***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: 1 . The degree to which disruption by mastication affects the glycaemic response to four different carbohydrate foods was investigated in healthy human volunteers ; each food was eaten by six subjects . 2 . Subjects ate meals of sweetcorn , white rice , diced apple or potato on two occasions ; on one occasion they chewed the food thoroughly , on the other occasion they swallowed each mouthful without chewing it . 3 . When the foods were chewed the postpr and ial blood glucose levels rose to levels which varied according to the food ingested . 4 . Swallowing without chewing reduced the glycaemic response to each food , achieving a similar effect as administration of viscous polysaccharides or ' slow-release ' carbohydrates The determine the effect of different foods on the blood glucose , 62 commonly eaten foods and sugars were fed individually to groups of 5 to 10 healthy fasting volunteers .  Blood glucose levels were measured over 2 h , and expressed as a percentage of the area under the glucose response curve when the same amount of carbohydrate was taken as glucose . The largest rises were seen with vegetables ( 70 + /- 5 % ) , followed by breakfast cereals ( 65 + /- 5 % ) , cereals and biscuits ( 60 + /- 3 % ) , fruit ( 50 + /- 5 % ) , dairy products ( 35 + /- 1 % ) , and dried legumes ( 31 + /- 3 % ) . A significant negative relationship was seen between fat ( p less than 0.01 ) and protein ( p less than 0.001 ) and postpr and ial glucose rise but not with fiber or sugar content The glycaemic index ( GI ) concept was originally introduced to classify different sources of carbohydrate (CHO)-rich foods , usually having an energy content of > 80 % from CHO , to their effect on post-meal glycaemia . It was assumed to apply to foods that primarily deliver available CHO , causing hyperglycaemia . Low-GI foods were classified as being digested and absorbed slowly and high-GI foods as being rapidly digested and absorbed , result ing in different glycaemic responses . Low-GI foods were found to induce benefits on certain risk factors for CVD and diabetes . Accordingly it has been proposed that GI classification of foods and drinks could be useful to help consumers make ' healthy food choices ' within specific food groups . Classification of foods according to their impact on blood glucose responses requires a st and ardised way of measuring such responses . The present review discusses the most relevant method ological considerations and highlights specific recommendations regarding number of subjects , sex , subject status , inclusion and exclusion criteria , pre-test conditions , CHO test dose , blood sampling procedures , sampling times , test r and omisation and calculation of glycaemic response area under the curve . All together , these technical recommendations will help to implement or reinforce measurement of GI in laboratories and help to ensure quality of results . Since there is current international interest in alternative ways of expressing glycaemic responses to foods , some of these methods are discussed The glycemic response ( GR ) to food is influenced by both intrinsic and extrinsic factors . A consistent observation in GR studies is the wide within- and between-individual variations . The authors hypothesize that between-individual variations in the GR , insulin response ( IR ) and gastric emptying occur even when food particle size is st and ardized . Volunteers were tested on 2 nonconsecutive days after an overnight fast in r and omized order . On 1 day , the volunteers consumed large ( > 2000 μm ) rice particles , and on the second day , small rice particles ( 500 - 1000 μm ) . Subsequently , gastric emptying using the sodium [ (13)C ] acetate breath test ( for 240 minutes ) and GR and IR ( for 120 minutes ) from finger-prick blood sample s were measured . The incremental area under the curve ( IAUC ) for the GR for small particles varied 45 % more compared with whole rice . The small particles elicited a significantly greater GR IAUC than the large particles . The st and ard deviations associated with the IR IAUC for the small particles was 140 % greater than that of the large particles . The total IAUC for IR was also significantly greater for the small particles than the large particles . The between-individual variations associated with gastric emptying times were similar for both sample s. The gastric emptying latency phase , lag , and half time were significantly shorter for the small particles . Ingesting small particles causes faster gastric emptying and produces greater glycemic and IRs . Between-individual variations in GR and IR can be observed even when all the food associated factors including ingested particle size ( mastication ) are controlled for in humans To determine the influence of masticatory efficiency on postpr and ial satiety and glycaemic response , twenty-one healthy males were recruited for this r and omised cross-over trial . The participants consumed a fixed amount of pizza provided in equal-sized portions by chewing each portion either fifteen or forty times before swallowing .  Subjective appetite was measured by appetite question naires at regular intervals for 3 h after the meal and plasma sample s were collected for the measurement of selected satiety-related hormones , glucose , insulin and glucose-dependent insulinotropic peptide ( GIP ) concentrations . An ad libitum meal was provided shortly after the last blood sample was drawn and the amount eaten recorded . Compared with fifteen chews , chewing forty times per portion result ed in lower hunger ( P= 0·009 ) , preoccupation with food ( P= 0·005 ) and desire to eat ( P= 0·002 ) . Meanwhile , plasma concentrations of glucose ( P= 0·024 ) , insulin ( P < 0·001 ) and GIP ( P < 0·001 ) were higher following the forty-chews meal . Chewing forty times before swallowing also result ed in a higher plasma cholecystokinin concentration ( P= 0·045 ) and a trend towards a lower ghrelin concentration ( P= 0·051 ) . However , food intake at the subsequent test meal did not differ ( P= 0·851 ) . The results suggest that a higher number of masticatory cycles before swallowing may provide beneficial effects on satiety and facilitate glucose absorption Objective : To determine and compare the glycaemic index ( GI ) values of a range of  Vietnamese foods in two racial groups . Design and subjects : Twelve healthy subjects ( six Asian and six Caucasian ) consumed 50 g carbohydrate portions of a reference food ( glucose sugar ) and nine Vietnamese foods ( three rices , three noodle products and three sweet foods ) in r and om order after an overnight fast . The reference food was tested on two separate occasions , and the Vietnamese foods were each tested once . Capillary blood sample s were taken at time 0 ( fasting ) , 15 , 30 , 45 , 60 , 90 and 120 min from the start of each meal . Sample s were analysed for plasma glucose and the incremental areas under the plasma glucose curves ( AUC ) were used to calculate the GI values of the test foods , using glucose as the reference food ( ie GI value of glucose=100 ) . The mean GI value of each food was calculated for the entire group of subjects ( n=12 ) and for both racial groups ( n=6 ) . Results : The three rices had surprisingly high GI values ( 86–109 ) , whereas the noodle products had relatively low GI values ( 39–61 ) . The sugar-rich foods produced intermediate GI values ( 54–79 ) . The GI values for the nine foods calculated separately for the two racial groups were not significantly different from each other ( P=0.26 ) . Conclusions : The GI values derived from Caucasian subjects are likely to be applicable to Asian population s. Varieties of imported rice from Thail and were found to have high GI values . Alternative low-GI staples , such as rice noodles , may be preferable for Asian/Vietnamese people with diabetes . Sponsorship : This study was funded by the University of Sydney . European Journal of Clinical Nutrition ( 2001 ) 55 , Background Glycemic index ( GI ) is intended to be a property of food but some reports are suggestive that GI is influenced by participant characteristics when glucose is used as a reference . Objective To examine the influence of different reference foods on observed GI . Design The GIs of five varieties of rice and a sugary beverage ( LoGiCane ™ ) were tested in 31 European and 32 Chinese participants using glucose or jasmine rice as reference foods . The GIs of two ready-to-eat breakfast cereals ( Kellogg ’s cornflakes and Sustain ) were tested in 20 younger and 60 older people using glucose or Sustain as reference foods . Results The  GIs of rice tended to be higher in the Chinese compared with the Europeans when glucose was used as a reference ( jasmine 80 vs 68 , P = 0.033 ; basmati 67 vs 57 , P = 0.170 ; brown 78 vs 65 , P = 0.054 ; Doongara 67 vs 55 , P = 0.045 ; parboiled 72 vs 57 , P = 0.011 ) . There were no between-group differences in GI when jasmine rice was the reference . The GIs of breakfast cereals tended to be lower in younger compared with older groups ( cornflakes 64 vs 81 , P = 0.008 ; Sustain 56 vs 66 , P = 0.054 ) . There was no between-group difference in the GI of cornflakes when Sustain was the reference ( cornflakes 115 vs 120 , P = 0.64 ) . There was no ethnic difference in GI when glucose was the reference for another sugary food ( LoGiCane ™ 60 vs 62 ; P = 0.69 ) . Conclusions A starchy reference may be more appropriate than a glucose beverage when attempting to derive universally applicable GI values of starchy foods . Trial registration The Chinese/European trial is registered with the Australian New Zeal and Clinical Trials Registry as ACTRN12612000519853 Coffee and tea may influence glycaemic responses but it is not clear whether they affect the glycaemic index ( GI ) value of foods . Therefore , to see if coffee and tea affected the mean and SEM of GI values , the GI of fruit leather ( FL ) and cheese puffs ( CP ) were determined twice in ten subjects using the FAO/WHO protocol with white bread as the reference food . In one series subjects chose to drink 250 ml of either coffee or tea with all test meals , while in the other series they drank 250 ml water . The tests for both series were conducted as a single experiment with the order of all tests being r and omised . Coffee and tea increased the overall mean peak blood glucose increment compared with water by 0.25 ( SEM 0.09 ) mmol/l ( P=0.02 ) , but did not significantly affect the incremental area under the glucose response curve . Mean GI values were not affected by coffee or tea but the SEM was reduced by about 30 % ( FL : 31 ( SEM 4 ) v. 35 ( SEM 7 ) and CP : 76 ( SEM 6 ) v. 75 ( SEM 8) for coffee or tea v. water , respectively ) . The error mean square term from the ANOVA of the GI values was significantly smaller for coffee or tea v. water ( F(18 , 18 ) = 2.31 ; P=0.04 ) . We conclude that drinking coffee or tea with test meals does not affect the mean GI value obtained , but may reduce variability and , hence , improve precision We studied 12 subjects with diabetes to determine how well the glycemic index ( Gl ) predicted the ranking of glycemic responses of different foods in individuals . All subjects ate three mixed meals ( bread , rice , or spaghetti with GIs of 100 , 79 , and 61 , respectively ) four times in a r and omized complete block design . The mean glycemic response areas of the different meals ranked according to the predicted Gl in every individual . The observed mean ± SD Gl values of the meals were significantly different from each other ( bread 100 ± 7 , rice 75 ± 9 , spaghetti 54 ± 9 ) , with no significant difference in response between subjects . It is concluded that individuals share common mean Gl values for different foods . Within confidence limits determined by the variability of glycemic responses , the number of repeated tests conducted , and the expected Gl difference , the Gl can be used to predict the ranking of the mean glycemic responses of mixed meals taken by individuals Consumption of a low glycemic index ( GI ) diet may be helpful in the management and prevention of diabetes and cardiovascular disease . The investigation of GI has been predominantly confined to white subjects . We hypothesized that differences in glycemic response ( GR ) may be observable in subjects of different ethnic origin . The objective of the present study was to determine GR to a high GI ( glucose ) and low GI ( maltitol ) test drink in subjects of different ethnic origin . In a r and omized , single-blind crossover trial , 10 whites , 10 South Indians and 10 Chinese subjects consumed either glucose or maltitol test drink containing 50 g of one of the test products on different occasions . Capillary blood glucose sample s were taken at 15 and 10 minutes before and 0 , 15 , 30 , 45 , 60 , 90 , 120 , 150 , and 180 minutes after consumption of the test 
    Output:
    
Conclusions : With the possible exception of rice , existing evidence suggests that GI values do not differ when measured in Caucasians versus non-Caucasians .