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The Relationship between Glycemic Index and Human Health

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (30 June 2019) | Viewed by 113540

Special Issue Editors


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Guest Editor
University Paderborn, Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Universität Paderborn, Germany
Interests: public health nutrition; carbohydrate nutrition; primary prevention; health promotion; diabetes; obesity; nutrition in childhood and adolescence; lifecourse epidemiology

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Guest Editor
School of Molecular Bioscience, The University of Sydney, NSW 2006, Australia
Interests: all aspects of carbohydrates, including diet and diabetes; the glycemic index and insulin resistance; obesity; pregnancy
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Special Issue Information

Dear Colleagues,

Reducing postprandial glycemia is recognized as a beneficial physiological effect. Ways to reduce postprandial glycemia include slowing carbohydrate absorption by consuming low glycemic index (GI) and low glycemic load (GL) foods to reduce the dietary GI and GL. Accumulating evidence supports a role of a low GI/GL diet in the prevention of major chronic diseases.

This Special Issue of Nutrients encourages the submission of original research or systematic reviews (including meta-analyses) addressing the following questions:

  • How can we improve the measurement of the GI of carbohydrate-containing foods and/or the estimation of dietary GI and GL?
  • Which novel mechanisms should be considered when discussing the effect of the dietary GI/GL and major chronic diseases?
  • What is the role of the dietary GI/GL in the prevention and treatment of obesity, type 2 diabetes and cardiovascular disease? Is the quality of carbohydrate more important than the amount?
  • What are the long-term associations between dietary GI/GL and population risk of cancer, neurodegenerative diseases, and cognitive function?
  • Which public health measures are required to facilitate the consumption of low GI/GL diets?
  • Are all low GI/GL diets sustainable from a healthy planet perspective?
  • Which carbohydrate-based foods will provide an optimal combination of health benefits, environmental sustainability, cost, and public acceptability?

Prof. Anette E. Buyken
Prof. Jennie Brand-Miller
Guest Editors

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Keywords

  • Glycemic index
  • Glycemic load
  • Methodology
  • Novel mechanisms
  • Interventional evidence
  • Observational evidence
  • Public health implications

Published Papers (13 papers)

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Editorial

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3 pages, 179 KiB  
Editorial
The Relationship between Glycemic Index and Health
by Jennie Brand-Miller and Anette E. Buyken
Nutrients 2020, 12(2), 536; https://doi.org/10.3390/nu12020536 - 19 Feb 2020
Cited by 12 | Viewed by 6255
Abstract
There is no question that elevated postprandial glycemia is a significant driver of common chronic diseases globally [...] Full article
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)

Research

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32 pages, 7964 KiB  
Article
Glycemic Index, Glycemic Load and Cancer Risk: An Updated Meta-Analysis
by Federica Turati, Carlotta Galeone, Livia S. A. Augustin and Carlo La Vecchia
Nutrients 2019, 11(10), 2342; https://doi.org/10.3390/nu11102342 - 02 Oct 2019
Cited by 66 | Viewed by 8407
Abstract
Diets high in glycemic index (GI) and glycemic load (GL) have been related to an increased risk of selected cancers, but additional quantification is required. We updated a systematic review and meta-analysis published in 2015 to May 2019 to provide quantitative information on [...] Read more.
Diets high in glycemic index (GI) and glycemic load (GL) have been related to an increased risk of selected cancers, but additional quantification is required. We updated a systematic review and meta-analysis published in 2015 to May 2019 to provide quantitative information on GI/GL and cancer risk. Relative risks (RR) and the corresponding 95 % confidence intervals (CI) for the highest versus the lowest categories of GI and GL were extracted from selected studies and pooled using random-effects models. Twenty reports (>22,000 cancer cases) have become available after January 2015, and 15 were added to the meta-analyses by cancer sites, which considered a total of 88 investigations. The five additional reports were reviewed, but not included in the meta-analyses, since data were inadequate to be pooled. For hormone-related cancers, summary RRs for the highest versus lowest GI and GL intakes were moderately increased. They ranged from 1.04 (breast) to 1.12 (endometrium) for GI and from 1.03 (prostate) to 1.22 (ovary) for GL, of borderline significance. High GI was associated with small increased risks of colorectal (summary RR for GI: 1.20, 95% CI, 1.07–1.34—GL: 1.09, 95% CI, 0.97–1.22, 19 studies), bladder (GI: 1.25, 95% CI, 1.11–1.41—GL: 1.10, 95% CI, 0.85–1.42, four studies) and kidney cancers (GI: 1.16, 95% CI, 1.02–1.32—GL: 1.14, 95% CI, 0.81–1.60, five studies). GL was not significantly related to those cancer sites. Stomach, prostate and lung cancers were not associated with GI and GL. The present analysis, based on an updated comprehensive evaluation of the epidemiological literature, indicates moderate unfavorable effects of high versus low GI on colorectal, and possibly bladder and kidney cancers, and a possible moderate positive association between GL and endometrial cancer. Full article
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
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8 pages, 1079 KiB  
Article
Determination of Postprandial Glycemic Responses by Continuous Glucose Monitoring in a Real-World Setting
by Martin Röhling, Tobias Martin, Meinolf Wonnemann, Martin Kragl, Horst Harald Klein, Lutz Heinemann, Stephan Martin and Kerstin Kempf
Nutrients 2019, 11(10), 2305; https://doi.org/10.3390/nu11102305 - 27 Sep 2019
Cited by 11 | Viewed by 3641
Abstract
Background: Self-monitoring of blood glucose using capillary glucose testing (C) has a number of shortcomings compared to continuous glucose monitoring (CGM). We aimed to compare these two methods and used blood glucose measurements in venous blood (IV) as a reference. Postprandial blood glucose [...] Read more.
Background: Self-monitoring of blood glucose using capillary glucose testing (C) has a number of shortcomings compared to continuous glucose monitoring (CGM). We aimed to compare these two methods and used blood glucose measurements in venous blood (IV) as a reference. Postprandial blood glucose levels were measured after 50 g oral glucose load and after the consumption of a portion of different foods containing 50 g of carbohydrates. We also evaluated the associations between postprandial glucose responses and the clinical characteristics of the participants at the beginning of the study. Methods: 12 healthy volunteers (age: 36 ± 17 years, BMI: 24.9 ± 3.5 kg/m2) ate white bread (WB) and whole grain (WG) bread and drank a 50 g glucose drink as reference. Postprandial glucose responses were evaluated by CGM, IV and C blood glucose measurements. Incremental area under the curve (AUCi) of postprandial blood glucose was calculated for 1 h (AUCi 0-60) and 2 h (AUCi 0-120). Results: After the consumption of white bread and whole grain bread, the AUCi 0-60 min did not differ between CGM and IV or C. AUCi 0-120 min of CGM showed no difference compared to C. Correlation analyses revealed a positive association of age with glucose AUCi 0-120 (r = 0.768; P = 0.004) and WG AUCi 0-120 (r = 0.758; P = 0.004); fasting blood glucose correlated with WG AUCi 0-120 (r = 0.838; P < 0.001). Conclusion: Despite considerable inter-individual variability of postprandial glycemic responses, CGM evaluated postprandial glycemic excursions which had comparable results compared to standard blood glucose measurements under real-life conditions. Associations of AUCi 0-60 and AUCi 0-120 postprandial glucose response with age or fasting blood glucose could be shown. Full article
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
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12 pages, 595 KiB  
Article
Glycemic Index and Insulinemic Index of Foods: An Interlaboratory Study Using the ISO 2010 Method
by Thomas M.S. Wolever, Alexandra Meynier, Alexandra L. Jenkins, Jennie C. Brand-Miller, Fiona S. Atkinson, David Gendre, Sébastien Leuillet, Murielle Cazaubiel, Béatrice Housez and Sophie Vinoy
Nutrients 2019, 11(9), 2218; https://doi.org/10.3390/nu11092218 - 13 Sep 2019
Cited by 19 | Viewed by 6470
Abstract
An official method for determining food glycemic index (GI) was published by the Organization for International Standardization (ISO) in 2010, but its performance has not been assessed. Therefore, we aimed to determine the intra- and inter-laboratory variation of food GI values measured using [...] Read more.
An official method for determining food glycemic index (GI) was published by the Organization for International Standardization (ISO) in 2010, but its performance has not been assessed. Therefore, we aimed to determine the intra- and inter-laboratory variation of food GI values measured using the 2010 ISO method. Three laboratories (Australia, Canada and France) determined the GI and insulinemic-index (II) of six foods in groups of 13–15 participants using the 2010 ISO method and intra- and inter-laboratory Standard Deviations (SDs) were calculated. Overall mean food GIs varied from 47 to 86 (p < 0.0001) with no significant difference among labs (p = 0.57) and no food × laboratory interaction (p = 0.20). Within-laboratory SD was similar among foods (range, 17.8–22.5; p = 0.49) but varied among laboratories (range 17.5–23.1; p = 0.047). Between-laboratory SD of mean food GI values ranged from 1.6 to 6.7 (mean, 5.1). Mean glucose and insulin responses varied among foods (p < 0.001) with insulin (p = 0.0037), but not glucose (p = 0.054), varying significantly among labs. Mean II varied among foods (p < 0.001) but not among labs (p = 0.94). In conclusion, we found that using the 2010 ISO method, the mean between-laboratory SD of GI was 5.1. This suggests that the ISO method is sufficiently precise to distinguish a mean GI = 55 from a mean GI ≥ 70 with 97–99% probability. Full article
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
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11 pages, 2227 KiB  
Article
Effect of Bread Structure and In Vitro Oral Processing Methods in Bolus Disintegration and Glycemic Index
by Andrea Aleixandre, Yaiza Benavent-Gil and Cristina M. Rosell
Nutrients 2019, 11(9), 2105; https://doi.org/10.3390/nu11092105 - 04 Sep 2019
Cited by 17 | Viewed by 4398
Abstract
The growing interest in controlling the glycemic index of starchy-rich food has encouraged research about the role of the physical structure of food. The aim of this research was to understand the impact of the structure and the in vitro oral processing methods [...] Read more.
The growing interest in controlling the glycemic index of starchy-rich food has encouraged research about the role of the physical structure of food. The aim of this research was to understand the impact of the structure and the in vitro oral processing methods on bolus behavior and starch hydrolysis of wheat bread. Two different bread structures (loaf bread and bread roll) were obtained using different shaping methods. Starch hydrolysis during in vitro oro-gastro-intestinal digestion using the INFOGEST protocol was analyzed and oral processing was simulated by applying two different disintegration processes (basic homogenizer, crystal balls). The bread structure, and thus the shaping method during breadmaking, significantly affected the bolus particle size during all digestion stages. The different in vitro oral processing methods affected the bolus particle sizes after the oral phase in both breads, but they affected the particle size distribution after the gastric and intestinal phase only in the case of loaf bread. Aggregates were observed in the gastric phase, which were significantly reduced in the intestinal phase. When simulated oral processing with crystal balls led to bigger particle size distribution, bread rolls presented the highest in vitro starch hydrolysis. The type of in vitro oral processing allowed discrimination of the performance of the structures of the two breads during starch hydrolysis. Overall, crumb structure significantly affected texture properties, but also had a significant impact on particle size during digestion and starch digestibility. Full article
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
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11 pages, 783 KiB  
Article
Abscisic Acid Standardized Fig (Ficus carica) Extracts Ameliorate Postprandial Glycemic and Insulinemic Responses in Healthy Adults
by Fiona S. Atkinson, Agusti Villar, Anna Mulà, Andrea Zangara, Ester Risco, Carsten R. Smidt, Raquel Hontecillas, Andrew Leber and Josep Bassaganya-Riera
Nutrients 2019, 11(8), 1757; https://doi.org/10.3390/nu11081757 - 31 Jul 2019
Cited by 20 | Viewed by 6756
Abstract
Abscisic acid (ABA) can improve glucose homeostasis and reduce inflammation in mammals by activating lanthionine synthetase C-like 2 (LANCL2). This study examined the effects of two fig fruit extracts (FFEs), each administered at two different ABA doses, on glycemic index (GI) and insulinemic [...] Read more.
Abscisic acid (ABA) can improve glucose homeostasis and reduce inflammation in mammals by activating lanthionine synthetase C-like 2 (LANCL2). This study examined the effects of two fig fruit extracts (FFEs), each administered at two different ABA doses, on glycemic index (GI) and insulinemic index (II) to a standard glucose drink. In a randomized, double-blind crossover study, 10 healthy adults consumed 4 test beverages containing FFE with postprandial glucose and insulin assessed at regular intervals over 2 h to determine GI and II responses. Test beverages containing 200 mg FFE-50× and 1200 mg FFE-10× significantly reduced GI values by −25% (P = 0.001) and −24% (P = 0.002), respectively. Two lower doses of FFE also reduced GI values compared with the reference drink (by approximately −14%), but the differences did not reach statistical significance. Addition of FFE to the glucose solution significantly reduced II values at all dosages and displayed a clear dose-response reduction: FFE-50× at 100 mg and 200 mg (−14% (P < 0.05) and −24% (P = 0.01), respectively) and FFE-10× at 600 mg and 1200 mg (−16% (P < 0.05) and −24% (P = 0.01), respectively). FFE supplementation is a promising nutritional intervention for the management of acute postprandial glucose and insulin homeostasis, and it is a possible adjunctive treatment for glycemic management of chronic metabolic disorders such as prediabetes and type 2 diabetes mellitus. Full article
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
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19 pages, 6295 KiB  
Article
Salmon in Combination with High Glycemic Index Carbohydrates Increases Diet-Induced Thermogenesis Compared with Salmon with Low Glycemic Index Carbohydrates–An Acute Randomized Cross-Over Meal Test Study
by Lone V. Nielsen, Signe Nyby, Lars Klingenberg, Christian Ritz, Ulrik K. Sundekilde, Hanne C. Bertram, Margriet S. Westerterp-Plantenga, Bjørn Liaset, Karsten Kristiansen, Lise Madsen and Anne Raben
Nutrients 2019, 11(2), 365; https://doi.org/10.3390/nu11020365 - 10 Feb 2019
Cited by 2 | Viewed by 5230
Abstract
The study investigated the acute effects of meals containing either salmon or veal in combination with carbohydrates with high or low glycemic index (GI) on diet-induced thermogenesis (DIT) (primary endpoint), appetite sensations, and energy intake (EI). Twenty-five overweight men and women ingested four [...] Read more.
The study investigated the acute effects of meals containing either salmon or veal in combination with carbohydrates with high or low glycemic index (GI) on diet-induced thermogenesis (DIT) (primary endpoint), appetite sensations, and energy intake (EI). Twenty-five overweight men and women ingested four iso-caloric test meals: salmon with mashed potatoes (high GI) (SM), salmon with wholegrain pasta (low GI) (SP), veal with mashed potatoes (VM) and veal with wholegrain pasta (VP). Energy expenditure was measured in the fasting state and six times postprandially for 25 min with 5-min breaks between each measurement. Appetite sensations were measured every 30 min. Blood samples, from arterialized venous blood, were drawn every 20 min until an ad libitum buffet-style lunch was served 3.5 h later. DIT was 40% higher after the SM meal compared to the SP meal (p = 0.002). Prospective food consumption was lower after the SM meal compared with the VP meal (p = 0.01). There were no differences in satiety, hunger, fullness, or ad libitum EI between the test meals (all p > 0.05). In conclusion, salmon with high GI carbohydrates increased DIT compared to salmon with low GI carbohydrates. This indicates that DIT is sensitive to the GI of the carbohydrates after intake of salmon but not veal. Full article
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
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16 pages, 540 KiB  
Article
The Glycaemic Index-Food-Frequency Questionnaire: Development and Validation of a Food Frequency Questionnaire Designed to Estimate the Dietary Intake of Glycaemic Index and Glycaemic Load: An Effort by the PREVIEW Consortium
by Elske M. Brouwer-Brolsma, Agnes A.M. Berendsen, Diewertje Sluik, Anne M. Van de Wiel, Anne Raben, Jeanne H.M. De Vries, Jennie Brand-Miller and Edith J.M. Feskens
Nutrients 2019, 11(1), 13; https://doi.org/10.3390/nu11010013 - 20 Dec 2018
Cited by 11 | Viewed by 5582
Abstract
Dietary glycaemic index (GI) and glycaemic load (GL) are indices used to quantify the effect of carbohydrate quality and quantity on postprandial glycaemia. GI/GL-health associations are widely studied but data on the validity of integrated GI/GL measurements are scarce. We evaluated the performance [...] Read more.
Dietary glycaemic index (GI) and glycaemic load (GL) are indices used to quantify the effect of carbohydrate quality and quantity on postprandial glycaemia. GI/GL-health associations are widely studied but data on the validity of integrated GI/GL measurements are scarce. We evaluated the performance of a food-frequency questionnaire (FFQ) specifically developed to assess GI/GL. In total, 263 Dutch men and 212 women (aged 55 ± 11 years) completed a 58-item GI-FFQ, an 183-item general-FFQ and a 2-day 24 h-recall and donated blood for glycated haemoglobin (HbA1c) determination. The level of agreement between these methods was evaluated by (1) cross-classification, (2) correlations and (3) Bland and Altman plots. The three dietary assessment methods provided comparable mean intake estimates for total carbohydrates (range: 214–237 g/day), mono/disaccharides (100–107 g/day), polysaccharides (114–132 g/day), as well as bread, breakfast cereals, potatoes, pasta, rice, fruit, dairy, cakes/cookies and sweets. Mean (±SD) GI estimates were also comparable between the GI-FFQ (54 ± 3), general-FFQ (53 ± 4) and 24 h-recalls (53 ± 5). Mean (±SD) GI-FFQ GL (117 ± 37) was slightly lower than the general-FFQ GL (126 ± 38) and 24 h-recalls GL (127 ± 37). Classification of GI in quartiles was identical for the GI-FFQ and general-FFQ for 43% of the population (r = 0.58) and with 24 h-recalls for 35% of the population (de-attenuated r = 0.64). For GL, this was 48% (r = 0.65) and 44% (de-attenuated r = 0.74). Correlations between GI and HbA1c were low (r = −0.09 for GI-FFQ, r = −0.04 for general-FFQ and r = 0.07 for 24 h-recalls). In conclusion, compared to a general-FFQ and 24 h-recalls, the GI-FFQ showed a moderate to good relative validity for carbohydrates, carbohydrate-rich foods and GI/GL. No metric predicted HbA1c. Full article
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
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15 pages, 1406 KiB  
Article
Comparison of Low Glycaemic Index and High Glycaemic Index Potatoes in Relation to Satiety: A Single-Blinded, Randomised Crossover Study in Humans
by Sabina S. H. Andersen, Jonas M. F. Heller, Thea Toft Hansen and Anne Raben
Nutrients 2018, 10(11), 1726; https://doi.org/10.3390/nu10111726 - 10 Nov 2018
Cited by 14 | Viewed by 9459
Abstract
High glycaemic index (GI) foods have been proposed to reduce satiety and thus promote overweight and obesity. Generally, potatoes have a high GI, but they also provide many beneficial nutrients and they are a highly important food source globally. In this study, we [...] Read more.
High glycaemic index (GI) foods have been proposed to reduce satiety and thus promote overweight and obesity. Generally, potatoes have a high GI, but they also provide many beneficial nutrients and they are a highly important food source globally. In this study, we investigated how a low GI potato affected subjective satiety as compared to a high GI potato. Twenty healthy men (aged 18–40 years; body mass index (BMI) 18–27 kg/m2) participated in this single-blinded, controlled, randomised crossover trial. On each of the two trial days, the subjects were given a 500-gram portion of either a low or high GI potato variety (Carisma® low GI and Arizona high GI). Subjective appetite sensations were measured at baseline and at +15 min, +45 min, +75 min, +105 min, and +135 min after consumption of the test meal until an ad libitum meal was served at +150 min. No significant differences in the primary endpoint, satiety, were found between the two potato varieties (all p > 0.05). Furthermore, no significant differences were found in the secondary endpoints; hunger, fullness, and prospective food consumption, or ad libitum energy intake (all p > 0.05). In conclusion, the results of this study do not indicate that the GI of potatoes is important for satiety in normal-weight men. Full article
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
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Review

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13 pages, 1168 KiB  
Review
Comparative Effect of Low-Glycemic Index versus High-Glycemic Index Breakfasts on Cognitive Function: A Systematic Review and Meta-Analysis
by Celia Álvarez-Bueno, Vicente Martínez-Vizcaíno, Estela Jiménez López, María Eugenia Visier-Alfonso, Andrés Redondo-Tébar and Iván Cavero-Redondo
Nutrients 2019, 11(8), 1706; https://doi.org/10.3390/nu11081706 - 24 Jul 2019
Cited by 8 | Viewed by 5874
Abstract
This systematic review and meta-analysis aims to compare the effect of High-Glycemic Index (GI) versus Low-GI breakfasts on cognitive functions, including memory and attention, of children and adolescents. We systematically searched the MEDLINE (via PubMed), EMBASE, Cochrane Central Register of Controlled Trials, Cochrane [...] Read more.
This systematic review and meta-analysis aims to compare the effect of High-Glycemic Index (GI) versus Low-GI breakfasts on cognitive functions, including memory and attention, of children and adolescents. We systematically searched the MEDLINE (via PubMed), EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science databases, from their inception until June 2019. Articles comparing the effect of Low-GI versus High-GI breakfasts on the cognitive function (i.e., immediate memory, delayed memory, and attention) of children and adolescents were included. The DerSimonian and Laird method was used to compute the pooled effect sizes (ESs) and their respective 95% confidence intervals (CIs). The pooled ESs were 0.13 (95% CI: −0.11, 0.37) for immediate memory and 0.07 (95% CI: −0.15, 0.28) for delayed memory. For attention, the pooled ES was −0.01 (95% CI: −0.27, 0.26). In summary, GI breakfasts do not affect cognitive domains in children and adolescents. Full article
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
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34 pages, 882 KiB  
Review
Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: Assessment of Causal Relations
by Geoffrey Livesey, Richard Taylor, Helen F. Livesey, Anette E. Buyken, David J. A. Jenkins, Livia S. A. Augustin, John L. Sievenpiper, Alan W. Barclay, Simin Liu, Thomas M. S. Wolever, Walter C. Willett, Furio Brighenti, Jordi Salas-Salvadó, Inger Björck, Salwa W. Rizkalla, Gabriele Riccardi, Carlo La Vecchia, Antonio Ceriello, Antonia Trichopoulou, Andrea Poli, Arne Astrup, Cyril W. C. Kendall, Marie-Ann Ha, Sara Baer-Sinnott and Jennie C. Brand-Milleradd Show full author list remove Hide full author list
Nutrients 2019, 11(6), 1436; https://doi.org/10.3390/nu11061436 - 25 Jun 2019
Cited by 114 | Viewed by 18291
Abstract
While dietary factors are important modifiable risk factors for type 2 diabetes (T2D), the causal role of carbohydrate quality in nutrition remains controversial. Dietary glycemic index (GI) and glycemic load (GL) have been examined in relation to the risk of T2D in multiple [...] Read more.
While dietary factors are important modifiable risk factors for type 2 diabetes (T2D), the causal role of carbohydrate quality in nutrition remains controversial. Dietary glycemic index (GI) and glycemic load (GL) have been examined in relation to the risk of T2D in multiple prospective cohort studies. Previous meta-analyses indicate significant relations but consideration of causality has been minimal. Here, the results of our recent meta-analyses of prospective cohort studies of 4 to 26-y follow-up are interpreted in the context of the nine Bradford-Hill criteria for causality, that is: (1) Strength of Association, (2) Consistency, (3) Specificity, (4) Temporality, (5) Biological Gradient, (6) Plausibility, (7) Experimental evidence, (8) Analogy, and (9) Coherence. These criteria necessitated referral to a body of literature wider than prospective cohort studies alone, especially in criteria 6 to 9. In this analysis, all nine of the Hill’s criteria were met for GI and GL indicating that we can be confident of a role for GI and GL as causal factors contributing to incident T2D. In addition, neither dietary fiber nor cereal fiber nor wholegrain were found to be reliable or effective surrogate measures of GI or GL. Finally, our cost–benefit analysis suggests food and nutrition advice favors lower GI or GL and would produce significant potential cost savings in national healthcare budgets. The high confidence in causal associations for incident T2D is sufficient to consider inclusion of GI and GL in food and nutrient-based recommendations. Full article
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
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51 pages, 4836 KiB  
Review
Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies
by Geoffrey Livesey, Richard Taylor, Helen F. Livesey, Anette E. Buyken, David J. A. Jenkins, Livia S. A. Augustin, John L. Sievenpiper, Alan W. Barclay, Simin Liu, Thomas M. S. Wolever, Walter C. Willett, Furio Brighenti, Jordi Salas-Salvadó, Inger Björck, Salwa W. Rizkalla, Gabriele Riccardi, Carlo La Vecchia, Antonio Ceriello, Antonia Trichopoulou, Andrea Poli, Arne Astrup, Cyril W. C. Kendall, Marie-Ann Ha, Sara Baer-Sinnott and Jennie C. Brand-Milleradd Show full author list remove Hide full author list
Nutrients 2019, 11(6), 1280; https://doi.org/10.3390/nu11061280 - 05 Jun 2019
Cited by 162 | Viewed by 27046
Abstract
Published meta-analyses indicate significant but inconsistent incident type-2 diabetes (T2D)-dietary glycemic index (GI) and glycemic load (GL) risk ratios or risk relations (RR). It is now over a decade ago that a published meta-analysis used a predefined standard to identify valid studies. Considering [...] Read more.
Published meta-analyses indicate significant but inconsistent incident type-2 diabetes (T2D)-dietary glycemic index (GI) and glycemic load (GL) risk ratios or risk relations (RR). It is now over a decade ago that a published meta-analysis used a predefined standard to identify valid studies. Considering valid studies only, and using random effects dose–response meta-analysis (DRM) while withdrawing spurious results (p < 0.05), we ascertained whether these relations would support nutrition guidance, specifically for an RR > 1.20 with a lower 95% confidence limit >1.10 across typical intakes (approximately 10th to 90th percentiles of population intakes). The combined T2D–GI RR was 1.27 (1.15–1.40) (p < 0.001, n = 10 studies) per 10 units GI, while that for the T2D–GL RR was 1.26 (1.15–1.37) (p < 0.001, n = 15) per 80 g/d GL in a 2000 kcal (8400 kJ) diet. The corresponding global DRM using restricted cubic splines were 1.87 (1.56–2.25) (p < 0.001, n = 10) and 1.89 (1.66–2.16) (p < 0.001, n = 15) from 47.6 to 76.1 units GI and 73 to 257 g/d GL in a 2000 kcal diet, respectively. In conclusion, among adults initially in good health, diets higher in GI or GL were robustly associated with incident T2D. Together with mechanistic and other data, this supports that consideration should be given to these dietary risk factors in nutrition advice. Concerning the public health relevance at the global level, our evidence indicates that GI and GL are substantial food markers predicting the development of T2D worldwide, for persons of European ancestry and of East Asian ancestry. Full article
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
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12 pages, 261 KiB  
Discussion
Incretin Hormones: The Link between Glycemic Index and Cardiometabolic Diseases
by Teresa Salvatore, Riccardo Nevola, Pia Clara Pafundi, Lucio Monaco, Carmen Ricozzi, Simona Imbriani, Luca Rinaldi and Ferdinando Carlo Sasso
Nutrients 2019, 11(8), 1878; https://doi.org/10.3390/nu11081878 - 13 Aug 2019
Cited by 13 | Viewed by 4839
Abstract
This review aimed to describe the potential mechanisms by which incretin hormones could mediate the relationship between glycemic index and cardiometabolic diseases. A body of evidence from many studies suggests that low glycemic index (GI) diets reduces the risk for type 2 diabetes [...] Read more.
This review aimed to describe the potential mechanisms by which incretin hormones could mediate the relationship between glycemic index and cardiometabolic diseases. A body of evidence from many studies suggests that low glycemic index (GI) diets reduces the risk for type 2 diabetes and coronary heart disease. In fact, despite the extensive literature on this topic, the mechanisms underlying unfavorable effects of high GI foods on health remain not well defined. The postprandial and hormonal milieu could play a key role in the relationship between GI and cardiovascular risk. Incretin hormones, glucagon-like peptide1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are important regulators of postprandial homeostasis by amplifying insulin secretory responses. Response of GIP and GLP-1 to GI have been studied more in depth, also by several studies on isomaltulose, which have been taken as an ideal model to investigate the kinetics of incretin secretion in response to foods’ GI. In addition, extrapancreatic effects of these incretin hormones were also recently observed. Emerging from this have been exciting effects on several targets, such as body weight regulation, lipid metabolism, white adipose tissue, cardiovascular system, kidney, and liver, which may importantly affect the health status. Full article
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
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