Glycemic index and glycemic load in relation to glucose intolerance among Greenland's Inuit population

Steno Diabetes Center, Gentofte, Denmark.
Diabetes research and clinical practice (Impact Factor: 2.54). 05/2012; 97(2):298-305. DOI: 10.1016/j.diabres.2012.05.005
Source: PubMed


Intake of carbohydrates which elicit a large glycemic response is hypothesized to increase the risk of diabetes. However, studies assessing the relationship between glycemic index (GI) and glycemic load (GL) and diabetes are inconsistent. Only few studies have studied the relationship between GI and GL and markers of glucose metabolism, mostly in western populations.
To determine the relationship between GI and GL and indices of glucose metabolism and prevalence of diabetes in Greenland's Inuit population.
The Inuit Health in Transition Study is a geographically representative cross-sectional study among aged ≥18years. Diet was assessed using a 67-item food frequency questionnaire. Logistic and linear regression was used to assess the association between GI and GL and diabetes, impaired fasting glucose, impaired glucose tolerance, HbA(1c), fasting plasma glucose, 2h plasma glucose, HOMA2-IR and HOMA2-%β.
No association was found between GI and GL and diabetes. GL was significantly inversely associated with IFG (OR: 0.91 (0.84-0.98)). While GI was positively associated with FPG, GL was positively associated with both HOMA2-IR and HOMA2-%β and inversely associated with IFG.
These findings do not support a link between dietary GI or GL and risk of type 2 diabetes among Greenland's Inuit population.

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    ABSTRACT: Data available on the effect of quality (glycemic index [GI]) and quantity (glycemic load [GL]) of carbohydrates on the risk factors of cardiovascular disease (CVD) are inconsistent. The objective of this study was to examine the association between dietary GI, GL, and CVD risk factors among Tehranian adults, the participants of the Tehran Lipid and Glucose Study. This population- based cross-sectional study was conducted on 2457 subjects (46% men and 54% women), aged 19 to 84 years. Dietary GI and GL were measured using a validated 168- item semiquantitative food frequency questionnaire. Anthropometrics, blood pressure, fasting blood glucose, and lipid profiles were measured. The mean intakes of GI and GL were 68.3 and 244.8, respectively. Rice (26.6%) and bread (19.0%) were the major contributors to dietary GI and GL, respectively. Higher dietary GI and GL were associated with high intakes of carbohydrate, fiber, refined grain, fruits, simple sugar, snack, and desserts. After adjustment for lifestyle and dietary variables, a higher dietary GI was positively associated with triglycerides and high-density lipoprotein (HDL) cholesterol concentrations among obese subjects. Dietary GL was positively associated with fasting and 2-h blood glucose among nonobese subjects, after adjustment for confounders. Dietary GI and GL were associated with a few CVD risk factors, and body mass index levels may modulate these associations.
    07/2013; 16(7):401-7.
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    ABSTRACT: Background/objectives: The aim was to investigate the associations of glycemic index (GI), glycemic load (GL), carbohydrate and fiber intakes with hyperglycemia in type 2 diabetic patients. Subjects/methods: In a cross-sectional study of 640 type 2 diabetic patients aged 28-75 years, usual dietary intakes were assessed by validated food frequency questionnaire. We used published international and Iranian tables of GI based on the white bread. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI). Results: High-GL diet was associated with higher risk of hyperglycemia in type 2 diabetic patients after controlling for potential confounders. In multivariable model, OR (95% CI) for the highest vs the lowest quartile of GL was 2.58 (1.08-6.15) for elevated fasting serum glucose (FSG) (>130 mg/dl) (P(trend) = 0.02) and was 3.05 (1.33-7.03) for elevated HbA1c (>8.6%) (P(trend)=0.008). After additional adjusting for dietary fiber and protein intakes, the relation of GL with elevated FSG and HbA1c was stable. GI was not significantly associated with either elevated FSG or HbA1c. In multivariable model, OR (95% CI) for the highest vs lowest quartile of the substitution of dietary carbohydrate for fat intake was 2.32 (1.37-3.92) for elevated HbA1c (P(trend) = 0.001). Higher intake of dietary fiber was associated with lower risk of elevated FSG (highest vs lowest quartile: OR, 0.53; 95% CI: 0.28-0.99; P(trend) = 0.04), but not with lower risk of elevated HbA1c. Conclusions: GL and carbohydrate intake were positively associated with the risk of hyperglycemia in type 2 diabetic patients; but the benefit in pursuing a low-GI diet without considering carbohydrate and energy intakes in these patients should be further investigated.
    European journal of clinical nutrition 02/2014; 68(4). DOI:10.1038/ejcn.2013.288 · 2.71 Impact Factor