Mismatch between measured and perceived glycaemic index of Malaysian snack foods: a preliminary study

Mismatch between measured and perceived glycaemic index of Malaysian snack foods: a preliminary study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Brief Communication Mismatch between measured and perceived glycaemic index of Malaysian snack foods: a preliminary study Ching Li Lee, Yi Qi Cheow, Gabrielle Tho, Farah Hasbullah, Dr Winnie Chee, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8586671/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract This study investigated the concordance between measured glycaemic index (GI) values of Asian snack foods and consumer perceptions of their GI, addressing limited empirical evidence and inconsistencies in GI labelling. The measured GI of seven commonly consumed Malaysian snacks was determined in at least 10 healthy adults using standard GI testing protocol, while consumer perceptions of the GI category (low, medium, or high) of these snacks were assessed via an online survey completed by 110 adults. With measured GI, four snacks were classified as high GI, one as medium, and two as low. Consumer accuracy in correctly identifying GI categories varied widely, ranged from 5.5% – 89.1%, with systematic overestimation of low-GI snacks and underestimation of some high-GI snacks. These findings highlight a disconnect between actual and perceived GI values, underscoring the need for clearer GI labelling, targeted education, and improved GI communication. Health sciences/Health care/Nutrition Health sciences/Health care/Disease prevention Figures Figure 1 INTRODUCTION The glycaemic index (GI) indicates how rapidly a food increases postprandial glycaemia ( 1 ). Consumption of low-GI foods has been associated with a reduced risk of type 2 diabetes (T2D), cardiovascular disease, diabetes-related cancer, and all-cause mortality ( 2 ). Likewise, adherence to a low-GI diet has been shown to improve glycaemic control in people living with diabetes compared with a high-GI diet ( 3 ). Nutrition labelling guides consumers to make healthier food choices ( 4 ). However, unlike carbohydrate content, the inclusion of GI information on food labels is not regulated in many countries ( 5 ). This lack of standardisation may contribute to consumers’ difficulty in accurately estimating the glycaemic impacts of foods ( 6 ). Hence, this preliminary study examined measured GI of Malaysian snacks in relation to consumers’ perceived GI. MATERIALS AND METHODS Participants For in vivo GI determination, a minimum of 10 healthy adults were recruited from volunteer databases to detect GI differences in humans with 80% statistical power at a 0.05 significance level ( 7 ). Eligible participants were men and women, aged 18–30 years, non-smokers, and with normal fasting blood glucose concentrations (< 5.6 mmol/L). Exclusion criteria included food allergies and the use of medications known to interfere with carbohydrate metabolism. A total of 110 Malaysian adults completed an online survey on consumers’ perceived GI values of snacks. With seven snacks assessed in the survey, this sample size met the recommended minimum sample-to-item ratio of 5:1 for exploratory surveys ( 8 ). Written informed consent was obtained from all participants prior to data collection. Test foods Seven commonly consumed Malaysian snacks were included: ‘Apam Beras’ (steamed rice flour cakes), ‘Onde-Onde’ (glutinous rice balls with palm sugar filling), ‘Green gram porridge’ (sweet mung bean dessert with coconut milk), ‘String hoppers’ (steamed rice noodles with coconut and brown sugar), ‘Agar-agar’ (jelly prepared from agar powder and sugar), ‘Tau Fu Fah’ (soybean pudding with syrup), and ‘Portuguese egg tart’ (puff pastry with egg custard). Measured GI The GI of the test foods was determined according to ISO 26642:2010 methodology. The glycaemic carbohydrate content of each test food was determined via proximate analysis. Test portions containing 50 g of glycaemic carbohydrate were served with 250 mL plain water whereas the reference food was prepared by dissolving 54.7 g of glucose monohydrate in 250 mL plain water. Participants attended 10 morning sessions (seven test foods and three reference foods), following a 10-hour overnight fast and abstention from vigorous physical activity. Participants consumed the test foods within 15 minutes, while seated alone in a comfortable, temperature-controlled environment to minimise the influence of social interactions. Two finger-prick capillary blood samples were collected at baseline; the average was calculated as the fasting glucose concentration. Thereafter, the test foods were served, and subsequent finger-prick capillary blood samples were collected at 15-, 30-, 45-, 60-, 90- and 120-minutes post-consumption. Single-use lancing devices (On Call Sterile Lancet, ACON Laboratories Inc., San Diego, California, USA) were used for finger-pricks and blood samples were collected on glucose test strips (On Call Sure Blood Glucose Test Strips, ACON Laboratories Inc., USA). Blood glucose concentrations were measured based on electrochemical detection with glucose dehydrogenase-flavin adenine dinucleotide (GDH-FAD) enzyme system. The inter-assay coefficient of variation (CV) was < 3.6%, as determined using standard solutions (On Call Sure Sync Blood Glucose Monitoring System, ACON Laboratories Inc., USA). Incremental area under the blood glucose curve (iAUC), excluding the area beneath the fasting concentration, was calculated using the trapezoidal rule in Microsoft Excel (2022). The GI of each test food was calculated for individual participants as the iAUC of the test food expressed as a percentage of the mean iAUC of the reference food. The final GI of each test food was reported as the mean ± standard error from at least 10 participants. Perceived GI For the assessment of perceived GI, each snack was presented as a photograph within an online questionnaire. Participants were asked to categorise each food as low GI (≤ 55), medium GI (56–70), or high GI (> 70). RESULTS Study population Participants involved in the in vivo GI testing were predominantly young female adults with normal fasting blood glucose levels. In comparison, survey respondents were also mainly female but were older and more heterogenous in age distribution (Table 1 ). Table 1 Measured versus perceived glycaemic index of the traditional Malaysian snacks a, b, c, d, e Snacks Measured Glycaemic Index Perceived Glycaemic Index Participants Quantity of snacks with 50g available carbohydrate GI value GI Category Participants Correct estimation of GI category Incorrect estimation of GI category Over estimated Under estimated Apam Beras Steamed cakes made with rice flour, yeast, water and sugar N = 11; Females: 100% Age: 21.5 ± 1.5 Fasting glucose: 4.7 ± 0.4 119.0 92 ± 9 High N = 110 Females: 76.4% Age: 30.9 ± 13.5 74 (67.3) 0 36 (32.7) Onde-Onde Boiled dough made with glutinous rice flour and filled with coconut palm sugar N = 11; Females: 100% Age: 21.5 ± 1.5 Fasting glucose: 4.7 ± 0.4 103.7 75 ± 8 High 98 (89.1) 0 12 (10.9) Green gram porridge Boiled dessert made with sweet green beans and coconut milk N = 11; Females: 100% Age: 21.9 ± 1.5 Fasting glucose: 4.7 ± 0.4 280.9 73 ± 6 High 29 (26.4) 0 81 (73.6) String hoppers Steamed noodles made with rice flour and served with brown sugar and shredded coconut N = 11; Females: 100% Age: 22.0 ± 1.9 Fasting glucose: 4.7 ± 0.3 117.6 71 ± 9 High 51 (46.4) 0 59 (53.6) Agar-agar Boiled jelly made with water, sugar, and agar-agar powder (gelling agent derived from red algae) N = 10; Females: 70% Age: 22.4 ± 2.3 Fasting glucose: 4.7 ± 0.4 212.8 70 ± 6 Medium 39 (35.5) 45 (40.9) 26 (23.6) Tau Fu Fah Steamed pudding made with soybean milk and served with brown sugar syrup N = 10; Females: 70% Age: 22.3 ± 2.1 Fasting glucose: 4.6 ± 0.4 467.3 55 ± 6 Low 8 (7.3) 102 (92.7) 0 Portuguese egg tart Baked puff pastry with an egg custard filling N = 11; Females: 100% Age: 22.0 ± 1.9 Fasting glucose: 4.7 ± 0.3 132.3 42 ± 5 Low 6 (5.5) 104 (94.5) 0 a Age in mean ± SD (years); b Fasting blood glucose in mean ± SD (mmol/L); c Quantity of snacks with 50g carbohydrates in g; d GI value in mean ± SEM; e Estimation of GI category in N (%) In vivo GI Four snacks were high GI, one was medium GI, and two were low GI (Table 1 ). In aggregate, low-GI snacks elicited a smaller postprandial glycaemic response, with a peak blood glucose concentration of 7.3 mmol/L, while high-GI snacks produced a substantially higher peak of 8.5 mmol/L (Fig. 1 ). Perceived GI Participants generally overestimated the GI of low-GI snacks and underestimated the GI of several high-GI foods (Table 1 ). Most participants correctly identified ‘Apam Beras’ (67.3%) and ‘Onde-Onde’ (89.1%) as high GI foods. Fewer participants recognised ‘Green gram porridge’ (26.4%) and ‘String hoppers’ (46.4%) as high GI. For ‘Agar-agar’ (medium GI), accuracy was modest (35.5%), with frequent over- (40.9%) and under-estimation (23.6%). Very few participants correctly identified the low GI of ‘Tau Fu Fah’ (7.3%) and ‘Portuguese egg tart’ (5.5%), with most overestimating their GI. DISCUSSION This preliminary study demonstrates a clear mismatch between the measured glycaemic index (GI) of commonly consumed Malaysian snack foods and consumer perception of their GI categories. Consumer estimates appeared to be driven more by perceived sweetness and health beliefs than physiological glycaemic response, consistent with GI misperceptions reported by Cabral et al. (2022) ( 9 ). Foods typically regarded as sweet, such as Onde-Onde , were more accurately identified as high GI, whereas snacks perceived as healthier or less refined, including Green gram porridge and String hoppers , were frequently underestimated despite high measured GI values. Conversely, low-GI foods such as Tau Fu Fah and Portuguese egg tart were commonly overestimated, indicating limited awareness of the influence of food matrix and macronutrient composition on glycaemic response. In the absence of regulated GI labelling, these findings highlight the need for clearer GI communication and targeted consumer education in Asian dietary contexts. Declarations ETHICAL APPROVAL This study received ethics approval by the Institutional Review Board at IMU University (4.2/JCM-271/2023, 4.4/JCM-300/2024). COMPETING INTERESTS The authors declare that they have no competing interests. FUNDING The research leading to these results received funds from IMU University (4.2/JCM-271/2023, 4.4/JCM-300/2024) AUTHOR CONTRIBUTIONS Ching Li Lee: Conceived and designed the experiments, performed the experiments, analysed the data, wrote the paper; Yi Qi Cheow: Performed the experiments, analysed the data, wrote the paper; Gabrielle Ngo Tho: Performed the experiments, wrote the paper; Farah Yasmin Hasbullah: Wrote the paper; Winnie Siew Swee Chee: Conceived and designed the experiments, wrote the paper; Christiani Jeyakumar Henry: Conceived and designed the experiments, wrote the paper DATA AVAILABILITY STATEMENT The data supporting the findings of this study are available from the corresponding author upon reasonable request. References Jenkins DJ, Wolever TM, Taylor RH, Barker H, Fielden H, Baldwin JM, et al. Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr. 1981;34(3):362–6. Jenkins DJA, Willett WC, Yusuf S, Hu FB, Glenn AJ, Liu S, et al. Association of glycaemic index and glycaemic load with type 2 diabetes, cardiovascular disease, cancer, and all-cause mortality: a meta-analysis of mega cohorts of more than 100 000 participants. Lancet Diabetes Endocrinol. 2024;12(2):107–18. Ojo O, Ojo O, Adebowale F, Wang XH. The Effect of Dietary Glycaemic Index on Glycaemia in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2018;10(3):373. Kelly B, Ng SH, Carrad A, Pettigrew S. The Potential Effectiveness of Front-of-Pack Nutrition Labeling for Improving Population Diets. Annu Rev Nutr. 2024;44(1):405–40. Barclay AW, Augustin LSA, Brighenti F, Delport E, Henry CJ, Sievenpiper JL, et al. Dietary Glycaemic Index Labelling: A Global Perspective. Nutrients. 2021;13(9):3244. König LM, Ziesemer K, Renner B. Quantifying Actual and Perceived Inaccuracy When Estimating the Sugar, Energy Content and Portion Size of Foods. Nutrients. 2019;11(10):2425. Brouns F, Bjorck I, Frayn KN, Gibbs AL, Lang V, Slama G, et al. Glycaemic index methodology. Nutr Res Rev. 2005;18(1):145–71. Memon MA, Ting H, Cheah JH, Thurasamy R, Chuah F, Cham TH. Sample Size for Survey Research: Review and Recommendations. Journal of Applied Structural Equation Modeling. 2020;4(2):i–xx. Cabral D, Fonseca SC, Moura AP, Oliveira JC, Cunha LM. Conceptualization of Rice with Low Glycaemic Index: Perspectives from the Major European Consumers. Foods. 2022;11(14):2172. Additional Declarations There is NO conflict of interest to disclose. Cite Share Download PDF Status: Under Review Version 1 posted Review # 1 received at journal 30 Mar, 2026 Reviewer # 1 agreed at journal 17 Mar, 2026 Reviewers invited by journal 09 Feb, 2026 Editor assigned by journal 13 Jan, 2026 Submission checks completed at journal 13 Jan, 2026 First submitted to journal 12 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8586671","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Brief Communication","associatedPublications":[],"authors":[{"id":588615084,"identity":"799addab-9d55-499e-b8c0-94d149659d4a","order_by":0,"name":"Ching Li Lee","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA60lEQVRIiWNgGAWjYDACCcYGBoYCCQY+BgbGBwlgoQRitBhIMLAxMDAbEKkFRBgwgLSwSTAQo4V/dnPbwy8GFgxs7M3HKh7mHGbgZ88xYLrZhseSOwfbjWVADuM5lnYjcdthBsmeNwbMuXi0GEgktklLgLRI5JiBtRjcyCFWi/z7bwUgLfbEaJH8ALaFh40BbIsEAS0SN4C2gAOZJ81YInFbOo/EmWcFh3PO4dbCPyP9meSPijpgQB1++PHnNms5/vbkjY9zynBrAQFmHgaG+gYohwdEHGBkw6+F8Qem2B/8WkbBKBgFo2BEAQDYWUhEaZVoNAAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0003-0773-0543","institution":"IMU University","correspondingAuthor":true,"prefix":"","firstName":"Ching","middleName":"Li","lastName":"Lee","suffix":""},{"id":588615085,"identity":"ca573ff5-e9d2-4c16-8cef-0ae4f2d7fd64","order_by":1,"name":"Yi Qi Cheow","email":"","orcid":"https://orcid.org/0000-0003-1263-410X","institution":"IMU University","correspondingAuthor":false,"prefix":"","firstName":"Yi","middleName":"Qi","lastName":"Cheow","suffix":""},{"id":588615086,"identity":"ab938fd1-10de-455b-99b7-9ba8df924f5b","order_by":2,"name":"Gabrielle Tho","email":"","orcid":"","institution":"IMU University","correspondingAuthor":false,"prefix":"","firstName":"Gabrielle","middleName":"","lastName":"Tho","suffix":""},{"id":588615087,"identity":"055eea8e-dbea-42c9-a970-5fbdcbfcc98c","order_by":3,"name":"Farah Hasbullah","email":"","orcid":"","institution":"IMU University","correspondingAuthor":false,"prefix":"","firstName":"Farah","middleName":"","lastName":"Hasbullah","suffix":""},{"id":588615088,"identity":"fab00627-712c-45df-b65b-60e1a3a6c54f","order_by":4,"name":"Dr Winnie Chee","email":"","orcid":"","institution":"National University of Malaysia","correspondingAuthor":false,"prefix":"Dr","firstName":"Winnie","middleName":"","lastName":"Chee","suffix":""},{"id":588615089,"identity":"2d71e0e4-b594-4452-8adb-0bb6f9f9ab4e","order_by":5,"name":"Christiani Henry","email":"","orcid":"","institution":"Glow NUS","correspondingAuthor":false,"prefix":"","firstName":"Christiani","middleName":"","lastName":"Henry","suffix":""}],"badges":[],"createdAt":"2026-01-13 03:10:42","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8586671/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8586671/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102624958,"identity":"61df97cf-c878-4fca-8715-ce2fe5ca8983","added_by":"auto","created_at":"2026-02-13 17:38:01","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":25018,"visible":true,"origin":"","legend":"\u003cp\u003eAggregate iAUC graph comparing high GI snacks and low GI snacks against the 50g glucose control. \u003csup\u003ea \u003c/sup\u003eAggregate values of 4 snacks (Apam Beras, Onde-Onde, Green gram porridge, String hoppers); \u003csup\u003eb\u003c/sup\u003e Aggregate values of 2 snacks (Tau Fu Fah, Portuguese egg tart)\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8586671/v1/5fc4c89ce38b9910251a9360.png"},{"id":102624959,"identity":"59f5c498-fef5-451c-8a9c-eebdbd2d5706","added_by":"auto","created_at":"2026-02-13 17:38:06","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":484220,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8586671/v1/2529ddcb-2e23-49e5-b109-bde7b10b4ebb.pdf"}],"financialInterests":"There is \u003cb\u003eNO\u003c/b\u003e conflict of interest to disclose.","formattedTitle":"Mismatch between measured and perceived glycaemic index of Malaysian snack foods: a preliminary study","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eThe glycaemic index (GI) indicates how rapidly a food increases postprandial glycaemia (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Consumption of low-GI foods has been associated with a reduced risk of type 2 diabetes (T2D), cardiovascular disease, diabetes-related cancer, and all-cause mortality (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Likewise, adherence to a low-GI diet has been shown to improve glycaemic control in people living with diabetes compared with a high-GI diet (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNutrition labelling guides consumers to make healthier food choices (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). However, unlike carbohydrate content, the inclusion of GI information on food labels is not regulated in many countries (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). This lack of standardisation may contribute to consumers\u0026rsquo; difficulty in accurately estimating the glycaemic impacts of foods (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Hence, this preliminary study examined measured GI of Malaysian snacks in relation to consumers\u0026rsquo; perceived GI.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eFor \u003cem\u003ein vivo\u003c/em\u003e GI determination, a minimum of 10 healthy adults were recruited from volunteer databases to detect GI differences in humans with 80% statistical power at a 0.05 significance level (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Eligible participants were men and women, aged 18\u0026ndash;30 years, non-smokers, and with normal fasting blood glucose concentrations (\u0026lt;\u0026thinsp;5.6 mmol/L). Exclusion criteria included food allergies and the use of medications known to interfere with carbohydrate metabolism. A total of 110 Malaysian adults completed an online survey on consumers\u0026rsquo; perceived GI values of snacks. With seven snacks assessed in the survey, this sample size met the recommended minimum sample-to-item ratio of 5:1 for exploratory surveys (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Written informed consent was obtained from all participants prior to data collection.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eTest foods\u003c/h3\u003e\n\u003cp\u003eSeven commonly consumed Malaysian snacks were included: \u0026lsquo;Apam Beras\u0026rsquo; (steamed rice flour cakes), \u0026lsquo;Onde-Onde\u0026rsquo; (glutinous rice balls with palm sugar filling), \u0026lsquo;Green gram porridge\u0026rsquo; (sweet mung bean dessert with coconut milk), \u0026lsquo;String hoppers\u0026rsquo; (steamed rice noodles with coconut and brown sugar), \u0026lsquo;Agar-agar\u0026rsquo; (jelly prepared from agar powder and sugar), \u0026lsquo;Tau Fu Fah\u0026rsquo; (soybean pudding with syrup), and \u0026lsquo;Portuguese egg tart\u0026rsquo; (puff pastry with egg custard).\u003c/p\u003e\n\u003ch3\u003eMeasured GI\u003c/h3\u003e\n\u003cp\u003eThe GI of the test foods was determined according to ISO 26642:2010 methodology. The glycaemic carbohydrate content of each test food was determined via proximate analysis. Test portions containing 50 g of glycaemic carbohydrate were served with 250 mL plain water whereas the reference food was prepared by dissolving 54.7 g of glucose monohydrate in 250 mL plain water.\u003c/p\u003e \u003cp\u003eParticipants attended 10 morning sessions (seven test foods and three reference foods), following a 10-hour overnight fast and abstention from vigorous physical activity. Participants consumed the test foods within 15 minutes, while seated alone in a comfortable, temperature-controlled environment to minimise the influence of social interactions. Two finger-prick capillary blood samples were collected at baseline; the average was calculated as the fasting glucose concentration. Thereafter, the test foods were served, and subsequent finger-prick capillary blood samples were collected at 15-, 30-, 45-, 60-, 90- and 120-minutes post-consumption. Single-use lancing devices (On Call Sterile Lancet, ACON Laboratories Inc., San Diego, California, USA) were used for finger-pricks and blood samples were collected on glucose test strips (On Call Sure Blood Glucose Test Strips, ACON Laboratories Inc., USA). Blood glucose concentrations were measured based on electrochemical detection with glucose dehydrogenase-flavin adenine dinucleotide (GDH-FAD) enzyme system. The inter-assay coefficient of variation (CV) was \u0026lt;\u0026thinsp;3.6%, as determined using standard solutions (On Call Sure Sync Blood Glucose Monitoring System, ACON Laboratories Inc., USA).\u003c/p\u003e \u003cp\u003eIncremental area under the blood glucose curve (iAUC), excluding the area beneath the fasting concentration, was calculated using the trapezoidal rule in Microsoft Excel (2022). The GI of each test food was calculated for individual participants as the iAUC of the test food expressed as a percentage of the mean iAUC of the reference food. The final GI of each test food was reported as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard error from at least 10 participants.\u003c/p\u003e\n\u003ch3\u003ePerceived GI\u003c/h3\u003e\n\u003cp\u003eFor the assessment of perceived GI, each snack was presented as a photograph within an online questionnaire. Participants were asked to categorise each food as low GI (\u0026le;\u0026thinsp;55), medium GI (56\u0026ndash;70), or high GI (\u0026gt;\u0026thinsp;70).\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n\u003ch2\u003eStudy population\u003c/h2\u003e\n\u003cp\u003eParticipants involved in the \u003cem\u003ein vivo\u003c/em\u003e GI testing were predominantly young female adults with normal fasting blood glucose levels. In comparison, survey respondents were also mainly female but were older and more heterogenous in age distribution (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eMeasured versus perceived glycaemic index of the traditional Malaysian snacks a, b, c, d, e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eSnacks\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eMeasured Glycaemic Index\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003ePerceived Glycaemic Index\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eParticipants\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eQuantity of snacks with 50g available carbohydrate\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eGI value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eGI Category\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eParticipants\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eCorrect estimation\u003c/p\u003e\n\u003cp\u003eof GI category\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eIncorrect estimation\u003c/p\u003e\n\u003cp\u003eof GI category\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eOver\u003c/p\u003e\n\u003cp\u003eestimated\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eUnder\u003c/p\u003e\n\u003cp\u003eestimated\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eApam Beras\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSteamed cakes made with rice flour, yeast, water and sugar\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u0026thinsp;=\u0026thinsp;11; Females: 100%\u003c/p\u003e\n\u003cp\u003eAge: 21.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e\n\u003cp\u003eFasting glucose: 4.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e119.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e92\u0026thinsp;\u0026plusmn;\u0026thinsp;9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHigh\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"7\" align=\"left\"\u003e\n\u003cp\u003eN\u0026thinsp;=\u0026thinsp;110\u003c/p\u003e\n\u003cp\u003eFemales: 76.4%\u003c/p\u003e\n\u003cp\u003eAge: 30.9\u0026thinsp;\u0026plusmn;\u0026thinsp;13.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e74 (67.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e36 (32.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eOnde-Onde\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBoiled dough made with glutinous rice flour and filled with coconut palm sugar\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u0026thinsp;=\u0026thinsp;11; Females: 100%\u003c/p\u003e\n\u003cp\u003eAge: 21.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e\n\u003cp\u003eFasting glucose: 4.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e103.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e75\u0026thinsp;\u0026plusmn;\u0026thinsp;8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHigh\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e98 (89.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12 (10.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eGreen gram porridge\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBoiled dessert made with sweet green beans and coconut milk\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u0026thinsp;=\u0026thinsp;11; Females: 100%\u003c/p\u003e\n\u003cp\u003eAge: 21.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e\n\u003cp\u003eFasting glucose: 4.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e280.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e73\u0026thinsp;\u0026plusmn;\u0026thinsp;6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHigh\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e29 (26.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e81 (73.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eString hoppers\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSteamed noodles made with rice flour and served with brown sugar and shredded coconut\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u0026thinsp;=\u0026thinsp;11; Females: 100%\u003c/p\u003e\n\u003cp\u003eAge: 22.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e\n\u003cp\u003eFasting glucose: 4.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e117.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e71\u0026thinsp;\u0026plusmn;\u0026thinsp;9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHigh\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51 (46.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e59 (53.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eAgar-agar\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBoiled jelly made with water, sugar, and agar-agar powder (gelling agent derived from red algae)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u0026thinsp;=\u0026thinsp;10; Females: 70%\u003c/p\u003e\n\u003cp\u003eAge: 22.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e\n\u003cp\u003eFasting glucose: 4.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e212.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e70\u0026thinsp;\u0026plusmn;\u0026thinsp;6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMedium\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e39 (35.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e45 (40.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26 (23.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eTau Fu Fah\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSteamed pudding made with soybean milk and served with brown sugar syrup\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u0026thinsp;=\u0026thinsp;10; Females: 70%\u003c/p\u003e\n\u003cp\u003eAge: 22.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e\n\u003cp\u003eFasting glucose: 4.6\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e467.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e55\u0026thinsp;\u0026plusmn;\u0026thinsp;6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLow\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8 (7.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e102 (92.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePortuguese egg tart\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBaked puff pastry with an egg custard filling\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u0026thinsp;=\u0026thinsp;11; Females: 100%\u003c/p\u003e\n\u003cp\u003eAge: 22.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e\n\u003cp\u003eFasting glucose: 4.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e132.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42\u0026thinsp;\u0026plusmn;\u0026thinsp;5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLow\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6 (5.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e104 (94.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\"\u003e\u003csup\u003ea\u003c/sup\u003e Age in mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (years); \u003csup\u003eb\u003c/sup\u003e Fasting blood glucose in mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (mmol/L); \u003csup\u003ec\u003c/sup\u003eQuantity of snacks with 50g carbohydrates in g; \u003csup\u003ed\u003c/sup\u003eGI value in mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SEM; \u003csup\u003ee\u003c/sup\u003e Estimation of GI category in N (%)\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eIn vivo\u003c/strong\u003e \u003cstrong\u003eGI\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFour snacks were high GI, one was medium GI, and two were low GI (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). In aggregate, low-GI snacks elicited a smaller postprandial glycaemic response, with a peak blood glucose concentration of 7.3 mmol/L, while high-GI snacks produced a substantially higher peak of 8.5 mmol/L (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003ePerceived GI\u003c/h3\u003e\n\u003cp\u003eParticipants generally overestimated the GI of low-GI snacks and underestimated the GI of several high-GI foods (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Most participants correctly identified \u0026lsquo;Apam Beras\u0026rsquo; (67.3%) and \u0026lsquo;Onde-Onde\u0026rsquo; (89.1%) as high GI foods. Fewer participants recognised \u0026lsquo;Green gram porridge\u0026rsquo; (26.4%) and \u0026lsquo;String hoppers\u0026rsquo; (46.4%) as high GI. For \u0026lsquo;Agar-agar\u0026rsquo; (medium GI), accuracy was modest (35.5%), with frequent over- (40.9%) and under-estimation (23.6%). Very few participants correctly identified the low GI of \u0026lsquo;Tau Fu Fah\u0026rsquo; (7.3%) and \u0026lsquo;Portuguese egg tart\u0026rsquo; (5.5%), with most overestimating their GI.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis preliminary study demonstrates a clear mismatch between the measured glycaemic index (GI) of commonly consumed Malaysian snack foods and consumer perception of their GI categories. Consumer estimates appeared to be driven more by perceived sweetness and health beliefs than physiological glycaemic response, consistent with GI misperceptions reported by Cabral \u003cem\u003eet al.\u003c/em\u003e (2022) (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Foods typically regarded as sweet, such as \u003cem\u003eOnde-Onde\u003c/em\u003e, were more accurately identified as high GI, whereas snacks perceived as healthier or less refined, including \u003cem\u003eGreen gram porridge\u003c/em\u003e and \u003cem\u003eString hoppers\u003c/em\u003e, were frequently underestimated despite high measured GI values. Conversely, low-GI foods such as \u003cem\u003eTau Fu Fah\u003c/em\u003e and \u003cem\u003ePortuguese egg tart\u003c/em\u003e were commonly overestimated, indicating limited awareness of the influence of food matrix and macronutrient composition on glycaemic response. In the absence of regulated GI labelling, these findings highlight the need for clearer GI communication and targeted consumer education in Asian dietary contexts.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eETHICAL APPROVAL\u003c/h2\u003e \u003cp\u003e This study received ethics approval by the Institutional Review Board at IMU University (4.2/JCM-271/2023, 4.4/JCM-300/2024).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCOMPETING INTERESTS\u003c/strong\u003e \u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFUNDING\u003c/h2\u003e \u003cp\u003eThe research leading to these results received funds from IMU University (4.2/JCM-271/2023, 4.4/JCM-300/2024)\u003c/p\u003e\u003ch2\u003eAUTHOR CONTRIBUTIONS\u003c/h2\u003e \u003cp\u003eChing Li Lee: Conceived and designed the experiments, performed the experiments, analysed the data, wrote the paper; Yi Qi Cheow: Performed the experiments, analysed the data, wrote the paper; Gabrielle Ngo Tho: Performed the experiments, wrote the paper; Farah Yasmin Hasbullah: Wrote the paper; Winnie Siew Swee Chee: Conceived and designed the experiments, wrote the paper; Christiani Jeyakumar Henry: Conceived and designed the experiments, wrote the paper\u003c/p\u003e\u003ch2\u003eDATA AVAILABILITY STATEMENT\u003c/h2\u003e \u003cp\u003eThe data supporting the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eJenkins DJ, Wolever TM, Taylor RH, Barker H, Fielden H, Baldwin JM, et al. Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr. 1981;34(3):362\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJenkins DJA, Willett WC, Yusuf S, Hu FB, Glenn AJ, Liu S, et al. Association of glycaemic index and glycaemic load with type 2 diabetes, cardiovascular disease, cancer, and all-cause mortality: a meta-analysis of mega cohorts of more than 100 000 participants. Lancet Diabetes Endocrinol. 2024;12(2):107\u0026ndash;18.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOjo O, Ojo O, Adebowale F, Wang XH. The Effect of Dietary Glycaemic Index on Glycaemia in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2018;10(3):373.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKelly B, Ng SH, Carrad A, Pettigrew S. The Potential Effectiveness of Front-of-Pack Nutrition Labeling for Improving Population Diets. Annu Rev Nutr. 2024;44(1):405\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBarclay AW, Augustin LSA, Brighenti F, Delport E, Henry CJ, Sievenpiper JL, et al. Dietary Glycaemic Index Labelling: A Global Perspective. Nutrients. 2021;13(9):3244.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eK\u0026ouml;nig LM, Ziesemer K, Renner B. Quantifying Actual and Perceived Inaccuracy When Estimating the Sugar, Energy Content and Portion Size of Foods. Nutrients. 2019;11(10):2425.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrouns F, Bjorck I, Frayn KN, Gibbs AL, Lang V, Slama G, et al. Glycaemic index methodology. Nutr Res Rev. 2005;18(1):145\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMemon MA, Ting H, Cheah JH, Thurasamy R, Chuah F, Cham TH. Sample Size for Survey Research: Review and Recommendations. Journal of Applied Structural Equation Modeling. 2020;4(2):i\u0026ndash;xx.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCabral D, Fonseca SC, Moura AP, Oliveira JC, Cunha LM. Conceptualization of Rice with Low Glycaemic Index: Perspectives from the Major European Consumers. Foods. 2022;11(14):2172.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-clinical-nutrition","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"ejcn","sideBox":"Learn more about [European Journal of Clinical Nutrition](http://www.nature.com/ejcn/)","snPcode":"41430","submissionUrl":"https://mts-ejcn.nature.com/cgi-bin/main.plex","title":"European Journal of Clinical Nutrition","twitterHandle":"@ejcneditor","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8586671/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8586671/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study investigated the concordance between measured glycaemic index (GI) values of Asian snack foods and consumer perceptions of their GI, addressing limited empirical evidence and inconsistencies in GI labelling. The measured GI of seven commonly consumed Malaysian snacks was determined in at least 10 healthy adults using standard GI testing protocol, while consumer perceptions of the GI category (low, medium, or high) of these snacks were assessed via an online survey completed by 110 adults. With measured GI, four snacks were classified as high GI, one as medium, and two as low. Consumer accuracy in correctly identifying GI categories varied widely, ranged from 5.5% \u0026ndash; 89.1%, with systematic overestimation of low-GI snacks and underestimation of some high-GI snacks. These findings highlight a disconnect between actual and perceived GI values, underscoring the need for clearer GI labelling, targeted education, and improved GI communication.\u003c/p\u003e","manuscriptTitle":"Mismatch between measured and perceived glycaemic index of Malaysian snack foods: a preliminary study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-13 17:37:43","doi":"10.21203/rs.3.rs-8586671/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"This content is not available.","date":"2026-03-30T10:30:31+00:00","index":1,"fulltext":"This content is not available."},{"type":"reviewerAgreed","content":"This content is not available.","date":"2026-03-17T09:35:28+00:00","index":1,"fulltext":"This content is not available."},{"type":"reviewersInvited","content":"","date":"2026-02-10T01:04:36+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-13T16:19:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-13T16:18:50+00:00","index":"","fulltext":""},{"type":"submitted","content":"European Journal of Clinical Nutrition","date":"2026-01-13T03:07:27+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-clinical-nutrition","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"ejcn","sideBox":"Learn more about [European Journal of Clinical Nutrition](http://www.nature.com/ejcn/)","snPcode":"41430","submissionUrl":"https://mts-ejcn.nature.com/cgi-bin/main.plex","title":"European Journal of Clinical Nutrition","twitterHandle":"@ejcneditor","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"4397803f-ad46-433f-a951-672f75b1d2a4","owner":[],"postedDate":"February 13th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":62622675,"name":"Health sciences/Health care/Nutrition"},{"id":62622676,"name":"Health sciences/Health care/Disease prevention"}],"tags":[],"updatedAt":"2026-02-13T17:37:43+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-13 17:37:43","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8586671","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8586671","identity":"rs-8586671","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}