Next Article in Journal
Exploring the Views and Dietary Practices of Older People at Risk of Malnutrition and Their Carers: A Qualitative Study
Next Article in Special Issue
Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: Assessment of Causal Relations
Previous Article in Journal
Irregular Dietary Habits with a High Intake of Cereals and Sweets Are Associated with More Severe Gastrointestinal Symptoms in IBS Patients
Previous Article in Special Issue
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
Article Menu
Issue 6 (June) cover image

Export Article

Open AccessReview

Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies

1
Independent Nutrition Logic Ltd, 21 Bellrope Lane, Wymondham NR180QX, UK
2
Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany
3
Departments of Nutritional Science and Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
4
Clinical Nutrition and Risk Factor Modification Centre, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada
5
Division of Endocrinology & Metabolism, Department of Medicine, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada
6
Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada
7
Epidemiology, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Napoli, Italy
8
Glycemic Index Foundation, 26 Arundel St, Glebe, NSW 2037 Sydney, Australia
9
Department of Epidemiology and Medicine, Brown University, Providence, RI 02912, USA
10
Departments of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health and Harvard Medical School, Boston, MA 02115, USA
11
Department of Food and Drug, University of Parma, 43120 Parma, Italy
12
Human Nutrition Unit, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d’Investigació Sanitària Pere Virgili (IISPV), Rovira i Virgili University, 43201 Reus, Spain
13
Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 27400 Madrid, Spain
14
Retired from Food for Health Science Centre, Antidiabetic Food Centre, Lund University, S-221 00 Lund, Sweden
15
Institute of Cardiometabolism and Nutrition, ICAN, Pitié Salpêtrière Hospital, F75013 Paris, France
16
Department of Clinical Medicine and Surgery, Federico II University, 80147 Naples, Italy
17
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 201330 Milan, Italy
18
IRCCS MultiMedica, Diabetes Department, Sesto San Giovanni, 20099 Milan, Italy
19
Hellenic Health Foundation, Alexandroupoleos 23, 11527 Athens, Greece
20
Nutrition Foundation of Italy, Viale Tunisia 38, I-20124 Milan, Italy
21
Department of Nutrition, Exercise and Sports (NEXS) Faculty of Science, University of Copenhagen, 2200 Copenhagen, Denmark
22
College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5B5, Canada
23
Spinney Nutrition, Shirwell, Barnstaple, Devon EX31 4JR, UK
24
Oldways, Boston, MA 02116, USA
25
Charles Perkins Centre and School of Life and Environmental Sciences, University of Sydney, Sydney NSW 2006, Australia
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(6), 1280; https://doi.org/10.3390/nu11061280
Received: 2 May 2019 / Revised: 28 May 2019 / Accepted: 30 May 2019 / Published: 5 June 2019
(This article belongs to the Special Issue The Relationship between Glycemic Index and Human Health)
  |  
PDF [4836 KB, uploaded 26 June 2019]
  |     |  

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 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. View Full-Text
Keywords: glycemic index; glycemic load; dietary fiber; protein; alcohol; type 2 diabetes; cohort studies; epidemiology; meta-analysis glycemic index; glycemic load; dietary fiber; protein; alcohol; type 2 diabetes; cohort studies; epidemiology; meta-analysis
Figures

Graphical abstract

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

Supplementary material

SciFeed

Share & Cite This Article

MDPI and ACS Style

Livesey, G.; Taylor, R.; Livesey, H.F.; Buyken, A.E.; Jenkins, D.J.A.; Augustin, L.S.A.; Sievenpiper, J.L.; Barclay, A.W.; Liu, S.; Wolever, T.M.S.; Willett, W.C.; Brighenti, F.; Salas-Salvadó, J.; Björck, I.; Rizkalla, S.W.; Riccardi, G.; Vecchia, C.L.; Ceriello, A.; Trichopoulou, A.; Poli, A.; Astrup, A.; Kendall, C.W.C.; Ha, M.-A.; Baer-Sinnott, S.; Brand-Miller, J.C. Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies. Nutrients 2019, 11, 1280.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Nutrients EISSN 2072-6643 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top