Simulating human carbohydrate digestion in vitro: a review of methods and the need for standardisation

Summary Numerous in vitro carbohydrate digestion methods exist for analysis of the likely glycaemic properties of foods. Generally these methods encompass simulations of oral, gastric and intestinal digestion processes, but the way in which physiological conditions are implemented across methods differs considerably. Some differences are in the mode of comminution, inclusion and duration of a gastric digestion, and choice of amylolytic enzyme. Incubation temperature, pH, duration and stirring mode also differ between methods. Such differences, particularly the method used to mimic chewing, can have a substantial influence on the relative estimate of glycaemic potency for a given food. To achieve estimates of high predictive power, and global relevance, a validated, standardised in vitro digestion method must be developed. This article provides a systematic review of commonly used and referred to in vitro carbohydrate digestion methods. Methodological discrepancies between protocols are identified thus defining the route a systematic standardisation investigation should take.