Dietary Glycemic Index, Glycemic Load, and Risk of Coronary Heart Disease, Stroke, and Stroke Mortality: A Systematic Review with Meta-Analysis

Background: The relationship between dietary glycemic index, glycemic load and risk of coronary heart disease (CHD), stroke, and stroke-related mortality is inconsistent. Methods: We systematically searched the MEDLINE, EMBASE, and Science Citation Index Expanded databases using glycemic index, glycemic load, and cardiovascular disease and reference lists of retrieved articles up to April 30, 2012. We included prospective studies with glycemic index and glycemic load as the exposure and incidence of fatal and nonfatal CHD, stroke, and stroke-related mortality as the outcome variable. Pooled relative risks (RR) and 95% confidence intervals (CI) were calculated using random-effects models. Results: Fifteen prospective studies with a total of 438,073 participants and 9,424 CHD cases, 2,123 stroke cases, and 342 deaths from stroke were included in the meta-analysis. Gender significantly modified the effects of glycemic index and glycemic load on CHD risk, and high glycemic load level was associated with higher risk of CHD in women (RR = 1.49, 95%CI 1.27−1.73), but not in men (RR = 1.08, 95%CI 0.91−1.27). Stratified meta-analysis by body mass index indicated that among overweight and obese subjects, dietary glycemic load level were associated with increased risk of CHD (RR = 1.49, 95%CI 1.27−1.76; P for interaction = 0.003). Higher dietary glycemic load, but not glycemic index, was positively associated with stroke (RR = 1.19, 95% CI 1.00−1.43). There is a linear dose-response relationship between dietary glycemic load and increased risk of CHD, with pooled RR of 1.05 (95%CI 1.02−1.08) per 50-unit increment in glycemic load level. Conclusion: High dietary glycemic load is associated with a higher risk of CHD and stroke, and there is a linear dose-response relationship between glycemic load and CHD risk. Dietary glycemic index is slightly associated with risk of CHD, but not with stroke and stroke-related death. Further studies are needed to verify the effects of gender and body weight on cardiovascular diseases

Relation between breast cancer and high glycemic index or glycemic load : a meta-analysis of prospective cohort studies

Breast cancer is the commonest form of cancer in women worldwide. It has been suggested that chronic hyperinsulinemia associated with insulin resistance plays a role in breast cancer etiology. To test the hyperinsulinemia hypothesis, a dietary pattern associated with a high glycemic index and glycemic load, both proxies for chronic hyperinsulinemia, should be associated with an increased risk of breast cancer. A meta-analysis restricted to prospective cohort studies was undertaken using a random effects model with tests for statistical significance, publication bias and heterogeneity. The metric for analysis was the risk of breast cancer in the highest relative to the lowest glycemic index and glycemic load dietary pattern. A dietary pattern with a high glycemic index was associated with a summary relative risk (SRR) of 1.05 (95% CI: 1.00, 1.11), and a high glycemic load with a SRR of 1.06 (95% CI: 1.00, 1.13). Adjustments for body mass index [BMI], physical activity and other lifestyle factors did not influence the SRR, nor did menopausal status and estrogen receptor status of the tumor. In conclusion, the current evidence supports a modest association between a dietary pattern with high glycemic index or glycemic load and the risk of breast cancer

The effect of the glycemic index of an evening meal on the metabolic responses to a standard high glycemic index breakfast and subsequent exercise in men

The study investigated the effect of the glycemic index of an evening meal on responses to a standard high glycemic index (HGI) breakfast the following morning. The metabolic responses to exercise 3 hours after breakfast were also investigated. 7 active males completed 2 trials. In each trial, participants were provided with an evening meal on day 1, either HGI or LGI (high or low glycemic index) carbohydrates. On day 2, participants were provided with a standard HGI breakfast, then performed a 60 minute run 3 hours later. Plasma glucose and serum insulin concentrates following breakfast were higher in the HGI trial compared to the LGI trial. During exercise there were no differences in substrate utilization. Results suggest that consuming a single LGI evening meal can improve glucose tolerance at breakfast but the metabolic responses to subsequent exercise were not affected

The metabolic responses to high carbohydrate meals with different glycemic indices consumed during recovery from prolonged strenuous exercise

This study investigated the metabolic responses to high glycemic index (HGI) or low glycemic index (LGI) meals consumed during recovery from prolonged exercise. 8 trained male athletes undertook 2 trials. Following an overnight fast, subjects completed a 90 minute run. Meals were provided 30 minutes and 2 hours following cessation of exercise. The plasma glucose responses to both meals were greater in the HGI trial compared to the LGI trial. Following breakfast, there were no differences in the serum insulin concentrations between the trials; however, following lunch, concentrations were higher in the HGI trial compared to the LGI trial. This suggests that the glycemic index of the carbohydrates consumed during the immediate post-exercise period might not be important as long as sufficient carbohydrate is consumed. The high insulin concentrations following a HGI meal later in the recovery period could facilitate further muscle glycogen resynthesis

Nutritional characterization of gluten free non-traditional pasta

When a food is formulated, its characterization is important from the chemical and biochemical point of view; even more whennon-traditional raw materials are used. Noodles were made with cassava starch and corn flour (4:1), milk, egg, salt and xanthangum. The chemical composition of the pasta was determined and the total and resistant starch content was quantified. Thehydrolysis rate of the starch was measured at different times, from which the hydrolysis index and, subsequently, the predictiveglycemic index was calculated. The chemical composition of the noodles showed its high content of total fibers. From thedigestibility tests, high values were obtained for proteins (93%), and average values for the starch (52%). The results of the starchhydrolysis kinetics showed a higher proportion of slowly digestible starch with a low glycemic index (46%). Analyzed noodles arewithin the dietary guidelines that suggest a diet with high total dietary fiber content and low glycemic index.Fil: Milde, Laura Beatríz. Universidad Nacional de Misiones. Facultad de Ciencias Exactas, Químicas y Naturales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; ArgentinaFil: Chigal, Paola Soledad. Universidad Nacional de Misiones. Facultad de Ciencias Exactas, Químicas y Naturales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; ArgentinaFil: Chiola Zayas, Maria Ofelia. Universidad Nacional de Misiones. Facultad de Ciencias Exactas, Químicas y Naturales; Argentin

In vitro indicator of the glycemic response to foods as a tool for diet prescriptions and evaluation

As dietas de baixo índice glicêmico e baixa carga glicêmica têm sido associadas à redução do risco de doenças crônicas. Por esse motivo há um interesse crescente na sua aplicação para avaliação e orientação nutricional. No entanto, existem limitações quanto ao uso de dados publicados de índice glicêmico e carga glicêmica, pela variedade e formas de processamento dos alimentos vegetais existentes. Devido à dificuldade de realização de ensaios in vivo, uma vez que são custosos, trabalhosos, invasivos e necessitam de período considerável de experimentação, foram desenvolvidas metodologias in vitro que, a partir da velocidade de digestão dos carboidratos, permitem estimar o índice glicêmico dos alimentos de forma prática, simples e econômica. O presente trabalho apresenta o uso de um marcador in vitro, o índice de hidrólise, na estimativa do índice glicêmico e da carga glicêmica, o método mais empregado por pesquisadores brasileiros, visando à sua aplicação por profissionais da área de Nutrição. Os cálculos e as interpretações para estimativa do Índice glicêmico e da carga glicêmica são apresentados por meio de um exemplo prático com alguns alimentos brasileiros e com o grão de amaranto submetido a diferentes processamentos. Na ausência de dados referentes à resposta glicêmica do alimento de interesse, os valores do marcador in vitro podem ser utilizados para estimar o índice glicêmico e a carga glicêmica dos alimentos. Porém, este marcador não deve ser utilizado indiscriminadamente, uma vez que leva em consideração apenas os fatores intrínsecos aos alimentos que influenciam o aproveitamento dos carboidratos disponíveis.Low glycemic index and low glycemic load diets have been associated with a reduced risk of certain chronic diseases. For this reason, there has been a growing interest in using these concepts' for nutritional assessment and diet prescription. However, the usage of published glycemic index and glycemic load data is limited, because of the variety of types and preparations of plant-source foods. Since in vivo trials are difficult because of their cost labor-intense and time-consuming procedures, in vitro methods have been developed. These methods are based on the speed of digestion of the different carbohydrates, which allows the glycemic index of foods to be estimated in a practical, simple and cheap manner. This paper presents the use of an in vitro indicator, the hydrolysis index, to estimate the glycemic index and glycemic load. This method is the most commonly used glycemic load and index estimation method in Brazil and this paper aims to promote its use among dieticians. The calculations and interpretations to estimate glycemic load and index are presented by means of a practical example using some Brazilian staple foods and the amaranth grain processed in different ways. In the absence of data on the glycemic response of a particular food, the hydrolysis index can be used to estimate its glycemic index and load. However, the in vitro predictor cannot be used indiscriminately in substitution to glycemic index, since it takes into account only the intrinsic factors of foods that affect the glycemic response.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Pasta consumption and connected dietary habits: Associations with glucose control, adiposity measures, and cardiovascular risk factors in people with type 2 diabetes—TOSCA.IT study

Background: Pasta is a refined carbohydrate with a low glycemic index. Whether pasta shares the metabolic advantages of other low glycemic index foods has not really been investigated. The aim of this study is to document, in people with type-2 diabetes, the consumption of pasta, the connected dietary habits, and the association with glucose control, measures of adiposity, and major cardiovascular risk factors. Methods: We studied 2562 participants. The dietary habits were assessed with the European Prospective Investigation into Cancer and Nutrition (EPIC) questionnaire. Sex-specific quartiles of pasta consumption were created in order to explore the study aims. Results: A higher pasta consumption was associated with a lower intake of proteins, total and saturated fat, cholesterol, added sugar, and fiber. Glucose control, body mass index, prevalence of obesity, and visceral obesity were not significantly different across the quartiles of pasta intake. No relation was found with LDL cholesterol and triglycerides, but there was an inverse relation with HDL-cholesterol. Systolic blood pressure increased with pasta consumption; but this relation was not confirmed after correction for confounders. Conclusions: In people with type-2 diabetes, the consumption of pasta, within the limits recommended for total carbohydrates intake, is not associated with worsening of glucose control, measures of adiposity, and major cardiovascular risk factors

Glycemic index and glycemic response of corn starch porridge with addition of oats, flaxseed or soluble fiber isolated

Indexación: ScopusIntroduction: Fibers are commonly known to contribute in the improvement of glycemic and lipid profile, exerting a beneficial effect on health, but its effect on the glycemic index of food is still controversial. Objective: To evaluate the effect of adding high-fiber foods (oats and flaxseed) and a supplement of soluble fiber isolated on the glycemic index (GI) and glycemic response of a porridge of corn starch. Methodology: The study was of crossover, where six healthy subjects ingested preparations based on a maize porridge added to different foods rich in fiber, the GI of the preparations was calculated according to the methodology of FAO. Results: The preparation of linseed added resulting in a lesser glycemic response times 45-90 min and with the addition of oat preparation showed the best results at times 60 and 90 minutes. The mean area under the curve of the glycemic response and GI of the preparations did not differ. Conclusion: Oatmeal linseed seem foods with beneficial properties reduce the glycemic response to food.http://revista.nutricion.org/revista.asp?id=4

Associations of Adiponectin with Adiposity, Insulin Sensitivity, and Diet in Young, Healthy, Mexican Americans and Non-Latino White Adults.

Low circulating adiponectin levels may contribute to higher diabetes risk among Mexican Americans (MA) compared to non-Latino whites (NLW). Our objective was to determine if among young healthy adult MAs have lower adiponectin than NLWs, independent of differences in adiposity. In addition, we explored associations between adiponectin and diet. This was an observational, cross-sectional study of healthy MA and NLW adults living in Colorado (U.S.A.). We measured plasma total adiponectin, adiposity (BMI, and visceral adipose tissue), insulin sensitivity (IVGTT), and self-reported dietary intake in 43 MA and NLW adults. Mean adiponectin levels were 40% lower among MA than NLW (5.8 ± 3.3 vs. 10.7 ± 4.2 µg/mL, p = 0.0003), and this difference persisted after controlling for age, sex, BMI, and visceral adiposity. Lower adiponectin in MA was associated with lower insulin sensitivity (R² = 0.42, p < 0.01). Lower adiponectin was also associated with higher dietary glycemic index, lower intake of vegetables, higher intake of trans fat, and higher intake of grains. Our findings confirm that ethnic differences in adiponectin reflect differences in insulin sensitivity, but suggest that these are not due to differences in adiposity. Observed associations between adiponectin and diet support the need for future studies exploring the regulation of adiponectin by diet and other environmental factors