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Fabios E, Martínez-González MÁ, García-Blanco L, de la O V, Santiago S, Zazpe I, Martín-Calvo N. Association between the Carbohydrate Quality Index (CQI) and Nutritional Adequacy in a Pediatric Cohort: The SENDO Project. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1711. [PMID: 37892374 PMCID: PMC10605036 DOI: 10.3390/children10101711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
Suboptimal micronutrient intake in children remains a public health concern around the world. This study examined the relationship between a previously defined dietary carbohydrate quality index (CQI) and the risk of micronutrient intake inadequacy in a pediatric cohort of Spanish preschoolers. Children aged 4-5 years old were recruited at their medical center or at school, and information on sociodemographic, dietary, and lifestyle variables were collected through a self-administered online questionnaire. Dietary information was obtained from a validated 147-item semi-quantitative food frequency questionnaire. We calculated the CQI and categorized participants into quartiles according to their scores. We assessed the intakes of 20 micronutrients and evaluated the probability of intake inadequacy by using the estimated average requirement cut-off point. Generalized estimating equations were used to adjust for potential confounders and account for the intra-cluster correlations between siblings. The adjusted proportions of children with an inadequate intake of ≥three micronutrients were 23%, 12%, 11%, and 9% in the first, second, third, and fourth quartiles of the CQI, respectively. Children in the highest quartile of the CQI had 0.22-fold lower odds (95% CI 0.10-0.48) of having ≥three inadequate micronutrient intakes than their peers in the lowest quartile. These findings reinforce the relevance of carbohydrate quality in children's diets.
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Affiliation(s)
- Elise Fabios
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (E.F.); (V.d.l.O.); (I.Z.); (N.M.-C.)
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (E.F.); (V.d.l.O.); (I.Z.); (N.M.-C.)
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain;
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, 28029 Madrid, Spain
| | - Lorena García-Blanco
- San Juan Primary Care Health Center, Servicio Navarro de Salud-Osasunbidea, 31011 Pamplona, Spain;
| | - Víctor de la O
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (E.F.); (V.d.l.O.); (I.Z.); (N.M.-C.)
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, 28049 Madrid, Spain
| | - Susana Santiago
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain;
- Department of Nutrition, Food Science and Physiology, School of Pharmacy, University of Navarra, 31008 Pamplona, Spain
| | - Itziar Zazpe
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (E.F.); (V.d.l.O.); (I.Z.); (N.M.-C.)
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain;
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, 28029 Madrid, Spain
- Department of Nutrition, Food Science and Physiology, School of Pharmacy, University of Navarra, 31008 Pamplona, Spain
| | - Nerea Martín-Calvo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (E.F.); (V.d.l.O.); (I.Z.); (N.M.-C.)
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain;
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, 28029 Madrid, Spain
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Basiri R, Seidu B, Cheskin LJ. Key Nutrients for Optimal Blood Glucose Control and Mental Health in Individuals with Diabetes: A Review of the Evidence. Nutrients 2023; 15:3929. [PMID: 37764713 PMCID: PMC10536295 DOI: 10.3390/nu15183929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/31/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Diabetes is associated with an increased risk of mental disorders, including depression, anxiety, and cognitive decline. Mental disorders can also contribute to the development of diabetes through various mechanisms including increased stress, poor self-care behaviors, and adverse effects on glucose metabolism. Consequently, individuals suffering from either of these conditions frequently experience comorbidity with the other. Nutrition plays an important role in both diabetes and mental health disorders including depression and anxiety. Deficiencies in specific nutrients such as omega-3 fatty acids, vitamin D, B vitamins, zinc, chromium, magnesium, and selenium have been implicated in the pathogenesis of both diabetes and mental disorders. While the impact of nutrition on the progression and control of diabetes and mental disorders is broadly acknowledged, there is a notable knowledge gap concerning the implications of distinct nutrients in preventing and mitigating symptoms of both conditions when they coexist. The aim of this study was to examine the role of nutrition in improving glucose homeostasis and promoting mental well-being among individuals with diabetes. Further, we evaluated the preventive or delaying effects of key nutrients on the simultaneous manifestation of these conditions when one of them is present. Our findings indicated that the use of personalized dietary interventions and targeted nutrient supplementation can improve metabolic and mental health outcomes in patients with type 2 diabetes.
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Affiliation(s)
- Raedeh Basiri
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
- Institute for Biohealth Innovation, George Mason University, Fairfax, VA 22030, USA
| | - Blessing Seidu
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
| | - Lawrence J. Cheskin
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
- Institute for Biohealth Innovation, George Mason University, Fairfax, VA 22030, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
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Vinoy S, Goletzke J, Rakhshandehroo M, Schweitzer L, Flourakis M, Körner A, Alexy U, van Schothorst EM, Ceriello A, Zakrzewski-Fruer JK, Buyken A. Health relevance of lowering postprandial glycaemia in the paediatric population through diet': results from a multistakeholder workshop. Eur J Nutr 2023; 62:1093-1107. [PMID: 36534178 PMCID: PMC10030539 DOI: 10.1007/s00394-022-03047-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 10/20/2022] [Indexed: 12/23/2022]
Abstract
To summarize current knowledge and gaps regarding the role of postprandial glycaemic response in the paediatric population, a workshop was organized in June 2021 by the European branch of the International Life Science Institute (ILSI). This virtual event comprised of talks given by experts followed by in-depth discussions in breakout sessions with workshop participants. The main pre-specified topics addressed by the workshop organizing committee to the invited speakers and the workshop participants were: (1) the role of glycaemic responses for paediatric health, based on mechanistic insights from animal and human data, and long-term evidence from observational and intervention studies in paediatric populations, and (2) changes in metabolism and changes in dietary needs from infancy to adolescence. Each talk as well as the discussions were summarised, including the main identified research gaps. The workshop led to the consensus on the crucial role on health of postprandial glycaemic response in paediatric population. However, a lack of scientific data has been identified regarding detailed glucose and insulin profiles in response to foods commonly consumed by paediatric populations, as well as a lack of long-term evidence including the need for suitable predictors during childhood and adolescence to anticipate health effects during adulthood.
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Affiliation(s)
- Sophie Vinoy
- Mondelēz International, Nutrition Research, Clamart, France
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Nicholls J. Perspective: The Glycemic Index Falls Short as a Carbohydrate Food Quality Indicator to Improve Diet Quality. Front Nutr 2022; 9:896333. [PMID: 35529459 PMCID: PMC9067577 DOI: 10.3389/fnut.2022.896333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
This perspective examines the utility of the glycemic index (GI) as a carbohydrate quality indicator to improve Dietary Guidelines for Americans (DGA) adherence and diet quality. Achieving affordable, high-quality dietary patterns can address multiple nutrition and health priorities. Carbohydrate-containing foods make important energy, macronutrient, micronutrient, phytochemical, and bioactive contributions to dietary patterns, thus improving carbohydrate food quality may improve diet quality. Following DGA guidance helps meet nutrient needs, achieve good health, and reduce risk for diet-related non-communicable diseases in healthy people, yet adherence by Americans is low. A simple indicator that identifies high-quality carbohydrate foods and improves food choice may improve DGA adherence, but there is no consensus on a definition. The GI is a measure of the ability of the available carbohydrate in a food to increase blood glucose. The GI is well established in research literature and popular resources, and some have called for including the GI on food labels and in food-based dietary guidelines. The GI has increased understanding about physiological responses to carbohydrate-containing foods, yet its role in food-based dietary guidance and diet quality is unresolved. A one-dimensional indicator like the GI runs the risk of being interpreted to mean foods are "good" or "bad," and it does not characterize the multiple contributions of carbohydrate-containing foods to diet quality, including nutrient density, a core concept in the DGA. New ways to define and communicate carbohydrate food quality shown to help improve adherence to high-quality dietary patterns such as described in the DGA would benefit public health.
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A Review of In Vitro Methods for Measuring the Glycemic Index of Single Foods: Understanding the Interaction of Mass Transfer and Reaction Engineering by Dimensional Analysis. Processes (Basel) 2022. [DOI: 10.3390/pr10040759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The Glycemic Index (GI) has been described by an official method ISO (International Organization for Standardization) 26642:2010 for labeling purposes. The development of in vitro methods for GI measurement has faced significant challenges. Mass transfer and reaction engineering theory may assist in providing a quantitative understanding of in vitro starch digestion and glycemic response from an engineering point of view. We suggest that in vitro GI measurements should consider the mouth and the stomach in terms of fluid mechanics, mass transfer, length scale changes, and food-solvent reactions, and might consider a significant role for the intestine as an absorption system for the glucose that is generated before the intestine. Applying mass transfer and reaction engineering theory may be useful to understand quantitative studies of in vitro GI measurements. The relative importance of reactions and mass-transfer has been estimated from literature measurements through estimating the Damköhler numbers (Da), and the values estimated of this dimensionless group (0.04–2.9) suggest that both mass transfer and chemical reaction are important aspects to consider.
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Higher carbohydrate quality index is associated with better adequate micronutrient consumption in Brazilian women. NUTR HOSP 2022; 39:594-602. [DOI: 10.20960/nh.03662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Balanced carbohydrate ratios are associated with improved diet quality in Australia: A nationally representative cross-sectional study. PLoS One 2021; 16:e0253582. [PMID: 34242252 PMCID: PMC8270120 DOI: 10.1371/journal.pone.0253582] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/09/2021] [Indexed: 12/30/2022] Open
Abstract
Background Carbohydrate quality influences major health outcomes; however, the best criteria to assess carbohydrate quality remain unknown. Objective The objectives were to: i) evaluate whether a diet that meets a carbohydrate ratio (simple, modified or dual ratio) is associated with higher nutrient intakes and diet quality, and ii) model the impact of substituting carbohydrate foods that meet the proposed ratios in place of foods that do not, on nutrient intakes. Design A secondary analysis of cross-sectional data from the 2011–12 Australian National Nutrition and Physical Activity Survey. Participants/Setting National data from participants aged 2 years and older (n = 12,153). Main outcome measures Ratios were defined as (i) simple ratio, 10:1 (10g carbohydrate:≥1g dietary fiber); (ii) modified ratio, 10:1:2 (10g carbohydrate:≥1g dietary fiber:≤2g free sugars); and (iii) dual ratio, 10:1 & 1:2 (10g carbohydrate:≥1g dietary fiber & ≤2g free sugars per 1g dietary fiber). Ratios were compared to nutrient intakes obtained via automated multiple-pass 24-hour dietary recall and diet quality calculated using the Australian Healthy Eating Index. Statistical analyses performed Substitution dietary modelling was performed. Data were analyzed using paired and independent sample t-tests. Results Ratio adherence was highest for simple (50.2% adults; 28.6% children), followed by dual (40.6% adults; 21.7% children), then modified (32.7% adults; 18.6% children) ratios. Participants who met any ratio reported higher nutrient intake and diet quality compared to those who failed to meet the respective ratio (P < .001 for all), with the greatest nutrient intakes found for those who met modified or dual ratios. Dietary modelling improved nutrient intakes for all ratios, with the greatest improvement found for the dual ratio. Conclusions All carbohydrate ratios were associated with higher diet quality, with a free sugars constraint in the dual ratio providing the greatest improvements.
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Krela-Kaźmierczak I, Czarnywojtek A, Skoracka K, Rychter AM, Ratajczak AE, Szymczak-Tomczak A, Ruchała M, Dobrowolska A. Is There an Ideal Diet to Protect against Iodine Deficiency? Nutrients 2021; 13:513. [PMID: 33557336 PMCID: PMC7914421 DOI: 10.3390/nu13020513] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/17/2022] Open
Abstract
Iodine deficiency is a global issue and affects around 2 billion people worldwide, with pregnant women as a high-risk group. Iodine-deficiency prevention began in the 20th century and started with global salt iodination programmes, which aimed to improve the iodine intake status globally. Although it resulted in the effective eradication of the endemic goitre, it seems that salt iodination did not resolve all the issues. Currently, it is recommended to limit the consumption of salt, which is the main source of iodine, as a preventive measure of non-communicable diseases, such as hypertension or cancer the prevalence of which is increasing. In spite of the fact that there are other sources of iodine, such as fish, seafood, dairy products, water, and vegetables, the high consumption of processed food with a high content of unionised salt, alternative diets or limited salt intake can still lead to iodine deficiency. Thus, iodine deficiency remains a relevant issue, with new, preventive solutions necessary. However, it appears that there is no diet which would fully cover the iodine requirements, and iodine food supplementation is still required.
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Affiliation(s)
- Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, 60-355 Poznan, Poland; (I.K.-K.); (A.M.R.); (A.E.R.); (A.S.-T.); (A.D.)
| | - Agata Czarnywojtek
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.C.); (M.R.)
- Department of Pharmacology, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| | - Kinga Skoracka
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, 60-355 Poznan, Poland; (I.K.-K.); (A.M.R.); (A.E.R.); (A.S.-T.); (A.D.)
| | - Anna Maria Rychter
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, 60-355 Poznan, Poland; (I.K.-K.); (A.M.R.); (A.E.R.); (A.S.-T.); (A.D.)
| | - Alicja Ewa Ratajczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, 60-355 Poznan, Poland; (I.K.-K.); (A.M.R.); (A.E.R.); (A.S.-T.); (A.D.)
| | - Aleksandra Szymczak-Tomczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, 60-355 Poznan, Poland; (I.K.-K.); (A.M.R.); (A.E.R.); (A.S.-T.); (A.D.)
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.C.); (M.R.)
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, 60-355 Poznan, Poland; (I.K.-K.); (A.M.R.); (A.E.R.); (A.S.-T.); (A.D.)
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9
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Meroni A, Muirhead RP, Atkinson FS, Fogelholm M, Raben A, Brand-Miller JC. Is a Higher Protein-Lower Glycemic Index Diet More Nutritious Than a Conventional Diet? A PREVIEW Sub-study. Front Nutr 2020; 7:603801. [PMID: 33365325 PMCID: PMC7750310 DOI: 10.3389/fnut.2020.603801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/16/2020] [Indexed: 12/27/2022] Open
Abstract
High protein diets and low glycemic index (GI) diets have been associated with improved diet quality. We compared the changes in nutrient intakes of individuals at high risk of developing type-2 diabetes over 3 y who followed either a higher protein-lower GI diet (HPLG) or a conventional moderate protein-moderate GI diet (MPMG). This post hoc analysis included 161 participants with overweight and pre-diabetes from the Australian cohort of the PREVIEW study (clinical trial registered in https://www.clinicaltrials.gov/ct2/show/NCT01777893?term=NCT01777893&draw=2&rank=1) who were randomly assigned to a HPLG diet (25% energy from protein, dietary GI ≤ 50, n = 85) or a MPMG diet (15% energy from protein, dietary GI ≥ 56, n = 76). Food records were collected at 0-mo (baseline) and at 6-, 12-, 24-, and 36-mo (dietary intervention period). Linear mixed models were used to compare the differences in total energy, macro- and micronutrients, dietary GI, glycemic load (GL) and body weight between the two diet groups at the 4 dietary intervention time points. At 3 y, 74% participants from the HPLG diet and 74% participants from the MPMG diet completed the trial. The HPLG group showed significantly higher protein intake and lower dietary GI and GL than the MPMG group (group fixed effect P < 0.001 for all three parameters). By 6-, 12-, 24-, and 36-mo there was a 3.0, 2.7, 2.2, and 1.4% point difference in protein intake and 6.2, 4.1, 4.8, and 3.9 GI unit difference between the groups. The intake of energy and saturated fat decreased (mostly in the first 6-mo), while the intake of dietary fiber increased (from mo-0 to mo-12 only) in both diets, with no significant differences between the diets. The dietary intakes of zinc (group fixed effect P = 0.05), selenium (P = 0.01), niacin (P = 0.01), vitamin B12 (P = 0.01) and dietary cholesterol (group by time fixed effect P = 0.001) were higher in the HPLG group than in the MPMG group. Despite both diets being designed to be nutritionally complete, a HPLG diet was found to be more nutritious in relation to some micronutrients, but not cholesterol, than a MPMG diet.
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Affiliation(s)
- Alice Meroni
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Roslyn P Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Fiona S Atkinson
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Mikael Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Anne Raben
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jennie C Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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10
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The association between carbohydrate quality and nutrient adequacy in Australian adults. Eur J Clin Nutr 2020; 74:1594-1602. [PMID: 32253376 DOI: 10.1038/s41430-020-0620-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/19/2020] [Accepted: 03/19/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES To examine the association between various carbohydrate quality indicators and nutrient adequacy in Australian adults. SUBJECTS/METHODS Dietary data from adult participants of the 2011-2012 Australian Health Survey (weighted n = 6150) who had completed two 24 h recalls were analyzed. Glycaemic indices (GI) of foods were estimated based on a published method. Quartiles of dietary GI (dGI) and glycaemic load (dGL), and intakes of high (CHOhighGI) and low-GI carbohydrates (CHOlowGI) were derived. Estimated marginal means and standard errors of nutrient and food group intakes by quartiles were calculated using ANCOVA. Odds ratios of not meeting the nutrient reference values for Australia and New Zealand (NRVs) by quartiles of the carbohydrate quality indicators were calculated by logistic regression. Analyses were adjusted for known confounders. RESULTS Participants with higher CHOhighGI had lower intakes of the majority of nutrients examined, except sodium and %energy from free sugars. They were also more than 100% more likely to not meet the NRVs of vitamin A (2.19, 95% CI 1.89, 2.84), vitamin C (3.93, 95% CI: 1.61, 9.60), vitamin E (2.63, 95% CI: 2.08, 3.31), iron (2.27, 95% CI: 1.48, 3.49), magnesium (2.50, 95% CI: 2.01, 3.12), potassium (2.25, 95% CI: 1.79, 2.83), %EFS (2.74, 95% CI: 2.22, 3.38), and LCn3PUFA (2.35, 95% CI: 1.76, 3.16). Similar results were observed for dGI and dGL, while trends for CHOlowGI were in opposite direction in general. CONCLUSIONS Of the carbohydrate quality indicators examined, CHOhighGI was the strongest predictor of nutrient adequacy. Improvement in nutrient adequacy likely contributed to the health protective effect of a low-GI diet.
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11
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Shahdadian F, Saneei P, Milajerdi A, Esmaillzadeh A. Dietary glycemic index, glycemic load, and risk of mortality from all causes and cardiovascular diseases: a systematic review and dose-response meta-analysis of prospective cohort studies. Am J Clin Nutr 2019; 110:921-937. [PMID: 31187856 DOI: 10.1093/ajcn/nqz061] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 03/25/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Previous findings on the association of dietary glycemic index (GI) and glycemic load (GL) with mortality are conflicting. OBJECTIVES The aim of this study was to summarize earlier findings on the association between dietary GI and GL and the risk of cardiovascular disease (CVD) and all-cause mortality. METHODS A comprehensive literature search was performed of electronic databases, including MEDLINE (PubMed), Scopus, ISI Web of Science, EMBASE, and Google scholar, up to September 2018. Prospective cohort studies that reported GI and GL as the exposure and all-cause or CVD mortality as the outcome were included in the analysis. The random-effects model was used to estimate pooled RR and 95% CIs of all-cause and CVD mortality. RESULTS Eighteen cohort studies with a total of 251,497 participants, reporting 14,774 cases of all-cause mortality and 3658 cases of CVD mortality, were included in the present analysis. No significant association was found between dietary GI and all-cause mortality (RR: 1.07; 95% CI: 0.96, 1.19) and CVD mortality (RR: 1.02; 95% CI: 0.87, 1.20). In addition, dietary GL was not associated with all-cause mortality (RR: 1.08; 95% CI: 0.93, 1.27) or CVD mortality (RR: 1.07; 95% CI: 0.92, 1.25). However, the highest dietary GI, in comparison to the lowest one, significantly increased the risk of all-cause mortality in women (RR: 1.17; 95% CI: 1.02, 1.35). No evidence for a nonlinear association between dietary GI or GL and all-cause and CVD mortality was found (P > 0.05). CONCLUSIONS This meta-analysis of prospective cohort studies showed no significant association between either dietary GI or GL and all-cause and CVD mortality in men, but a positive association of GI with all-cause mortality in women.
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Affiliation(s)
- Farnaz Shahdadian
- Students' Scientific Research Center.,Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Milajerdi
- Students' Scientific Research Center.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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12
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Livesey G, Taylor R, Livesey HF, Buyken AE, Jenkins DJA, Augustin LSA, Sievenpiper JL, Barclay AW, Liu S, Wolever TMS, Willett WC, Brighenti F, Salas-Salvadó J, Björck I, Rizkalla SW, Riccardi G, Vecchia CL, Ceriello A, Trichopoulou A, Poli A, Astrup A, Kendall CWC, Ha MA, Baer-Sinnott S, Brand-Miller JC. Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: Assessment of Causal Relations. Nutrients 2019; 11:E1436. [PMID: 31242690 PMCID: PMC6628270 DOI: 10.3390/nu11061436] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/20/2019] [Accepted: 06/20/2019] [Indexed: 12/22/2022] Open
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 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.
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Affiliation(s)
- Geoffrey Livesey
- Independent Nutrition Logic Ltd, 21 Bellrope Lane, Wymondham NR180QX, UK.
| | - Richard Taylor
- Independent Nutrition Logic Ltd, 21 Bellrope Lane, Wymondham NR180QX, UK.
| | - Helen F Livesey
- Independent Nutrition Logic Ltd, 21 Bellrope Lane, Wymondham NR180QX, UK.
| | - Anette E Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany.
| | - David J A Jenkins
- Departments of Nutritional Science and Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
- Division of Endocrinology and Metabolism, Department of Medicine, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
| | - Livia S A Augustin
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
- Epidemiology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Napoli, Italy.
| | - John L Sievenpiper
- Departments of Nutritional Science and Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
- Division of Endocrinology and Metabolism, Department of Medicine, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
| | - Alan W Barclay
- Glycemic Index Foundation, 26 Arundel St, Glebe, Sydney NSW 2037, Australia.
| | - Simin Liu
- Department of Epidemiology and Medicine, Brown University, Providence, RI 02912, USA.
| | - Thomas M S Wolever
- Departments of Nutritional Science and Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
| | - Walter C Willett
- Departments of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health and Harvard Medical School, Boston, MA 02115, USA.
| | - Furio Brighenti
- Department of Food and Drug, University of Parma, 43120 Parma, Italy.
| | - Jordi Salas-Salvadó
- 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.
- Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 27400 Madrid, Spain.
| | - Inger Björck
- Retired from Food for Health Science Centre, Antidiabetic Food Centre, Lund University, S-221 00 Lund, Sweden.
| | - Salwa W Rizkalla
- Institute of Cardiometabolism and Nutrition, ICAN, Pitié Salpêtrière Hospital, F75013 Paris, France.
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, 80147 Naples, Italy.
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 201330 Milan, Italy.
| | - Antonio Ceriello
- IRCCS MultiMedica, Diabetes Department, Sesto San Giovanni, 20099 Milan, Italy.
| | | | - Andrea Poli
- Nutrition Foundation of Italy, Viale Tunisia 38, I-20124 Milan, Italy.
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports (NEXS) Faculty of Science, University of Copenhagen, 2200 Copenhagen, Denmark.
| | - Cyril W C Kendall
- Departments of Nutritional Science and Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5B5, Canada.
| | - Marie-Ann Ha
- Spinney Nutrition, Shirwell, Barnstaple, Devon EX31 4JR, UK.
| | | | - Jennie C Brand-Miller
- Charles Perkins Centre and School of Life and Environmental Sciences, University of Sydney, Sydney NSW 2006, Australia.
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13
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Hernandez TL, Mande A, Barbour LA. Nutrition therapy within and beyond gestational diabetes. Diabetes Res Clin Pract 2018; 145:39-50. [PMID: 29679625 PMCID: PMC6195478 DOI: 10.1016/j.diabres.2018.04.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 04/03/2018] [Indexed: 02/08/2023]
Abstract
With the global rising prevalence of gestational diabetes (GDM), an adaptable, economical approach to nutrition therapy that effectively controls maternal glycemia while promoting normal fetal growth will have far-reaching implications. The conventional focus has been to rigidly limit all types of carbohydrate. While controlling glucose, this approach fosters maternal anxiety and is a primary barrier to adherence. Many mothers substitute fat for carbohydrate, which may unintentionally enhance lipolysis, promote elevated free fatty acids (FFA), and worsen maternal insulin resistance (IR). Nutrition that worsens IR may facilitate nutrient shunting across the placenta, promoting excess fetal fat accretion. Evidence suggests that liberalizing higher quality, nutrient-dense carbohydrates results in controlled fasting/postprandial glucose, lower FFA, improved insulin action, vascular benefits, and may reduce excess infant adiposity. Thus, a less carbohydrate-restricted approach may improve maternal adherence when combined with higher quality carbohydrates, lower fat, appropriate caloric intake, and ethnically acceptable foods. Such a diet can be culturally sensitive, socioeconomically attentive, minimize further weight gain in GDM, with potential relevance for pregnancies complicated by overweight/obesity. Future research is needed to better understand the effect of macronutrient composition on the placenta and gut microbiome, the benefits/risks of nonnutritive sweeteners, and whether precision-nutrition is beneficial in pregnancy.
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Affiliation(s)
- Teri L Hernandez
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States; College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States.
| | - Archana Mande
- Colorado Clinical and Translational Science Institute, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Linda A Barbour
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Colorado School of Medicine, Aurora, CO, United States
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14
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Murakami K, Sasaki S. A low–glycemic index and –glycemic load diet is associated with not only higher intakes of micronutrients but also higher intakes of saturated fat and sodium in Japanese children and adolescents: the National Health and Nutrition Survey. Nutr Res 2018; 49:37-47. [DOI: 10.1016/j.nutres.2017.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 10/20/2017] [Accepted: 10/20/2017] [Indexed: 10/18/2022]
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15
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Vos MB, Kaar JL, Welsh JA, Van Horn LV, Feig DI, Anderson CAM, Patel MJ, Cruz Munos J, Krebs NF, Xanthakos SA, Johnson RK. Added Sugars and Cardiovascular Disease Risk in Children: A Scientific Statement From the American Heart Association. Circulation 2017; 135:e1017-e1034. [PMID: 27550974 PMCID: PMC5365373 DOI: 10.1161/cir.0000000000000439] [Citation(s) in RCA: 345] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Poor lifestyle behaviors are leading causes of preventable diseases globally. Added sugars contribute to a diet that is energy dense but nutrient poor and increase risk of developing obesity, cardiovascular disease, hypertension, obesity-related cancers, and dental caries. METHODS AND RESULTS For this American Heart Association scientific statement, the writing group reviewed and graded the current scientific evidence for studies examining the cardiovascular health effects of added sugars on children. The available literature was subdivided into 5 broad subareas: effects on blood pressure, lipids, insulin resistance and diabetes mellitus, nonalcoholic fatty liver disease, and obesity. CONCLUSIONS Associations between added sugars and increased cardiovascular disease risk factors among US children are present at levels far below current consumption levels. Strong evidence supports the association of added sugars with increased cardiovascular disease risk in children through increased energy intake, increased adiposity, and dyslipidemia. The committee found that it is reasonable to recommend that children consume ≤25 g (100 cal or ≈6 teaspoons) of added sugars per day and to avoid added sugars for children <2 years of age. Although added sugars most likely can be safely consumed in low amounts as part of a healthy diet, few children achieve such levels, making this an important public health target.
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16
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Dietary glycaemic index and glycaemic load among Australian children and adolescents: results from the 2011–2012 Australian Health Survey. Br J Nutr 2016; 116:178-87. [DOI: 10.1017/s0007114516001823] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThis study aimed to examine the dietary glycaemic index (GI) and glycaemic load (GL) of Australian children and adolescents, as well as the major food groups contributing to GL, in the recent 2011–2012 Australian Health Survey. Plausible food intake data from 1876 children and adolescents (51 % boys), collected using a multiple-pass 24-h recall, were analysed. The GI of foods was assigned based on a step-wise published method using values from common GI databases. Descriptive statistics were calculated for dietary GI, GL and contribution to GL by food groups, stratified by age group and sex. Linear regression was used to test for trends across age groups for BMI, dietary GI and GL, and intakes of energy, nutrients and food groups. Pearson’s χ2 test was used to test for differences between age groups for categorical subject characteristic variables. Mean dietary GI and GL of participants were 55·5 (sd 5·3) and 137·4 (sd 50·8), respectively. The main contributors to dietary GL were starchy foods: breads, cereal-based dishes, breakfast cereals, flours, grains and potatoes accounted for 41 % of total GL. Sweetened beverages, fruit and vegetable juices/drinks, cake-type desserts and sweet biscuits contributed 15 %. No significant difference (at P<0·001) was observed between sexes. In conclusion, Australian children and adolescents appear to consume diets with a lower GI than European children. Exchanging high-GI foods for low-GI alternatives within core and non-core foods may improve diet quality of Australian children and adolescents.
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17
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Azadbakht L, Mohammadifard N, Akhavanzanjani M, Taheri M, Golshahi J, Haghighatdoost F. The association between dietary glycemic index, glycemic load and diet quality indices in Iranian adults: results from Isfahan Healthy Heart Program. Int J Food Sci Nutr 2016; 67:161-9. [DOI: 10.3109/09637486.2015.1134443] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Leila Azadbakht
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Akhavanzanjani
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marzieh Taheri
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jafar Golshahi
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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18
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Goletzke J, Buyken AE, Louie JCY, Moses RG, Brand-Miller JC. Dietary micronutrient intake during pregnancy is a function of carbohydrate quality. Am J Clin Nutr 2015; 102:626-32. [PMID: 26178724 DOI: 10.3945/ajcn.114.104836] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 06/15/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Despite normal gestational weight gain, dietary studies in pregnant women show intakes below the recommendations for energy and micronutrients. OBJECTIVE This study compared changes in dietary intake from the second to third trimester with emphasis on energy intake and carbohydrate quality. DESIGN These post hoc analyses were based on 566 women participating in the Pregnancy and Glycemic Index Outcomes study, a randomized controlled trial comparing the effect of low-glycemic index (GI) dietary advice with healthy eating advice on selected pregnancy outcomes. With the use of multilevel mixed-regression analysis, changes in total energy intake, starch, sugar, fiber intake, GI, and glycemic load (GL) were correlated with intake of different micronutrients. RESULTS Energy intake decreased in the third trimester, and most women did not meet the national recommended amounts for iron, folate, and dietary fiber from food sources alone. After adjustment for age, ethnicity, prepregnancy body mass index, and intervention group, change in energy intake was positively related to change in intake of all micronutrients (P < 0.001). GI, GL, and starch intake were inversely related to micronutrient intake (P < 0.001), whereas higher total sugars predicted higher intake (P < 0.001). Associations with dietary fiber were inconsistent. CONCLUSIONS Normal pregnancy can be associated with a decline in energy and micronutrient intake from diet. Low dietary GI and GL were the best predictors of a favorable micronutrient profile. This trial was registered at www.anzctr.org.au as ACTRN12610000174088.
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Affiliation(s)
- Janina Goletzke
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany; School of Molecular Bioscience and
| | - Anette E Buyken
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany
| | | | - Robert G Moses
- Illawarra Shoalhaven Local Health District Wollongong, Wollongong, Australia
| | - Jennie C Brand-Miller
- School of Molecular Bioscience and Charles Perkins Centre, University of Sydney, Sydney, Australia; and
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19
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Augustin LSA, Kendall CWC, Jenkins DJA, Willett WC, Astrup A, Barclay AW, Björck I, Brand-Miller JC, Brighenti F, Buyken AE, Ceriello A, La Vecchia C, Livesey G, Liu S, Riccardi G, Rizkalla SW, Sievenpiper JL, Trichopoulou A, Wolever TMS, Baer-Sinnott S, Poli A. Glycemic index, glycemic load and glycemic response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC). Nutr Metab Cardiovasc Dis 2015; 25:795-815. [PMID: 26160327 DOI: 10.1016/j.numecd.2015.05.005] [Citation(s) in RCA: 387] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 05/08/2015] [Accepted: 05/08/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS The positive and negative health effects of dietary carbohydrates are of interest to both researchers and consumers. METHODS International experts on carbohydrate research held a scientific summit in Stresa, Italy, in June 2013 to discuss controversies surrounding the utility of the glycemic index (GI), glycemic load (GL) and glycemic response (GR). RESULTS The outcome was a scientific consensus statement which recognized the importance of postprandial glycemia in overall health, and the GI as a valid and reproducible method of classifying carbohydrate foods for this purpose. There was consensus that diets low in GI and GL were relevant to the prevention and management of diabetes and coronary heart disease, and probably obesity. Moderate to weak associations were observed for selected cancers. The group affirmed that diets low in GI and GL should always be considered in the context of diets otherwise understood as healthy, complementing additional ways of characterizing carbohydrate foods, such as fiber and whole grain content. Diets of low GI and GL were considered particularly important in individuals with insulin resistance. CONCLUSIONS Given the high prevalence of diabetes and pre-diabetes worldwide and the consistency of the scientific evidence reviewed, the expert panel confirmed an urgent need to communicate information on GI and GL to the general public and health professionals, through channels such as national dietary guidelines, food composition tables and food labels.
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Affiliation(s)
- L S A Augustin
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.
| | - C W C Kendall
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada; Department of Nutritional Science, University of Toronto, Toronto, Canada; University of Saskatchewan, Saskatoon, Canada
| | - D J A Jenkins
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada; Department of Nutritional Science, University of Toronto, Toronto, Canada
| | - W C Willett
- Department of Nutrition, Harvard School of Public Health, Boston, USA
| | - A Astrup
- Department of Nutrition, Exercise and Sports (NEXS), Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - A W Barclay
- Glycemic Index Foundation, Sydney, Australia
| | - I Björck
- Food for Health Science Centre, Lund University, Lund, Sweden
| | - J C Brand-Miller
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia
| | - F Brighenti
- Department of Food Sciences, University of Parma, Parma, Italy
| | - A E Buyken
- Department of Nutritional Epidemiology, University of Bonn, Bonn, Germany
| | - A Ceriello
- Institut d' Investigación Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomedica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Barcelona, Spain
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - G Livesey
- Independent Nutrition Logic, Wymondham, UK
| | - S Liu
- Department of Epidemiology and Medicine, Brown University, Providence, USA
| | - G Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - S W Rizkalla
- Institute Cardiometabolism and Nutrition (ICAN), University Pierre et Marie Curie, Pitié Salpêtrière Hospital, Paris, France; National Institute of Health and Medical Research (INSERM), University Pierre et Marie Curie and Pitié Salpêtrière Hospital, Paris, France
| | - J L Sievenpiper
- Department of Nutritional Science, University of Toronto, Toronto, Canada
| | - A Trichopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - T M S Wolever
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada; Department of Nutritional Science, University of Toronto, Toronto, Canada
| | | | - A Poli
- Nutrition Foundation of Italy, Milan, Italy
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20
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Sánchez-Tainta A, Zazpe I, Bes-Rastrollo M, Salas-Salvadó J, Bullo M, Sorlí JV, Corella D, Covas MI, Arós F, Gutierrez-Bedmar M, Fiol M, de la Corte FG, Serra-Majem L, Pinto X, Schröeder H, Ros E, López-Sabater MC, Estruch R, Martínez-González MA. Nutritional adequacy according to carbohydrates and fat quality. Eur J Nutr 2015; 55:93-106. [PMID: 25616935 DOI: 10.1007/s00394-014-0828-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 12/23/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the association between carbohydrate quality, fat quality or adherence to the Mediterranean diet and intake adequacy of 19 micronutrients in the PREDIMED (PREvención con DIeta MEDiterránea) trial, a multicenter, randomized, controlled, parallel group and primary prevention trial conducted in Spain. METHODS We assessed baseline dietary intake of 6,542 elderly subjects at high cardiovascular risk through a validated food frequency questionnaire (FFQ) and a validated 14-item Mediterranean diet (Med-diet) score. We used a multidimensional carbohydrate quality index (CQI) using four criteria and a fat quality index (FQI) according to the ratio (MUFA + PUFA)/(SFA + TFA). The probability of intake adequacy was calculated comparing the intakes to DRI, and also using the probabilistic approach. Absolute and adjusted probability of having inadequate intake for either ≥6 DRI or ≥8 DRI were estimated to assess nutritional adequacy according to quintiles of each index. RESULTS The lowest prevalence of inadequate micronutrient intake (≥8 DRI) was found in the highest quintile of CQI or Med-diet score, and in the lowest quintile of FQI (adjusted fold risk: 1.4, 3.4 and 10.2 respectively in comparison with the lowest quintile). P for trend <0.001 in three multivariable models. A higher CQI or Med-Diet score and a lower FQI were significantly associated with a lower fold risk of unmet EAR values. CONCLUSIONS A multidimensional assessment of CQI can be a useful tool to evaluate the quality of carbohydrates. This score and a 14-item Med-diet score were positively related to overall micronutrient adequacy in elderly participants.
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Affiliation(s)
- Ana Sánchez-Tainta
- Department of Preventive Medicine and Public Health, School of Medicine-Clinica Universidad de Navarra, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.
| | - Itziar Zazpe
- Department of Preventive Medicine and Public Health, School of Medicine-Clinica Universidad de Navarra, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.
- Department of Nutrition and Food Sciences, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, School of Medicine-Clinica Universidad de Navarra, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
| | - Jordi Salas-Salvadó
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Human Nutrition Unit, Sant Joan Hospital, IISPV, Universitat Rovira i Virgili, Reus, Spain.
| | - Mónica Bullo
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Human Nutrition Department, University Rovira i Virgili, Reus, Spain.
| | - José Vicente Sorlí
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
- Primary Care Division, Valencia Institute of Health and Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Dolores Corella
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Department of Preventive Medicine, University of Valencia, Valencia, Spain.
| | - M Isabel Covas
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Cardiovascular Epidemiology Unit, Municipal Institute for Medical Research (IMIM), Barcelona, Spain.
| | - Fernando Arós
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Department of Cardiology, University Hospital Txagorritxu-University Hospital of Alava, Vitoria, Spain.
| | - Mario Gutierrez-Bedmar
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Department of Preventive Medicine and Public Health, University of Málaga, Málaga, Spain.
| | - Miquel Fiol
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Son Espases, Palma de Mallorca, Spain.
| | - F García de la Corte
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Primary Care Division of Sevilla, Department of Family Medicine, San Pablo Health Center, Sevilla, Spain.
| | - Lluis Serra-Majem
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
| | - Xavier Pinto
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.
| | - Helmut Schröeder
- IMIM-Hospital del Mar Medical Research Institute and CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain.
- Instituto de Salud Carlos III, Madrid, Spain.
| | - Emilio Ros
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Lipid Clinic, Department of Endocrinology and Nutrition, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain.
| | - M Carmen López-Sabater
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain.
| | - Ramón Estruch
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Department of Internal Medicine, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain.
| | - Miguel Angel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine-Clinica Universidad de Navarra, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
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21
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Association between dietary carbohydrate intake quality and micronutrient intake adequacy in a Mediterranean cohort: the SUN (Seguimiento Universidad de Navarra) Project. Br J Nutr 2014; 111:2000-9. [DOI: 10.1017/s0007114513004364] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Epidemiological research confirms that the prevalence of suboptimal micronutrient intakes across Europe is an emerging concern in terms of public health. The aim of the present study was to investigate the association between a new index of carbohydrate (CHO) quality and micronutrient intake adequacy in the ‘Seguimiento Universidad de Navarra (SUN)’ cohort. The baseline assessment extended from 1999 to March 2012. We assessed 16 841 participants who completed a validated 136-item semi-quantitative FFQ at baseline. We created a new index to evaluate CHO quality for the following four criteria: dietary fibre intake; glycaemic index; whole grains:total grains ratio; solid CHO:total CHO ratio. The subjects were classified into quintiles according to this index. We evaluated the intakes of Zn, I, Se, Fe, Ca, K, P, Mg, Cr and vitamins B1, B2, B3, B6, B12, C, A, D, E and folic acid. The probability of intake adequacy was evaluated using the estimated average requirement cut-point approach and the probabilistic approach. Logistic regression analysis was used to assess the nutritional adequacy according to the CHO quality index (CQI). Participants in the highest quintile of CQI were found to have the lowest prevalence of inadequacy. A higher quality of CHO intake was found to be associated with a lower risk of nutritional inadequacy in comparison with the lowest quintile of CQI (adjusted OR 0·06, 95 % CI 0·02, 0·16;Pfor trend < 0·001). A higher CQI was found to be strongly associated with better micronutrient intake adequacy in the young Mediterranean cohort, stressing the importance of focusing nutritional education not only on CHO quantity, but also on quality.
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Glycemic index claims on food labels: review of Health Canada's evaluation. Eur J Clin Nutr 2013; 67:1229-33. [DOI: 10.1038/ejcn.2013.193] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 09/05/2013] [Indexed: 11/08/2022]
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Camilleri GM, Verger EO, Huneau JF, Carpentier F, Dubuisson C, Mariotti F. Plant and animal protein intakes are differently associated with nutrient adequacy of the diet of French adults. J Nutr 2013; 143:1466-73. [PMID: 23864509 DOI: 10.3945/jn.113.177113] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The sustainability of dietary plant and animal protein consumption is an important issue, but few data are available to ascertain the health-related impact of animal and plant protein intake. The objective was to study the relationships between animal and plant protein intake and diet quality, as reflected by an integrated index of nutrient adequacy. Using data on 1912 adults from the French Individual and National Consumption Survey 2 (2006-2007), we assessed diet quality by using the PANDiet, a unique score combining 35 probabilities of having an adequate nutrient intake, and used multiple regression analysis to study the relationship with intakes of plant, animal, and related food source proteins. After adjustments for intakes of energy, alcohol, and protein from other sources and sociodemographic factors, plant protein intake was positively associated with the PANDiet, irrespective of sex (β = 0.50, P < 0.0001). By contrast, total and animal protein intakes were differently associated with the PANDiet according to sex, with a positive association in women (β = 0.07 and β = 0.08, respectively; P < 0.01) and an inverse association in men (β = -0.07 and β = -0.05, respectively; P < 0.01). The relationships between the PANDiet and intakes of protein from animal food sources varied: for instance, associations were inverse for red meat and poultry in men but not in women, whereas irrespective of sex, they were positive for fish, milk, and yogurt and inverse for processed meat, cheese, and eggs. These findings show that plant protein is a robust marker of a healthy diet, whereas total animal protein includes different subtypes of animal protein that largely vary in their relationship with diet quality. These data could help refine protein recommendations from a qualitative and dietary standpoint.
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Affiliation(s)
- Géraldine M Camilleri
- AgroParisTech, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, Paris, France
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Penaforte FR, Japur CC, Pigatto LP, Chiarello PG, Diez-Garcia RW. Short-term impact of sugar consumption on hunger and ad libitum food intake in young women. Nutr Res Pract 2013; 7:77-81. [PMID: 23610598 PMCID: PMC3627933 DOI: 10.4162/nrp.2013.7.2.77] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 10/09/2012] [Accepted: 12/11/2012] [Indexed: 11/04/2022] Open
Abstract
The hypothesis of this study was that greater sugar consumption at breakfast promotes a stronger sensation of hunger and a later increase in energy consumption. The objective was to assess the relation between sugar consumption in a meal and the subsequent sensations of hunger and ad libitum food consumption. Sixteen women consumed a breakfast accompanied by 2 drinks sweetened ad libitum with sugar. After 3 h, a lunch was offered to evaluate ad libitum food consumption. During the period from breakfast to lunch, hunger sensations were evaluated at 30 min intervals. Women were divided according to the median amount of sugar used to sweeten the breakfast drinks (20 g). The group who consumed sugar above the median showed a greater hunger sensation in the preprandial period, and a greater ad libitum intake at lunch (390 ± 130 g × 256 ± 67 g, P = 0.002), compared to the group who had a lower sugar consumption. The amount of sugar consumed at breakfast was correlated positively with the sensation of preprandial hunger and food intake at lunch. We concluded that foods with a high glycemic index can modulate the appetite within a short period of time.
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Affiliation(s)
- Fernanda Ro Penaforte
- Laboratory of Eating Practices and Behavior (PratiCA), Course of Nutrition and Metabolism, University of São Paulo, Ribeirão Preto, SP, Brazil. ; Department of Nutrition, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
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Louie JCY, Markovic TP, Ross GP, Foote D, Brand-Miller JC. Higher glycemic load diet is associated with poorer nutrient intake in women with gestational diabetes mellitus. Nutr Res 2013; 33:259-65. [DOI: 10.1016/j.nutres.2013.02.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 02/11/2013] [Accepted: 02/19/2013] [Indexed: 01/17/2023]
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Haghighatdoost F, Azadbakht L. Dietary treatment options for depression among diabetic patient, focusing on macronutrients. J Diabetes Res 2013; 2013:421832. [PMID: 24199205 PMCID: PMC3806238 DOI: 10.1155/2013/421832] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 08/28/2013] [Accepted: 08/29/2013] [Indexed: 01/02/2023] Open
Abstract
There is a bidirectional adverse association between diabetes and depression. The odds for experiencing depressive symptoms in diabetic patients are two times more than nondiabetic persons, and depression is an independent predictor for the onset of diabetes. However, depression has been approximately unrecognized and untreated in two-thirds of diabetic patients, which may lead to worsened diabetes complications. A cornerstone strategy for managing depression among diabetic patients is the use of diet to improve both health problems. Because of similar pathophysiology for chronic diseases and depression, it seems that similar dietary recommendations could be useful. However, few studies have been conducted among diabetic patients. Regarding the complications of diabetes such as renal diseases and coronary heart diseases, the proper range of various macronutrients should be clarified in depressed diabetic patients as well as the proper type of each macronutrient. In this paper, we reviewed the available data on the treatment of depression in diabetic patients.
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Affiliation(s)
- Fahimeh Haghighatdoost
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 21871, Iran
| | - Leila Azadbakht
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 21871, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan 21871, Iran
- *Leila Azadbakht:
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How can diet influence the risk of stroke? Int J Hypertens 2012; 2012:763507. [PMID: 22693656 PMCID: PMC3369476 DOI: 10.1155/2012/763507] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 03/20/2012] [Accepted: 04/04/2012] [Indexed: 02/07/2023] Open
Abstract
Cerebrovascular diseases are the second cause of mortality in the world, and hypertension is considered a main risk factor for occurrence of stroke. The mechanisms responsible for the increased stroke risk remain unclear. However, dietary interventions have been applied in the management and treatment of their risk factors, which include increased blood pressure levels, obesity, diabetes, and dyslipidemia. Further studies should be conducted to assess the effects of carotenoids, flavonoids, n-3 polyunsaturated fats, and lower salt and high glycemic index intake in risk of stroke.
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