Glycemic index, glycemic load, and risk of type 2 diabetes: results from 3 large US cohorts and an updated meta-analysis.

Shilpa N Bhupathiraju, Deirdre K Tobias, Vasanti S Malik, An Pan, Adela Hruby, JoAnn E Manson, Walter C Willett, Frank B Hu

Journal: The American journal of clinical nutrition 2015;100(1):218-32

PMID: 24787496

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Plain Language Summary

Carbohydrates are the principle dietary components that effect blood glucose concentrations. The association between Type 2 diabetes (T2D) and diets with different levels of sugars and carbohydrates has been controversial in the prevention of T2D. Foods can be measured for their impact on blood glucose concentration using the Glycaemic Index (GI) and the Glycaemic Load (GL). The objective of this meta-analysis was to update previous studies and evaluate the association between the GI and GL of dietary intake and the risk of T2D. The authors found a significant association between the GI and GL of food intake and T2D risk and conclude that high GI and GL foods increase the risk of T2D. However, GI is more strongly associated to T2D than GL.

Abstract

BACKGROUND

Epidemiologic evidence for the relation between carbohydrate quality and risk of type 2 diabetes (T2D) has been mixed.

OBJECTIVE

We prospectively examined the association of dietary glycemic index (GI) and glycemic load (GL) with T2D risk.

DESIGN

We prospectively followed 74,248 women from the Nurses' Health Study (1984-2008), 90,411 women from the Nurses' Health Study II (1991-2009), and 40,498 men from the Health Professionals Follow-Up Study (1986-2008) who were free of diabetes, cardiovascular disease, and cancer at baseline. Diet was assessed by using a validated questionnaire and updated every 4 y. We also conducted an updated meta-analysis, including results from our 3 cohorts and other studies.

RESULTS

During 3,800,618 person-years of follow-up, we documented 15,027 cases of incident T2D. In pooled multivariable analyses, those in the highest quintile of energy-adjusted GI had a 33% higher risk (95% CI: 26%, 41%) of T2D than those in the lowest quintile. Participants in the highest quintile of energy-adjusted GL had a 10% higher risk (95% CI: 2%, 18%) of T2D. Participants who consumed a combination diet that was high in GI or GL and low in cereal fiber had an ~50% higher risk of T2D. In the updated meta-analysis, the summary RRs (95% CIs) comparing the highest with the lowest categories of GI and GL were 1.19 (1.14, 1.24) and 1.13 (1.08, 1.17), respectively.

CONCLUSION

The updated analyses from our 3 cohorts and meta-analyses provide further evidence that higher dietary GI and GL are associated with increased risk of T2D.

Address: From the Departments of Nutrition (SNB, DKT, VSM, AH, WCW, and FBH) and Epidemiology (JEM, WCW, and FBH), Harvard School of Public Health, Boston, MA; the Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (AP); the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM); and the Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW and FBH).

DOI: 10.3945/ajcn.113.079533

Patient Centred Factor

Triggers: Glycaemic Index and Glycaemic Load

Clinical Imbalances

Hormonal Structural Integrity and Musculoskeletal

Laboratory Testing

Blood

Modifiable Lifestyle Factors

Diet Exercise and movement

Allocation Concealment

Nutrition Evidence Keywords

Glycaemic load

Bioactive Substances

Glycaemic load

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https://scite.ai/reports/24787496

MeSH Terms: Blood Glucose, Diabetes Mellitus, Type 2, Energy Intake, Follow-Up Studies, Glycemic Index, Humans, Incidence, Nutrition Assessment, Reproducibility of Results, Risk Factors, Surveys and Questionnaires, United States