Asia Pac J Clin Nutr 2008;17(1):35-39 35

Short Communication

Glycemic index of common Malaysian fruits

S Daniel Robert MSc
1
, Aziz Al-safi Ismail PhD
2
, Than Winn PhD
2
and Thomas MS
Wolever PhD DM
3


1
Program in Dietetics, School of Health Sciences, Health Campus, Universiti Sains Malaysia,
Kelantan, Malaysia
2
Department of Community Medicine, School of Medical Sciences, Health campus, Universiti Sains
Malaysia, Kelantan, Malaysia
3
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada


The objective of the present study was to measure the glycemic index of durian, papaya, pineapple and water-
melon grown in Malaysia. Ten (10) healthy volunteers (5 females, 5 males; body mass index 21.181.7kg/m)
consumed 50 g of available carbohydrate portions of glucose (reference food) and four test foods (durian, papaya,
pineapple and watermelon) in random order after an overnight fast. Glucose was tested on three separate occa-
sions, and the test foods were each tested once. Postprandial plasma glucose was measured at intervals for two
hours after intake of the test foods. Incremental areas under the curve were calculated, and the glycemic index
was determined by expressing the area under the curve after the test foods as a percentage of the mean area un-
der the curve after glucose. The results showed that the area under the curve after pineapple, 23224
mmolmin/L, was significantly greater than those after papaya, 14714, watermelon, 1398, and durian, 12413
mmolmin/L (p<0.05). Similarly, the glycemic index of pineapple, 824, was significantly greater than those of
papaya, 586, watermelon, 553, and durian, 495 (p<0.05). The differences in area under the curve and glyce-
mic index among papaya, watermelon and durian were not statistically significant. We conclude that pineapple
has a high glycemic index, whereas papaya is intermediate and watermelon and durian are low glycemic index
foods. The validity of these results depends on the accuracy of the data in the food tables upon which the portion
sizes tested were based.

Key Words: glucose, durian, papaya, pineapple, watermelon



INTRODUCTION
The concept of the glycemic index (GI) was

introduced as
a means of classifying carbohydrate containing

foods
based on the blood glucose response after food consump-
tion.
1
The GI is defined as the incremental area under the
blood glucose response curve (AUC) after a portion of
food containing 50g of the available carbohydrate is ex-
pressed as a percentage of the response after 50g of glu-
cose is taken by the same subject.
2
High GI diets may
have undesirable health effects by promoting hypergly-
cemia and hyperinsulinemia.
3,4
Recent studies report that
a high diet GI may increase risk of cardiovascular disease
(CVD)
5-7
and type 2 diabetes.
8-11
On the other hand, low
GI diets have been suggested to have health bene-
fits.
3,4,12,13
Low GI diets have been shown to improve
blood glucose control in patients with diabetes,
14-16
and
may help in the reduction of body weight,
17,18
and risk
factors for CVD.
7,14,19,20
As the awareness of the GI con-
cept is widespread, dietitians and nutritionists must be
able to understand the GI concept and provide nutrition
counseling to their patients.
Fruits are good sources of carbohydrates, vitamins and
minerals and are considered important for good health.
Studies suggest that fruits containing viscous fibers may
help control glucose responses by slowing the digestion
and absorption process.
21
Various kinds of fruits are
grown in plenty in the rich Malaysian soil throughout the
year. The Malaysian food pyramid recommends including
2 servings of fruit per day. Although Malaysians include a
wide variety of fruits in their diet, the GI of many of these
fruits has not been determined. Hence, we determined the
glycemic index of durian, papaya, pineapple and water-
melon.

MATERIALS AND METHODS
Setting
Study was conducted at the dietetics department, School
of Health Sciences, Universiti Sains Malaysia using inter-
nationally recognized GI methodology.
22,23


Subjects
Healthy men and non-pregnant, non-lactating women
aged 18-75 years were recruited from the Unversiti Sains
Malaysia campus and screened by height, weight, blood

Corresponding Author: Sathyasurya Daniel Robert MSc.,
Lecturer in Dietetics, Program in Dietetics, School of Health
Sciences, Health Campus, Universiti Sains Malaysia, 16150,
Kubang Kerian, Kota BharuKelantan, Malaysia
Tel: 6097663992; Fax: 6097647884
Email: dan77in@yahoo.com; daniel@kb.usm.my
Manuscript received 25 April 2007. Initial review completed 21
July 2007. Revision accepted 31 August 2007.
36 SD Robert, AA Ismail, T Winn and TMS Wolever
pressure and medical examination. Exclusion criteria
were: known history of AIDS or hepatitis, inflammatory
bowel disease, diabetes or heart conditions (angina, ar-
rhythmia or heart failure); history of an acute medical or
surgical event within the last 6 months; BMI > 23kg/m
2
;
use of medications; those who cannot or will not comply
with the experimental procedures. Ten healthy subjects (5
females and 5 males) with a mean age of 31.46.3years
and a mean body mass index of 21.21.7kg/m took part
in this study. However, the participation of two subjects
was discontinued by the investigators partway through the
study (before they had completed tests of durian and pa-
paya) because they became pregnant; therefore, the GI
values of durian and papaya were determined in the re-
maining 8 subjects. The research protocol was approved
by the institutional ethics review committee and informed
consent was obtained from all subjects.

Test foods and reference food
The four tropical fruits selected for study were durian
(Durio zibethinus), papaya (Carica papaya), pineapple
(Ananas comosa) and watermelon (Citrulius vulgaris
red variety). These test foods had the same degree of
ripeness at the time of purchase. The test foods were pur-
chased from the local fruit shop one day before use. Glu-
cose (Glucolin) was used as the reference food.

In-vivo test and blood sample analysis
We studied the subjects on 7 different occasions in the
morning after 10-12 hour overnight fasts. No restrictions
were placed on the meal that was eaten prior to the test.
On three occasions, subjects consumed 50g of glucose
dissolved in 400ml water. On the other four occasions the
subjects consumed a portion of one of the 4 test foods
containing 50g of available carbohydrate, defined as total
carbohydrate by difference minus dietary fiber. As the
dietary fiber information is not available in the nutrient
composition of Malaysian food table, we obtained the
data from the United States Department of Agricultures
(USDA) online nutrient database.
24
All test foods were
served with a drink of 250ml water. Each subject con-
sumed the test foods over a 10 to 13min period. Finger
prick capillary blood samples were taken fasting and at 15,
30, 45, 60, 90 and 120 min from when the subject first
started eating. Blood samples were drawn into 1.5ml ep-
pendorf tubes containing fluoride oxalate and were
quickly centrifuged to obtain plasma, which was stored at
-20C prior to analysis of glucose using an auto analyzer
(Spectra-E, Vitalab- Clinical Chemistry Analyser) which
uses the glucose oxidase method.
Data analysis
Statistical analyses was conducted using Microsoft Excel
Spread Sheets and the Statistics Program for Social Sci-
ences (SPSS, version 12.1.0) computer software package.
Incremental areas under the blood glucose response
curves (AUC), ignoring area beneath the fasting level,
were calculated geometrically.
2
The mean, SD and coeffi-
cient of variation (CV = 100SD /mean) of AUC values
for repeated glucose tests for each subject were calculated.
The AUC for each food was expressed as a percentage of
the mean AUC for glucose taken by the same subject and
the resulting values averaged to give the food GI. The GI
value of pineapple for one of the subjects was > 2SD
greater than the mean and as a result, was regarded as a
outlier and discarded.
2
The AUC values and GI values of
each subject were subjected to repeated measures
ANOVA and, after demonstrating significant heterogene-
ity, the significant differences between individual means
was assessed using Tukeys test to adjust for multiple
comparisons. The criterion for significance was 2-tailed
p<0.05. Pearsons product-moment correlation analysis
was employed to explore a potential correlation between
dietary fiber, fructose and GI. Results were expressed as
meanSEM.

RESULTS
The composition of the test meals are shown in Table 1
and expressed in terms of the portion size that was fed to
each subject. Among the test foods, durian contained the
highest amount of fat, while papaya contained the most

Table 1. Composition of test meals
32, 33


Food Portion size
(g)
Protein
(g)
Fat
(g)
Dietary Fiber

(g)
Fructose
(g)
Glucose
(g)
Sucrose
(g)
Av. Carbohydrate
(g)
Durian 207 5.6 7.0 7.9

50.0
Papaya 943 14.0 0.9 17.0 16.1 16.1 17.8 50.0
Pineapple 543 2.7 0.5 7.6 12.5 10.0 27.5 50.0
Watermelon 893 5.4 1.8 3.6 16.4 9.3 24.3 50.0

Data obtained from United States Department of Agricultures (USDA) online nutrient
database
24
;

No data available


0 30 60 90 120
5
7
9
11
Durian
Papaya
Watermelon
Pineapple
Glucose
a,b,c
d,e
c,d
d,f
d,f,g
Time (min)
P
l
a
s
m
a

G
l
u
c
o
s
e

(
m
m
o
l
/
L
)


Figure 1. Mean plasma glucose response of test foods
and the reference food. Values are means+/-SEM (n=8-10).
Comparison of glucose concentrations (p<0.05): a, durian vs.
papaya ; b, durian vs. watermelon; c, durian vs. pineapple; d,
durian vs. glucose; e, papaya vs. pineapple; f, watermelon vs.
glucose; g, papaya vs. glucose.
Glycemic index of common Malaysian fruits 37

protein and dietary fiber. The sucrose content of pineap-
ple is comparatively higher than other test foods. How-
ever, there was no available data on the types of sugar
found in durian.
The plasma glucose responses after the consumption of
glucose and the four test foods are shown in Figure 1.
The CV of the AUC of repeated glucose trials taken by 10
subjects was 20.94%. The mean AUC after glucose con-
sumption was significantly greater than those after papaya,
watermelon and durian (Table 2). Mean AUC after pine-
apple consumption, was not significantly different from
that of glucose, but was significantly greater than those
after papaya, watermelon and durian (Table 2). Prior to
the removal of the outlier, the GI value of pineapple was
909. After discarding the outlying value, the mean GI
value for pineapple (824) was still significantly greater
than those for papaya (586), watermelon (553) and
durian (495) (p<0.05; Table 2). Comparison of GI val-
ues of the test foods obtained in this study with that of the
GI values present in the international table is shown in
Table 3.

DISCUSSION
Many factors may influence the GI of fruits. These factors
include the type of sugars, degree of ripeness, fiber con-
tent, presence of anti nutrients, and acid content.
25-27
Our
study showed that the AUC and GI of pineapple were
higher than the other three fruits. In addition our GI value
for pineapple, 824, is significantly higher than the value
of 598 given in the International GI Tables
28
by un-
paired t-test (p=0.03). The dissimilarity of the GI values
of the same type of fruits grown in different places may
be due to the growing conditions or to differences in the
sugar composition of the individual fruits. As a fruit rip-
ens, the nutrient composition changes.
29
A fruit that ripens
early in the season will have a different nutrient content
from one of the same cultivated variety that ripens later in
the season. In addition nutrient composition is influenced
by time of harvest, period of storage and the method of
storage.
29
Thus, it is difficult for food composition tables
to accurately state nutrient composition data. The sugar
composition of the fruits grown in Malaysia is not yet
determined; therefore, the data that is given in Table 1
may not represent what was in the fruits we used in this
study. On the other hand, dietetic professionals plan diets
based on information given in such food composition
tables, so the results shown here are relevant to "real life"
situations. AUC and GI values for durian are compara-
tively lower than the other fruits. This may be due to the
presence of fiber and the high fat content of durian. The
dietary fiber present in foods could influence the diges-
tion and absorption of the carbohydrate they contain and
consequently their blood glucose responses.
21
However
there was no relationship detected between the dietary
fiber content of the fruits and their respective glycemic
index values (r=-0.03, p=0.9). Fat on the other hand does
not have a direct effect on blood glucose response, but it
may influence glycemic response indirectly by delaying
gastric emptying, and thus, carbohydrate absorption.
30

Recently Moghaddam et al found that across the range of
0 30g, protein and fat present in liquid test meals re-
duced the blood glucose responses independently from
each other in a linear, dose-dependent fashion.
31
However,
Moghaddam et al noted that the same effects might not
apply to solid meals. The type of sugar that is present in
durian is unknown. There is also no reported scientific
value with regard to the GI of durian and as a result this
might be the first study to determine the GI of durian.
Our GI value for papaya obtained in this study, 586,
was almost identical to that reported in the International
GI Tables, 591.
28
The relatively low GI value of papaya
may be due to the presence of fiber and the 14 g of pro-
tein found in portion size used in the study.
31
However,
the GI value of watermelon in this study, 553, tended to
be lower than that given in the International table, 7213,
although the difference is not statistically significant. The
proportion of fructose present in watermelon is slightly
higher than that of glucose; this may explain why the GI
value of watermelon is low. Fructose has a lower blood
glucose response (GI = 192) than glucose (GI = 993)
because fructose is absorbed by a saturable facilitated
diffusion process and must be converted to glucose by the
liver before entering the blood circulation.
28
Though there
was excellent correlation between the fructose content of
Table 2. Incremental area under the curve (AUC) and glycemic index (GI) values of glucose and the test foods

Area Under the Curve (mmolmin/L) Glycemic Index (%)
Glucose 25915
a
100
a

Pineapple 23224
a
824
b

Papaya 14714
b
586
c

Watermelon 1398
b
553
c

Durian 12413
b
495
c


Values are meansSEM;
ab
Means with different letter superscripts differ significantly, p<0.05.


Table 3. Comparison of GI values of the test foods obtained in this study with that of the GI values present in the
international table
28


Foods GI (International Table) Subjects (number) GI (this study) Subjects (number)
Durian

49 5 8
Papaya 59 1 10 58 6 8
Pineapple 59 8 11 82 4 9
Watermelon 72 13 8 55 3 10

Values are meansSEM;

No data available

38 SD Robert, AA Ismail, T Winn and TMS Wolever
the fruits and their respective GI values (r = -0.8), it was
not significant (p=0.4).
Further work is needed to confirm whether the GI val-
ues of pineapple and watermelon from Malaysia differ
from those in other countries, and to determine why these
differences exist. In addition, the composition of sugars
present in durian is not known. We conclude that, using
portion sizes based on food tables, durian and watermelon
grown in Malaysia can be classified as low GI foods, pa-
paya as an intermediate GI food, and pineapple as a high
GI food. The accuracy of these results depends upon ac-
curacy of the nutritional composition of the fruits as given
in food tables.

ACKNOWLEDGEMENTS
We thank the Universiti Sains Malaysia for the short-term grant.
The authors also wish to thank Jamaruddin, Ahmed Hafizuddin,
Chandran, Nurdiana, Nor Azzizah, Lukmi Ismail, Zaki Salamat,
Sahnusi, Carolin Daniel and all the subjects for their help in
conducting this study.

AUTHOR DISCLOSURES
Dr. Wolever is President and part-owner of Glycemic Index
Laboratories, Inc., a contract research organization; President
and part-owner of Glycaemic Index Testing, Inc., a corporation
which provides services related to the measurement of the gly-
cemic index of foods; received grant/research support from Car-
gill, Inc. and ILSI Europe; is a consultant for McCain Foods;
and received honoraria for consulting/speaking from the Dutch
Sugar Bureau and Mars Inc. Dr. Wolever is co-author of a
range of popular books on the glycemic index under the general
title of The Glucose Revolution: Authoritative Guide to the Gly-
cemic Index, published by Marlowe & Co., NY; he is also au-
thor of a scientific book entitled: The Glycaemic Index: A
Physiological Classification of Dietary Carbohydrate, published
by CABI, UK. S Daniel Robert, Aziz Al-safi Ismail and Than
Winn, no conflicts of interest.

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Short Communication

Glycemic index of common Malaysian fruits

S Daniel Robert MSc
1
, Aziz Al-safi Ismail PhD
2
, Than Winn PhD
2
and Thomas MS
Wolever PhD DM
3


1
Program in Dietetics, School of Health Sciences, Health Campus, Universiti Sains Malaysia,
Kelantan, Malaysia
2
Department of Community Medicine, School of Medical Sciences, Health campus, Universiti Sains
Malaysia, Kelantan, Malaysia
3
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada

10 (5 5 21.181.7kg/m)
50g () 4
()
2

(23224 mmolmin/L)
(14714)(1398)(12413) (p<0.05)
(844)(586)(553)(495) (p<0.05)
GI