between the Glycaemic Index of Some Traditional Saudi Foods and the Prevalence of Diabetes in
Saudi Arabia: A Review Article. J Diabetes Metab 5: 452 doi:10.4172/2155-6156.1000452
Page 7 of 7
65. Hallfrisch J, Behall K (2000) Mechanisms of the Effects of Grains on Insulin and
Glucose Responses. J Am Coll Nutr 19: S 320-S 325.
70. McMillan J, Brand-Miller J (2006) Low-glycaemic index diets and body weight
regulation. Int J Obesity 30: 540-546.
71. Liese A, Schulz M, Fang F, Wolever T, DAgostino RJ, et al. (2005) Dietary
glycemic index and glycemic load, carbohydrate and fiber intake, and measures
of insulin sensitivity, secretion, and adiposity in the Insulin Resistance
Atherosclerosis Study. Diabetes Care 28: 2832-2838.
67. Collison KS, Zaidi MZ, Subhani SN, Al-Rubeaan K, Shoukri M, et al. (2010)
Sugar-sweetened carbohydrated beverage consumption correlates with BMI,
waist circumference, and poor dietary choices in school children. BMC Public
Health 10: 1-13.
72. Englyst KN, Vinoy S, Englyst HN, Lang V (2003) Glycaemic index of cereal
products explained by their content of rapidly and slowly available glucose. Br
J Nutr 89: 329-339.
73. Wolever TMS, Barbeau MC, Charron S, Harrigan K, Leung S, et al. (2000a)
Guidelines for the nutritional management of diabetes mellitus in the new
millennium: a position by the Canadian Diabetes Association. Canadian J
Diabet Care 23: 5669.
69. Al-Farsi MA, Lee CY (2008) Nutritional and Functional Properties of Dates: A
Review. Crit Rev food Sci Nutr 48: 877-887.
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