Glycemic index, glycemic load, and chronic disease risk-a meta-analysis of observational studies. Am J Clin Nutr

Human Nutrition Unit, University of Sydney, Sydney, Australia.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 04/2008; 87(3):627-37.
Source: PubMed


Inconsistent findings from observational studies have prolonged the controversy over the effects of dietary glycemic index (GI) and glycemic load (GL) on the risk of certain chronic diseases.
The objective was to evaluate the association between GI, GL, and chronic disease risk with the use of meta-analysis techniques.
A systematic review of published reports identified a total of 37 prospective cohort studies of GI and GL and chronic disease risk. Studies were stratified further according to the validity of the tools used to assess dietary intake. Rate ratios (RRs) were estimated in a Cox proportional hazards model and combined by using a random-effects model.
From 4 to 20 y of follow-up across studies, a total of 40 129 incident cases were identified. For the comparison between the highest and lowest quantiles of GI and GL, significant positive associations were found in fully adjusted models of validated studies for type 2 diabetes (GI RR = 1.40, 95% CI: 1.23, 1.59; GL RR = 1.27, 95% CI: 1.12, 1.45), coronary heart disease (GI RR = 1.25, 95% CI: 1.00, 1.56), gallbladder disease (GI RR = 1.26, 95% CI: 1.13, 1.40; GL RR = 1.41, 95% CI: 1.25, 1.60), breast cancer (GI RR = 1.08, 95% CI: 1.02, 1.16), and all diseases combined (GI RR = 1.14, 95% CI: 1.09, 1.19; GL RR = 1.09, 95% CI: 1.04, 1.15).
Low-GI and/or low-GL diets are independently associated with a reduced risk of certain chronic diseases. In diabetes and heart disease, the protection is comparable with that seen for whole grain and high fiber intakes. The findings support the hypothesis that higher postprandial glycemia is a universal mechanism for disease progression.

Download full-text


Available from: Jennie C Brand-Miller,
    • "Interestingly, fruits and vegetables were included as part of the diet, and they may have cancelled out any negative effects of white rice (Liu, 2003). High glycemic index of white rice is likely the reason behind the worsening of cardiometabolic risks due to its consumption (Barclay et al., 2008; Jenkins et al., 2002; Miller et al., 1992). High glycemic index will promote postprandial hyperglycemia, glucose‐induced oxidative stress, and eventually, cardiometabolic risk (Ludwig, 2002; Rebolledo and Dato, 2005). "
    [Show abstract] [Hide abstract]
    ABSTRACT: White rice is a major staple food for people in low to middle income countries and it can increase the risk of cardiometabolic disease. Brown rice, especially when germinated, is a healthier alternative. Various functional properties have been documented for the bioactive-rich germinated brown rice. Nutrigenomic studies, dwelling on interactions at diet-genome interface, have expanded our understanding of the role of diets on health. The nutrigenomic basis for the functional properties of GBR have also been reported; its antihyperglycemic, hypocholesterolemic, and antioxidative effects are mediated by its bioactives, partly via transcriptional regulation of genes involved in gluconeogenesis, cholesterol metabolism, and oxidative stress, respectively. Additionally, GBR's ability to improve menopausal symptoms is reported to be due to its ability to upregulate bone metabolism and uterine estrogen related genes, and downregulate inflammatory genes. Food synergy plays a role in the overall functional effects of GBR. Further studies on proteomics, metabolomics, nutrikinetics, and nutridynamics are indicated.
    Genomics, Proteomics and Metabolomics in Nutraceuticals and Functional Foods, Second Edition edited by Debasis Bagchi, Anand Swaroop, Manashi Bagchi, 08/2015: chapter 39; John Wiley & Sons, Ltd, Chichester, UK., ISBN: 9781118930458
  • Source
    • "Numerous therapeutic strategies for the treatment of DM have emerged over the past decade, and providing medical nutrition therapy for the prevention and treatment of DM has shown tremendous potential benefits. Higher glucose concentrations are thought to play a direct pathogenic role in the disease process (Barclay et al., 2008), and some systematic reviews of intervention studies (Livesey et al., 2008a,b) have shown that foods with a low glycaemic index or load can help to normalise fasting blood glucose concentrations, improve glycated protein concentrations, and elevate insulin sensitivity in diabetic and nondiabetic subjects (Brand-Miller et al., 2003; Livesey et al., 2008a,b). Resistant maltodextrin (RMD) is a low viscosity, watersoluble , indigestible dextrin produced by the treatment of cornstarch with acid, enzymes and heat (Wakabayashi, 1993; Kishimoto et al., 1995). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study investigated the effect of resistant maltodextrin (RMD) on reproduction in streptozotocin (STZ)-nicotinamide-induced type 2 diabetic male rats. Forty male rats were induced with diabetes by a single intraperitoneal injection of STZ (50 mg kg(-1) ) and nicotinamide (100 mg kg(-1) ). Five groups were analysed in total: normal, diabetic rats without RMD, diabetic rats with RMD 1.2 g per 100 g diet (1×), with RMD 2.4 g per 100 g (2×), and with RMD 6.0 g per 100 g (5×). The groups of diabetic rats with the RMD supplement, compared to those without supplement, showed improved plasma glucose control, attenuated insulin resistance and recovery of testosterone level and spermatogenesis stage. The STZ-nicotinamide-induced diabetes mellitus (DM) caused a significant reduction in serum testosterone, testis androgen receptor (AR), steroidogenic acute regulatory protein (StAR) and 3β-hydroxysteroid dehydrogenase (3β-HSD) protein, but a statistical recovery in each of these was observed in the 5× group. TUNEL-positive cells were observed in the diabetic without RMD group, and RMD treatment reduced apoptotic germ cells. The expression of Bax/Bcl2 was induced in the diabetic group and also significantly reduced in the 5× group. Dietary RMD may improve metabolic control in STZ-nicotinamide-induced diabetic rats and attenuate hyperglycaemia-related impaired male reproduction and testicular function. © 2015 Blackwell Verlag GmbH.
    Andrologia 07/2015; DOI:10.1111/and.12454 · 1.63 Impact Factor
    • "Furthermore, reducing the glycemic index of an individual's diet for 4 d [37], 7 d [38], or 12 wk [39] produces an increase in the individual's insulin sensitivity and a decrease in the fasting plasma insulin concentration. Consistent with these findings, the results of meta-analyses of the results of 37 [40] and 21 [41] previously published prospective observational epidemiologic studies indicated the risk for developing type 2 diabetes is significantly positively correlated with the average glycemic index of an individual's habitual diet [40]. "

    Nutrition 03/2015; 31(3):539-41. DOI:10.1016/j.nut.2014.10.013 · 2.93 Impact Factor
Show more