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Ojo O, Ojo OO, Wang XH, Adegboye ARA. The Effects of a Low GI Diet on Cardiometabolic and Inflammatory Parameters in Patients with Type 2 and Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Nutrients 2019; 11:E1584. [PMID: 31336986 PMCID: PMC6683080 DOI: 10.3390/nu11071584] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/24/2019] [Accepted: 07/05/2019] [Indexed: 02/07/2023] Open
Abstract
The prevalence of diabetes is increasing globally, and its effect on patients and the healthcare system can be significant. Gestational diabetes mellitus (GDM) and type 2 diabetes are well established risk factors for cardiovascular disease, and strategies for managing these conditions include dietary interventions, such as the use of a low glycemic index (GI) diet. AIMS This review aimed to evaluate the effects of a low GI diet on the cardio-metabolic and inflammatory parameters in patients with type 2 diabetes and women with GDM and assess whether the effects are different in these conditions. METHODS This review was based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Three databases (EMBASE, Pubmed, and PsycINFO) were searched from inception to 20 February 2019 using search terms that included synonyms and Medical Subject Headings (MeSH) in line with the population, intervention, comparator, outcomes, and studies (PICOS) framework. Studies were evaluated for the quality and risk of bias. RESULTS 10 randomised controlled studies were included in the systematic review, while 9 were selected for the meta-analysis. Two distinct areas were identified: the effect of a low GI diet on lipid profile and the effect of a low GI diet on inflammatory parameters. The results of the meta-analysis showed that there were no significant differences (p > 0.05) between the low GI and higher GI diets with respect to total cholesterol, HDL, and LDL cholesterol in patients with type 2 diabetes. However, there was a significant difference (p = 0.027) with respect to triglyceride which increased by a mean of 0.06 mmol/L (0.01, 0.11) in patients with type 2 diabetes on higher GI diet. With respect to the women with GDM, the findings from the systematic review were not consistent in terms of the effect of a low GI diet on the lipid profile. The results of the meta-analysis did not show significant differences (p > 0.05) between low GI and higher GI diets with respect to adiponectin and C-reactive proteins in patients with type 2 diabetes, but a significant difference (p < 0.001) was observed between the two groups in relation to interleukin-6. CONCLUSION This systematic review and meta-analysis have demonstrated that there were no significant differences (p > 0.05) between the low GI and higher GI diets in relation to total cholesterol-HDL and LDL cholesterol-in patients with type 2 diabetes. However, a significant difference (p < 0.05) was observed between the two groups with respect to triglyceride in patients with type 2 diabetes. The results of the effect of a low GI diet on the lipid profile in patients with GDM were not consistent. With respect to the inflammatory parameters, the low GI diet significantly decreased interleukin-6 in patients with type 2 diabetes compared to the higher GI diet. More studies are needed in this area of research.
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Affiliation(s)
- Omorogieva Ojo
- Faculty of Education and Health, Department of Adult Nursing and Paramedic Science, University of Greenwich, London SE9 2UG, UK.
| | - Osarhumwese Osaretin Ojo
- South London and Maudsley NHS Foundation Trust, University Hospital, Lewisham High Street, London SE13 6LH, UK
| | - Xiao-Hua Wang
- The School of Nursing, Soochow University, Suzhou 215006, China
| | - Amanda Rodrigues Amorim Adegboye
- Faculty of Education and Health, Department of Psychology, Social Work & Counselling, University of Greenwich, London SE9 2UG, UK
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Zhang X, Zhu Y, Cai L, Ma L, Jing J, Guo L, Jin Y, Ma Y, Chen Y. Dietary glycemic index and glycemic load and their relationship to cardiovascular risk factors in Chinese children. Appl Physiol Nutr Metab 2016; 41:391-6. [PMID: 26944225 DOI: 10.1139/apnm-2015-0432] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to examine the cross-sectional associations between dietary glycemic index (GI) and glycemic load (GL) and cardiovascular disease (CVD) risk factors in Chinese children. A total of 234 Chinese schoolchildren aged 8-11 years in Guangdong participated in the study. Dietary intake was assessed via a 3-day dietary record. Seven established cardiovascular indicators were analyzed in this study: fasting plasma glucose (FPG), fasting triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure, and diastolic blood pressure. Higher dietary GI was significantly associated with higher TG levels (P = 0.037) and lower HDL-C levels (P = 0.005) after adjusting for age, sex, nutritional intake, physical activity, and body mass index z score. LDL-C was found to differ across tertiles of dietary GL. The middle tertile tended to show the highest level of LDL-C. TC, FPG, and blood pressure were independent of both dietary GI and GL. Our findings suggest that higher dietary GI is differentially associated with some CVD risk factors, including lower HDL-C and higher TG, in school-aged children from south China.
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Affiliation(s)
- Xinyu Zhang
- a Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Road 2, Guangzhou 510080, Guangdong, China
| | - Yanna Zhu
- a Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Road 2, Guangzhou 510080, Guangdong, China
| | - Li Cai
- a Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Road 2, Guangzhou 510080, Guangdong, China
| | - Lu Ma
- a Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Road 2, Guangzhou 510080, Guangdong, China
| | - Jin Jing
- a Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Road 2, Guangzhou 510080, Guangdong, China
| | - Li Guo
- a Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Road 2, Guangzhou 510080, Guangdong, China
| | - Yu Jin
- a Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Road 2, Guangzhou 510080, Guangdong, China
| | - Yinghua Ma
- b Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yajun Chen
- a Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Road 2, Guangzhou 510080, Guangdong, China
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Castro-Quezada I, Sánchez-Villegas A, Estruch R, Salas-Salvadó J, Corella D, Schröder H, Álvarez-Pérez J, Ruiz-López MD, Artacho R, Ros E, Bulló M, Covas MI, Ruiz-Gutiérrez V, Ruiz-Canela M, Buil-Cosiales P, Gómez-Gracia E, Lapetra J, Pintó X, Arós F, Fiol M, Lamuela-Raventós RM, Martínez-González MÁ, Serra-Majem L. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk. PLoS One 2014; 9:e107968. [PMID: 25250626 PMCID: PMC4176720 DOI: 10.1371/journal.pone.0107968] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 08/21/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04); P for trend = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.
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Affiliation(s)
- Itandehui Castro-Quezada
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Almudena Sánchez-Villegas
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
| | - Ramón Estruch
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Internal Medicine, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Jordi Salas-Salvadó
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Human Nutrition Department, School of Medicine, University Rovira i Virgili, Reus, Tarragona, Spain
| | - Dolores Corella
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group, Institut Municipal d'Investigació Medica (IMIM)-Institut de Recerca del Hospital del Mar, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
| | - Jacqueline Álvarez-Pérez
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
| | - María Dolores Ruiz-López
- Department of Nutrition and Food Science, School of Pharmacy, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technologies, University of Granada. Armilla, Granada, Spain
| | - Reyes Artacho
- Department of Nutrition and Food Science, School of Pharmacy, University of Granada, Granada, Spain
| | - Emilio Ros
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clinic, l'Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Mónica Bulló
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Human Nutrition Department, School of Medicine, University Rovira i Virgili, Reus, Tarragona, Spain
| | - María-Isabel Covas
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group, Institut Municipal d'Investigació Medica (IMIM)-Institut de Recerca del Hospital del Mar, Barcelona, Spain
| | - Valentina Ruiz-Gutiérrez
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Group of Nutrition and Lipid Metabolism, Instituto de la Grasa (CSIC), Seville, Spain
| | - Miguel Ruiz-Canela
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine – Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarra, Spain
| | - Pilar Buil-Cosiales
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine – Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarra, Spain
| | - Enrique Gómez-Gracia
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine, School of Medicine, University of Malaga, Malaga, Spain
| | - José Lapetra
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain
| | - Xavier Pintó
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Internal Medicine Service, Hospital of Bellvitge, Barcelona, Spain
| | - Fernando Arós
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Cardiology, Hospital Txagorritxu, Vitoria, Alava, Spain
| | - Miquel Fiol
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- University Institute for Health Sciences Investigation, University of Balearic Islands, Palma de Mallorca, Spain
- Department of Cardiology, Hospital Son Espases, Palma de Mallorca, Spain
| | - Rosa María Lamuela-Raventós
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Nutrition and Bromatology, School of Pharmacy, University of Barcelona, Barcelona, Spain
| | - Miguel Ángel Martínez-González
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine – Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarra, Spain
| | - Lluís Serra-Majem
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
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Van Rompay MI, McKeown NM, Castaneda-Sceppa C, Ordovás JM, Tucker KL. Carbohydrate nutrition differs by diabetes status and is associated with dyslipidemia in Boston Puerto Rican adults without diabetes. J Nutr 2013; 143:182-8. [PMID: 23269655 PMCID: PMC3542909 DOI: 10.3945/jn.112.168914] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Puerto Rican adults have a greater prevalence of type 2 diabetes (T2D) and lower HDL-cholesterol (HDL-C) than the general U.S. population. Carbohydrate nutrition may play a role in this disparity. Cross-sectional analyses included data from 1219 Puerto Ricans aged 45-75 y enrolled in the Boston Puerto Rican Health Study. Using the Pearson chi-square test and ANCOVA, lifestyle characteristics and dietary intake, as assessed by semiquantitative FFQ, were compared by T2D status based on fasting plasma glucose concentration and medication use. Food source rankings for carbohydrate, dietary glycemic load (GL), and fiber were obtained using the SAS procedure PROC RANK. Geometric mean plasma HDL-C and TG concentrations were compared across quintiles of dietary carbohydrate, glycemic index (GI), GL, and fiber by using ANCOVA and tests for linear trend. In multivariable analyses, individuals with T2D (39.5%) had lower dietary carbohydrate, GL, and total sugar intake from lower intake of sugar, fruit drinks, and soda compared with those without T2D. In individuals without T2D, dietary carbohydrate and GL were inversely associated with HDL-C (P < 0.0001). Associations between dietary fiber and HDL-C were confounded by carbohydrate intake, apparently from concurrent consumption of legumes with white rice, a refined carbohydrate food. No associations were observed between carbohydrate, dietary GI, GL, or fiber and TG. In conclusion, individuals with T2D showed evidence of dietary modification. Among those without diabetes, a high intake of refined carbohydrates was associated with decreased HDL-C. Longitudinal research on carbohydrate nutrition in relation to diabetes risk factors and blood lipids in Puerto Ricans is warranted.
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Affiliation(s)
- Maria I. Van Rompay
- Jean Mayer USDA Human Nutrition Research Center on Aging, and,Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA; and
| | - Nicola M. McKeown
- Jean Mayer USDA Human Nutrition Research Center on Aging, and,Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA; and
| | | | - José M. Ordovás
- Jean Mayer USDA Human Nutrition Research Center on Aging, and,Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA; and
| | - Katherine L. Tucker
- Jean Mayer USDA Human Nutrition Research Center on Aging, and,Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA; and,Department of Health Sciences, Northeastern University, Boston, MA,To whom correspondence should be addressed. E-mail:
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