Glycemic load, glycemic index, and body mass index in Spanish adults

Association between quality and quantity of carbohydrate intake with selected anthropometric indices among primary school girls in Kerman city, Iran: a cross-sectional study

BACKGROUND

The school-age is a crucial period of physical and cognitive growth, which requires an assessment of dietary intake and its influence on body weight and height. This study aims to determine the association between the quality and quantity of carbohydrate intake with selected anthropometric indices in primary school girls in Kerman City, Iran.

METHODS

This cross-sectional study was conducted on 330 primary school girls ages 6-12 years in Kerman. We used a validated and reliable dish-based 185-item food frequency questionnaire to evaluate people's food intake. We assessed the amount of carbohydrates in children's diets as the percentage of daily calories and grams per day. We used dietary fiber intake (grams/day), the glycemic load, the ratio of whole grain to total grain, and the ratio of solid carbohydrates to total carbohydrates to assess carbohydrate quality. Height, weight, and arm circumference were measured. We calculated body mass index (BMI) by dividing the weight in kilograms by the height in centimeters squared. We used the World Health Organization z-scores charts for girls 5 to 19 years old to assess z-scores for BMI-for-age (BAZ), height-for-age (HAZ), and weight-for-age (WAZ). Socioeconomic status and physical activity were assessed. We used ANOVA and ANCOVA statistical tests to assess the association between anthropometric indices and carbohydrate quantity and quality parameters.

RESULTS

Participants with the highest amount of carbohydrate intake had significantly higher anthropometric indices, including arm circumference, BMI-for-age z score (BAZ), and Height-for-age z score (HAZ) (p < 0.001, p < 0.001, and p = 0.009, respectively). With the increase in glycemic load (GL) and dietary fiber intake, anthropometric indices including arm circumference (GL: p < 0.001, Fiber: p < 0.001), BAZ (GL: p < 0.001, Fiber: P < 0.001), and HAZ (GL: P = 0.009, Fiber: p < 0.001) increased significantly.

CONCLUSIONS

We concluded that there was a positive association between the amount of carbohydrate intake and anthropometric indices (MUAC, BAZ, and HAZ). Also, with the increase in glycemic load and dietary fiber intake, the anthropometric indices including MUAC, BAZ, and HAZ increased.

Glycemic load, but not glycemic index, is associated with an increased risk of ovarian cancer: A systematic review and meta-analysis

The association between glycemic index (GI),glycemic load (GL) and ovarian cancer risk remains unclear. Carbohydrate intake promotes insulin secretion, leading to cell proliferation and invasion. We hypothesized that high GI and GL intake may increase ovarian cancer risk. Therefore, we conducted a meta-analysis after systematically searching PubMed, Embase, Web of Science, and Cochrane Library from inception to December 2022. Fixed- or random-effect models calculated the pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs). Subgroup, sensitivity, publication bias analysis, and dose-response analysis were performed. Nine original studies were included, involving 4716 cases and 119,960 controls. No significant association was observed between GI or GL and ovarian cancer risk (GI: RR = 1.02 [95% CI, 0.83-1.26]; GL: RR = 1.11 [95% CI, 0.84-1.47]). Subgroup analysis suggested the results were not significantly modified by any group. Sensitivity analysis identified the sources of heterogeneity. No publication bias was observed. A linear positive dose-response relationship was observed between dietary GL and ovarian cancer risk after removing heterogeneous sources (RR = 1.11 [95% CI, 1.05-1.17], I2 = 32.9%, P = .23 at 50 U/d; RR = 1.04 [95% CI, 1.02-1.07], I2 = 19.1%, P = .29 at 20 U/d). These outcomes suggest that high dietary GL, but not GI, is associated with significantly increased ovarian cancer risk. Thus, sufficient intake of a low dietary GL is important for reducing ovarian cancer risk.

Position statement on nutrition therapy for overweight and obesity: nutrition department of the Brazilian association for the study of obesity and metabolic syndrome (ABESO-2022)

Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual's global health. The main diet-related causes associated with excess weight are the high consumption of ultraprocessed foods, which are high in fats, sugars, and have high energy density; increased portion sizes; and low intake of fruits, vegetables, and grains. In addition, some situations negatively interfere with the weight loss process, such as fad diets that involve the belief in superfoods, the use of teas and phytotherapics, or even the avoidance of certain food groups, as has currently been the case for foods that are sources of carbohydrates. Individuals with obesity are often exposed to fad diets and, on a recurring basis, adhere to proposals with promises of quick solutions, which are not supported by the scientific literature. The adoption of a dietary pattern combining foods such as grains, lean meats, low-fat dairy, fruits, and vegetables, associated with an energy deficit, is the nutritional treatment recommended by the main international guidelines. Moreover, an emphasis on behavioral aspects including motivational interviewing and the encouragement for the individual to develop skills will contribute to achieve and maintain a healthy weight. Therefore, this Position Statement was prepared based on the analysis of the main randomized controlled studies and meta-analyses that tested different nutrition interventions for weight loss. Topics in the frontier of knowledge such as gut microbiota, inflammation, and nutritional genomics, as well as the processes involved in weight regain, were included in this document. This Position Statement was prepared by the Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), with the collaboration of dietitians from research and clinical fields with an emphasis on strategies for weight loss.

The Burden of Carbohydrates in Health and Disease

Foods high in carbohydrates are an important part of a healthy diet, since they provide the body with glucose to support bodily functions and physical activity. However, the abusive consumption of refined, simple, and low-quality carbohydrates has a direct implication on the physical and mental pathophysiology. Then, carbohydrate consumption is postulated as a crucial factor in the development of the main Western diseases of the 21st century. We conducted this narrative critical review using MedLine (Pubmed), Cochrane (Wiley), Embase, and CinAhl databases with the MeSH-compliant keywords: carbohydrates and evolution, development, phylogenetic, GUT, microbiota, stress, metabolic health, consumption behaviors, metabolic disease, cardiovascular disease, mental disease, anxiety, depression, cancer, chronic kidney failure, allergies, and asthma in order to analyze the impact of carbohydrates on health. Evidence suggests that carbohydrates, especially fiber, are beneficial for the well-being and growth of gut microorganisms and consequently for the host in this symbiotic relationship, producing microbial alterations a negative effect on mental health and different organic systems. In addition, evidence suggests a negative impact of simple carbohydrates and refined carbohydrates on mood categories, including alertness and tiredness, reinforcing a vicious circle. Regarding physical health, sugar intake can affect the development and prognosis of metabolic disease, as an uncontrolled intake of refined carbohydrates puts individuals at risk of developing metabolic syndrome and subsequently developing metabolic disease.

Interaction of MC4R rs17782313 variants and dietary carbohydrate quantity and quality on basal metabolic rate and general and central obesity in overweight/obese women: a cross-sectional study

BACKGROUND

Recent studies have shown that dietary carbohydrate quantity and quality as well as genetic variants may contribute to determining the metabolic rate and general and central obesity. This study aimed to examine interactions between melanocortin 4 receptor gene (MC4R) rs17782313 and dietary carbohydrate intake, glycemic index (GI), and glycemic load (GL) on body mass index (BMI), waist circumferences (WC), basal metabolic rate (BMR), and BMR/kg in overweight/obese women.

METHODS

A total of 282 Iranian women (BMI ≥ 25) aged 18-56 years were enrolled in this cross-sectional study. All participants were assessed for blood parameters, body composition, BMR, and dietary intake. Dietary carbohydrate intake, GI, and GL were determined using a valid, reliable 147-item food frequency questionnaire. MC4R rs17782313 was genotyped by the restriction fragment length polymorphism (PCR-RFLP) method.

RESULTS

After adjustment for age and energy intake, significant interactions were observed between carbohydrate intake and MC4R rs17782313 in terms of BMI (P Interaction = 0.007), WC (P Interaction = 0.02), and BMR/kg (P Interaction = 0.003) in this way that higher carbohydrate intake, compared with lower intake, was associated with an increase in BMI and WC for individuals with C allele carriers (TC + CC genotypes), while related to an increase in BMR/kg for those carrying the TT genotype. No significant interaction was found between MC4R rs17782313 and GI and GL on BMI, WC, BMR/kg, and BMR.

CONCLUSIONS

Interactions between the MC4R rs17782313 and carbohydrate intake probably can have an effect on BMI, WC, and BMR/kg in overweight/obese women.

Perspective: Does Glycemic Index Matter for Weight Loss and Obesity Prevention? Examination of the Evidence on "Fast" Compared with "Slow" Carbs

High-glycemic index (high-GI) foods (so-called fast carbs) have been hypothesized to promote fat storage and increase risk of obesity. To clarify whether dietary GI impacts body weight, we searched PubMed and the Cochrane Database of Systematic Reviews for observational studies reporting associations between BMI and dietary GI, and for meta-analyses of randomized controlled trials (RCTs) comparing low-GI and high-GI diets for weight loss. Data on 43 cohorts from 34 publications, totaling 1,940,968 adults, revealed no consistent differences in BMI when comparing the highest with the lowest dietary GI groups. In the 27 cohort studies that reported results of statistical comparisons, 70% showed that BMI was either not different between the highest and lowest dietary GI groups (12 of 27 cohorts) or that BMI was lower in the highest dietary GI group (7 of 27 cohorts). Results of 30 meta-analyses of RCTs from 8 publications demonstrated that low-GI diets were generally no better than high-GI diets for reducing body weight or body fat. One notable exception is that low-GI diets with a dietary GI at least 20 units lower than the comparison diet resulted in greater weight loss in adults with normal glucose tolerance but not in adults with impaired glucose tolerance. While carbohydrate quality, including GI, impacts many health outcomes, GI as a measure of carbohydrate quality appears to be relatively unimportant as a determinant of BMI or diet-induced weight loss. Based on results from observational cohort studies and meta-analyses of RCTs, we conclude that there is scant scientific evidence that low-GI diets are superior to high-GI diets for weight loss and obesity prevention.

Macronutrient Determinants of Obesity, Insulin Resistance and Metabolic Health

Obesity caused by the overconsumption of calories has increased to epidemic proportions. Insulin resistance is often associated with an increased adiposity and is a precipitating factor in the development of cardiovascular disease, type 2 diabetes, and altered metabolic health. Of the various factors contributing to metabolic impairments, nutrition is the major modifiable factor that can be targeted to counter the rising prevalence of obesity and metabolic diseases. However, the macronutrient composition of a nutritionally balanced "healthy diet" are unclear, and so far, no tested dietary intervention has been successful in achieving long-term compliance and reductions in body weight and associated beneficial health outcomes. In the current review, we briefly describe the role of the three major macronutrients, carbohydrates, fats, and proteins, and their role in metabolic health, and provide mechanistic insights. We also discuss how an integrated multi-dimensional approach to nutritional science could help in reconciling apparently conflicting findings.

An optimal glycemic load range is better for reducing obesity and diabetes risk among middle-aged and elderly adults

Background

Due to the lack of evidence, advice pertaining to glycemic load (GL) can be misleading. Does the excessive restriction of GL, mostly through an extreme reduction in carbohydrate intake, result in a relatively high intake of fat and protein and result in overweight and obesity? This study was performed to initially explore the optimal GL range.

Methods

A cross-sectional study involving 2029 participants aged 40 years or older in Guangzhou, China was conducted. Participants were divided into four groups according to cluster analysis. Dietary data were assessed using a previously validated 3-day food record.

Results

Instead of participants with the highest [cluster 1, median (interquartile ranges) GL was 112(107–119)/1000 kcal] and the lowest GL intake [cluster 4, 90(82–96)/1000 kcal], those with moderate GL intakes [clusters 2 and 3, 93(85–102) and 93(85–99)/1000 kcal, respectively] had a lower prevalence of overweight, obesity and diabetes. In addition, clusters 2 and 3 were more consistent with the macronutrient intake reference with adequate micronutrient intake. Therefore, the optimal GL range was determined to be (85–100)/1000 kcal, rather than “lower is better”.

Conclusions

Reducing the GL intake to prevent diabetes deserves more attention in the context of a balanced diet. An appropriate GL may be better than excessive restriction.

Breakfast and dinner insulin index and insulin load in relation to overweight in children and adolescents

PURPOSE

Hyperinsulinemia is related to the development of several chronic diseases, particularly obesity. Therefore, this study aimed to examine the association between the insulinemic potential of both total diet and meals, measured by the glycemic index (GI), glycemic load (GL), insulin index (II), and insulin load (IL), and overweight risk among children and adolescents.

METHODS

This cross-sectional study was conducted on 205 overweight and 146 normal-weight participants aged 6-18 years. Overweight was defined as body mass index ≥ 85th percentile of Turkish growth-reference data. Through the use of standard methodology, dietary and meal GI, GL, II, and IL were derived from dietary data collected via a 3-day dietary record. Associations were investigated using multivariable-adjusted regression analysis.

RESULTS

When controlling for potential covariates, a greater dietary II (OR 2.69, 95% CI 1.28, 5.68) and IL (OR 5.22, 95% CI 2.39, 11.38), as well as GL (OR 3.89, 95% CI 1.77, 8.56), was strongly associated with higher odds of overweight (both P_{for trend} < 0.001). Furthermore, breakfast GL (OR 4.87, 95% CI 2.15, 11.01), II (OR 3.88, 95% CI 1.79, 8.39), IL (OR 4.93, 95% CI 2.20, 11.05) and dinner GL (OR 2.39, 95% CI 1.10, 5.20), II (OR 3.81, 95% CI 1.73, 8.41), IL (OR 3.63, 95% CI 1.67, 7.91) were found to be a significant independent predictor of overweight (all P_{for trend} < 0.001) in pediatric population.

CONCLUSION

Our results suggest that dietary insulin demand, particularly for breakfast and dinner, was independently associated with overweight in children and adolescents. These findings may shed light on the relevance of considering meal insulin demand while developing dietary strategies in this population.

Dietary glycemic index, glycemic load, and lung cancer risk: A case-control study in Los Angeles County

BACKGROUND

Although there is some evidence of positive associations between both the glycemic index (GI) and glycemic load (GL) with cancer risk, the relationships with lung cancer risk remain largely unexplored. We evaluated the associations between GI and GL with lung cancer.

METHODS

The analyses were performed using data from a population-based case-control study recruited between 1999 and 2004 in Los Angeles County. Dietary factors were collected from 593 incident lung cancer cases and 1026 controls using a modified food frequency questionnaire. GI and GL were estimated using a food composition table. Adjusted odds ratios (ORs) and 95 % confidence intervals (CI) were estimated using unconditional logistic regression adjusting for potential confounders.

RESULTS

Dietary GI was positively associated with lung cancer (OR for upper vs. lower tertile = 1.62; 95 % CI: 1.17, 2.25). For histologic subtypes, positive associations were observed between GI and adenocarcinoma (OR for upper vs. lower tertile = 1.82; 95 % CI: 1.22, 2.70) and small cell carcinoma (OR for upper vs. lower tertile = 2.68; 95 % CI: 1.25, 5.74). No clear association between GL and lung cancer was observed.

CONCLUSION

These findings suggest that high dietary GI was associated with increased lung cancer risk, and the positive associations were observed for both lung adenocarcinoma and small cell lung carcinoma. Replication in an independent dataset is merited for a broader interpretation of our results.

Dietary fat quantity and quality in relation to general and abdominal obesity in women: a cross-sectional study from Ghana

BACKGROUND

Although relationships between obesity and total fat and fat types have been widely examined, the associations between the relative proportions of fatty acids calculated in the form of indices and obesity/overweight are lacking. The objective of this study was to assess associations between dietary fat quality indices and odds of obesity/overweight in women from Ghana.

METHODS

In this cross-sectional study, dietary information was obtained using 24-h dietary recall. The odds of obesity were evaluated across quintiles of specific DFQ indices [atherogenicity index (AI), thrombogenic index (TI), hypo- and hypercholesterolemic fatty acids ratio (h/H), omega-3 to omega-6 polyunsaturated fatty acids ratio (∑ω-3/∑ω-6), polyunsaturated fatty acids/saturated fatty acids ratio (PSR), dietary lipophilic index (LI) and percentage of energy from total fat (TF)].

RESULTS

After adjustment for covariates, general obesity and overweight were inversely associated with ∑ω-3/∑ω-6 ratio (OR: 0.63; 95% CI: 0.24-1.63; P for trend (P) = 0.005) and positively with TI (4.14; 95% CI: 1.78-9.66; P = 0.01) and LI (2.49; 95% CI: 1.14-5.43; P = 0.01). The odds of abdominal obesity based on waist circumference (WC) were significantly higher among participants in the fifth quintile (Q) compared with those in the first Q of AI (1.24; 95% CI: 0.56-2.74; P = 0.01), TI (4.14; 95% CI: 1.78-9.66; P = 0.009), LI (2.11; 95% CI: 0.98-4.55; P = 0.02) and TF (1.59; 95% CI: (0.73-3.46; P = 0.003). Similarly, waist to height ratio (WHtR) was positively associated with AI (2.89; 95% CI: 1.32-6.31; P = 0.04), TI (2.65; 95% CI: 1.22-5.76; P = 0.03), LI (3.32; 95% CI: 1.52-7.28; P = 0.007) and TF (1.83; 95% CI: 0.85-3.93; P = 0.009).

CONCLUSION

There was an inverse association between ∑ω-3/∑ω-6 ratio and general obesity and WC. We also found positive associations between abdominal obesity and AI and TF. Furthermore, TI and LI showed positive relationships with both general and abdominal obesity. Therefore, intake of dietary fatty acids in favor of higher ratios of ∑ω-3/∑ω-6 may be important in obesity prevention.

Dietary glycaemic index, glycaemic load and head and neck cancer risk: a pooled analysis in an international consortium

High dietary glycaemic index (GI) and glycaemic load (GL) may increase cancer risk. However, limited information was available on GI and/or GL and head and neck cancer (HNC) risk. We conducted a pooled analysis on 8 case-control studies (4081 HNC cases; 7407 controls) from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) of HNC, and its subsites, from fixed- or mixed-effects logistic models including centre-specific quartiles of GI or GL. GI, but not GL, had a weak positive association with HNC (OR_{Q4 vs. Q1} = 1.16; 95% CI = 1.02–1.31). In subsites, we found a positive association between GI and laryngeal cancer (OR_{Q4 vs. Q1} = 1.60; 95% CI = 1.30–1.96) and an inverse association between GL and oropharyngeal cancer (OR_{Q4 vs. Q1} = 0.78; 95% CI = 0.63–0.97). This pooled analysis indicates a modest positive association between GI and HNC, mainly driven by laryngeal cancer.

Association between Dietary Glycaemic Index and Glycaemic Load and Adiposity Indices in Polycystic Ovary Syndrome

Objective: Obesity is a key contributor to metabolic and reproductive outcomes in polycystic ovary syndrome (PCOS). The role of the dietary glycemic index (GI) and load (GL), and adiposity has been debated and studies on PCOS are scarce. We aimed to compare the dietary GI and GL and several anthropometric measurements in PCOS and control women. The association between dietary GI and GL and adiposity indices was examined in this cross-sectional study.Methods and materials: A study population consisted of 65 previously diagnosed with PCOS and 65 healthy women. All participants underwent detailed anthropometric, dietary and physical activity evaluation and categorized based on GI and GL tertiles.Results: When dietary GL was adjusted for age, physical activity level (PAL), and duration of diagnosis, there was a statistically significant inverse association between dietary GL and waist/hip ratio (WHR) (OR: 0.136; 95% CI: 0.021-0.874; p = 0.036) in women with PCOS. Both dietary GI (OR: 8.869; 95% CI: 1.194-65.910; p = 0.033 for tertile 2 in adjustment model) and GL (OR: 7.200; 95% CI: 1.635-31.712; p = 0.009 for tertile 3 in crude model; OR: 5.801; 95% CI: 1.242-27.096; p = 0.025 for tertile 3 in adjustment model) positively associated with WHR in healthy subjects. Also, positive association was observed between dietary GI and waist/height ratio (WHtR) (OR: 0.229; 95% CI: 0.063-0.826; p = 0.024 for tertile 2; OR: 0.277; 95% CI: 0.078-0.988; p = 0.048 for tertile 3) in healthy controls, however after adjustment for age and PAL, statistical significance was lost (OR: 1.051; 95% CI: 0.152-7.261; p = 0.959 for tertile 2; OR: 1.522; 95% CI: 0.225-10.297; p = 0.667 for tertile 3).Conclusion: The results of this study consistent with the literature that PCOS is associated with increased adiposity indices. There was no association between dietary GI/GL and BMI, WC, WHtR, and ABSI but dietary GL was inversely associated WHR in PCOS patients.

Glycemic Index, Glycemic Load and Cancer Risk: An Updated Meta-Analysis

Diets high in glycemic index (GI) and glycemic load (GL) have been related to an increased risk of selected cancers, but additional quantification is required. We updated a systematic review and meta-analysis published in 2015 to May 2019 to provide quantitative information on GI/GL and cancer risk. Relative risks (RR) and the corresponding 95 % confidence intervals (CI) for the highest versus the lowest categories of GI and GL were extracted from selected studies and pooled using random-effects models. Twenty reports (>22,000 cancer cases) have become available after January 2015, and 15 were added to the meta-analyses by cancer sites, which considered a total of 88 investigations. The five additional reports were reviewed, but not included in the meta-analyses, since data were inadequate to be pooled. For hormone-related cancers, summary RRs for the highest versus lowest GI and GL intakes were moderately increased. They ranged from 1.04 (breast) to 1.12 (endometrium) for GI and from 1.03 (prostate) to 1.22 (ovary) for GL, of borderline significance. High GI was associated with small increased risks of colorectal (summary RR for GI: 1.20, 95% CI, 1.07–1.34—GL: 1.09, 95% CI, 0.97–1.22, 19 studies), bladder (GI: 1.25, 95% CI, 1.11–1.41—GL: 1.10, 95% CI, 0.85–1.42, four studies) and kidney cancers (GI: 1.16, 95% CI, 1.02–1.32—GL: 1.14, 95% CI, 0.81–1.60, five studies). GL was not significantly related to those cancer sites. Stomach, prostate and lung cancers were not associated with GI and GL. The present analysis, based on an updated comprehensive evaluation of the epidemiological literature, indicates moderate unfavorable effects of high versus low GI on colorectal, and possibly bladder and kidney cancers, and a possible moderate positive association between GL and endometrial cancer.

Dietary glycemic index and glycemic load in relation to general obesity and central adiposity among adults

BACKGROUND & AIMS

Although the association between dietary Glycemic Index (GI), Glycemic Load (GL) and general/abdominal obesity has extensively been examined, limited data are available in this regard in developing countries. The aim of this study was to examine the association between dietary GI and GL with general and abdominal obesity.

METHODS

This cross-sectional study was conducted among adults in Isfahan, Iran. Dietary GI and GL were assessed using a validated dish-based 106-item semi-quantitative food frequency questionnaire (DS-FFQ). Data regarding height, weight and waist circumference were collected using a self-reported questionnaire. Overweight or obesity was defined as body mass index ≥25 kg/m², and abdominal obesity was defined as waist circumference ≥80 cm for women and ≥94 cm for men.

RESULTS

There was no significant association between dietary GI and GL and general obesity. After adjustment for potential confounders, participants in the highest quintile of dietary GI had a higher chance for abdominal obesity (OR: 1.29; 95% CI: 1.01-1.64), compared with those in the lowest quintile. No significant association was observed between dietary GL and abdominal obesity. After adjustment for potential confounders, women in the top quintile of dietary GI had higher chance for abdominal obesity compared with those in the bottom quintile (OR: 1.48, 95% CI: 1.02-2.15). No significant association was found between dietary GI and abdominal obesity among men. We failed to find any significant association between dietary GI and general obesity in either gender [Comparing top vs. bottom quintiles, for men: OR: 0.97; 95% CI: 0.74-1.29 and for women: OR: 1.01; 95% CI: 0.75-1.40]. No significant association was found between dietary GL and general [for men: OR: 1.13; 95% CI: 0.85-1.49 and for women: OR: 1.01; 95% CI: 0.76-1.35], as well as abdominal obesity [for men: OR: 1.21; 95% CI: 0.88-1.67 and for women: OR: 1.25; 95% CI: 0.88-1.77].

CONCLUSIONS

We found a significant positive association between dietary GI and abdominal obesity. When we conducted analyses stratified by gender, we also observed such association in women, but not in men. No other significant associations were observed between dietary GI and GL with general or abdominal obesity.

Relevance of the Glycemic Index and Glycemic Load for Body Weight, Diabetes, and Cardiovascular Disease

Despite initial enthusiasm, the relationship between glycemic index (GI) and glycemic response (GR) and disease prevention remains unclear. This review examines evidence from randomized, controlled trials and observational studies in humans for short-term (e.g., satiety) and long-term (e.g., weight, cardiovascular disease, and type 2 diabetes) health effects associated with different types of GI diets. A systematic PubMed search was conducted of studies published between 2006 and 2018 with key words glycemic index, glycemic load, diabetes, cardiovascular disease, body weight, satiety, and obesity. Criteria for inclusion for observational studies and randomized intervention studies were set. The search yielded 445 articles, of which 73 met inclusion criteria. Results suggest an equivocal relationship between GI/GR and disease outcome. The strongest intervention studies typically find little relationship among GI/GR and physiological measures of disease risk. Even for observational studies, the relationship between GI/GR and disease outcomes is limited. Thus, it is unlikely that the GI of a food or diet is linked to disease risk or health outcomes. Other measures of dietary quality, such as fiber or whole grains may be more likely to predict health outcomes. Interest in food patterns as predictors of health benefits may be more fruitful for research to inform dietary guidance.

Association of lower body mass index with increased glycemic variability in patients with newly diagnosed type 2 diabetes: a cross-sectional study in China

Previous studies have indicated that the pathogenesis of diabetes differs between obese and lean patients. We investigated whether newly diagnosed Chinese diabetic patients with different body mass indices (BMIs) have different glycemic variability, and we assessed the relationship between BMI and glycemic variability. This was a cross-sectional study that included 169 newly diagnosed and drug-naïve type 2 diabetic patients (mean age, 51.33 ± 9.83 years; 110 men). The clinical factors and results of the 75-g oral glucose tolerance test were all recorded. Glycemic variability was assessed using continuous glucose monitoring. Compared with overweight or obese patients (BMI ≥ 24 kg/m2), underweight or normal-weight patients (BMI < 24 kg/m2) had higher levels of blood glucose fluctuation parameters, particularly in terms of mean amplitude of glycemic excursion (MAGE 6.64 ± 2.38 vs. 5.67 ± 2.05; P = 0.007) and postprandial glucose excursions (PPGEs) (PPGE at breakfast, 7.72 ± 2.79 vs. 6.79 ± 2.40, P = 0.028; PPGE at lunch, 5.53 ± 2.70 vs. 5.07 ± 2.40, P = 0.285; PPGE at dinner, 5.96 ± 2.24 vs. 4.87 ± 2.50, P = 0.008). BMI was negatively correlated with glycemic variability (r = −0.243, P = 0.002). On multiple linear regression analyses, BMI (β = −0.231, P = 0.013) and Insulin Secretion Sensitivity Index-2 (β = −0.204, P = 0.048) were two independent predictors of glycemic variability. In conclusion, lower BMI was associated with increased glycemic variability, characterized by elevated PPGEs, in newly diagnosed Chinese type 2 diabetic patients.

A Japanese diet with low glycaemic index and glycaemic load is associated with both favourable and unfavourable aspects of dietary intake patterns in three generations of women

Objective

Western studies have suggested cultural differences in food and nutrient intake patterns associated with dietary glycaemic index (GI) and glycaemic load (GL). Here, we conducted a cross-sectional study to examine the GI and GL of Japanese diets in relation to food and nutrient intakes.

Design

Dietary intake was assessed using a validated, self-administered, diet history questionnaire.

Setting

A total of thirty-five of forty-seven prefectures in Japan.

Subjects

Young (age 18 years), middle-aged (mean age 48 years) and older (mean age 74 years) Japanese women (n 3961, 3800 and 2202, respectively).

Results

Irrespective of age, a positive association with dietary GI was seen for white rice only, which contributed most (37–42 %) to the variation in dietary GI. Conversely, all other food groups (such as fruit and vegetable juice, dairy products, noodles and fruit) were negative predictors of dietary GI. For dietary GL, 95–96 % of variation was explained by carbohydrate-rich food groups, all of which were positive predictors of GL. After adjustment for potential confounding factors, only carbohydrate intake was positively associated with dietary GI and GL, irrespective of age. Conversely, dietary GI and GL were inversely associated with intakes of all other nutrients examined (including SFA and Na).

Conclusions

A low-GI and -GL diet, which was characterized principally by a low intake of white rice, was associated with both favourable (higher intakes of dietary fibre and key vitamins and minerals) and unfavourable (higher intakes of SFA and Na) aspects of dietary intake patterns in three generations of Japanese women.

Comparison of Dietary Intake between Polycystic Ovary Syndrome Women and Controls

Polycystic Ovary syndrome (PCOS) is a complicated endocrinopathy affecting women in reproductive age. The crucial role of obesity and insulin resistance in progression of metabolic and cardiovascular features of PCOS has been confirmed. Although it has been suggested that there is a possible association between dietary pattern and risk of PCOS, few studies investigating the diet composition of PCOS women. The aim of this study was to compare the dietary intakes between women with polycystic ovary syndrome (PCOS) and eumenorrheic non hirsute women. This was a case control study of 142 women with PCOS and 140 eumenorrheic non hirsute healthy age and BMI matched controls. We compared the dietary intakes of our study group using a validated food frequency questionnaire (FFQ), using T-test or Mann-Whitney to compare the means of two groups. One way Anova was used to compare the tertiles of GI and GL in each group and a two way ANOVA was used to compare between tertiles of GI-GL and groups. The results demonstrated that energy and macronutrient intakes in PCOS women compared to controls were similar. PCOS group consumed more food items with high glycemic index (p=0.042) and less legumes (P=0.026) and vegetables (p=0.037) than controls. Both groups in the highest tertile of glycemic load (GL) had higher body mass index and waist circumference. Considering the results of this study, it was concluded that PCOS women had a dietary pattern that was characterized by a higher consumption of high GI food items and lower legumes and vegetables.

Glycemic responses, appetite ratings and gastrointestinal hormone responses of most common breads consumed in Spain. A randomized control trial in healthy humans

The present study was carried out to determine the glycemic index (GI), glycemic load (GL), insulinemic index (InI), appetite ratings and postprandial plasma concentrations of gastrointestinal hormones related to the control of food intake after the ingestion of the five most common breads consumed in Spain with different compositions and manufacturing processes. Twenty-two healthy adults participated in a randomized crossover study. The breads tested were Ordinary, Precooked-Frozen, Candeal-flour, Alfacar whites and Wholemeal. All breads portions were calculated to supply 50 g of available carbohydrates. In addition, 50 g of glucose was used as a reference. A linear mixed-effects model was used to compare data calculated for all breads with glucose load. The GI value varied from 61 for the Wholemeal, to Alfacar 68, Ordinary 76, and 78 and 86 for the Precooked-Frozen and Candeal-flour breads, respectively. Wholemeal and Alfacar had lower GI than glucose. All tested breads had a lower GL (ranged 9 to 18) compared with glucose. Wholemeal GL was similar to Alfacar, but lower than the other white breads. InI were significantly lower for all breads (ranged 68 to 73) compared with glucose, and similar among them. The intake of the Wholemeal bread led to a higher release of gastric inhibitory polypeptide compared with the Ordinary and Precooked breads and to a higher release of pancreatic polypeptide compared with the Precooked-Frozen bread. All breads affected appetite ratings similarly. In conclusion, based on GL, the Wholemeal bread would be expected to exert a favorable glycemic response.

Glycemic load, glycemic index, bread and incidence of overweight/obesity in a Mediterranean cohort: the SUN project

BACKGROUND

To evaluate prospectively the relationship between white, or whole grain bread, and glycemic index, or glycemic load from diet and weight change in a Mediterranean cohort.

METHODS

We followed-up 9 267 Spanish university graduates for a mean period of 5 years. Dietary habits at baseline were assessed using a semi-quantitative 136-item food-frequency questionnaire. Average yearly weight change was evaluated according to quintiles of baseline glycemic index, glycemic load, and categories of bread consumption. We also assessed the association between bread consumption, glycemic index, or glycemic load, and the incidence of overweight/obesity.

RESULTS

White bread and whole-grain bread were not associated with higher weight gain. No association between glycemic index, glycemic load and weight change was found.White bread consumption was directly associated with a higher risk of becoming overweight/obese (adjusted OR (≥2 portions/day) versus (≤1 portion/week): 1.40; 95% CI: 1.08-1.81; p for trend: 0.008). However, no statistically significant association was observed between whole-grain bread, glycemic index or glycemic load and overweight/obesity.

CONCLUSIONS

Consumption of white bread (≥2 portions/day) showed a significant direct association with the risk of becoming overweight/obese.

Mediterranean diet pyramid: a proposal for Italian people

Bread was a staple in the traditional Mediterranean diet of the early 1960s, as well as nowadays; however, it was a stone ground sourdough bread in Nicotera and probably in the Greek cohorts of the Seven Countries Study. In the present review, the nutritional characteristics of this food are analyzed in relation to its protective effects on coronary heart disease, metabolic diseases and cancer. According to our traditions, cultural heritage and scientific evidence, we propose that only cereal foods with low glycemic index (GI) and rich in fiber have to be placed at the base of the Mediterranean diet pyramid, whereas refined grains and high GI starchy foods have to be sited at the top.

Effect of a Mediterranean Diet Intervention on Dietary Glycemic Load and Dietary Glycemic Index: The PREDIMED Study

Objective. To compare the one year effect of two dietary interventions with MeDiet on GL and GI in the PREDIMED trial. Methods. Participants were older subjects at high risk for cardiovascular disease. This analysis included 2866 nondiabetic subjects. Diet was assessed with a validated 137-item food frequency questionnaire (FFQ). The GI of each FFQ item was assigned by a 5-step methodology using the International Tables of GI and GL Values. Generalized linear models were fitted to assess the relationship between the intervention group and dietary GL and GI at one year of follow-up, using control group as reference. Results. Multivariate-adjusted models showed an inverse association between GL and MeDiet + extra virgin olive oil (EVOO) group: β = −8.52 (95% CI: −10.83 to −6.20) and MeDiet + Nuts group: β = −10.34 (95% CI: −12.69 to −8.00), when comparing with control group. Regarding GI, β = −0.93 (95% CI: −1.38 to −0.49) for MeDiet + EVOO, β = −1.06 (95% CI: −1.51 to −0.62) for MeDiet + Nuts when comparing with control group. Conclusion. Dietary intervention with MeDiet supplemented with EVOO or nuts lowers dietary GL and GI.

The Effects of an Educational Self-Efficacy Intervention on Osteoporosis Prevention and Diabetes Self-Management Among Adults With Type 2 Diabetes Mellitus

Background:

Prevalence of osteoporosis (OP) is high among Chinese adults with diabetes. Assessment of OP and fracture risk as well as patient education should be included as part of the management of diabetes.

Purpose:

The purpose of this pilot study was to test the effectiveness of an educational self-efficacy intervention on knowledge about OP, dietary calcium intake, the importance of physical activity (PA), and glycemic control among Chinese adults with type 2 diabetes residing in Wuhan, China.

Method:

A quasi-experimental design with repeated measures was employed. Participants were assigned to either the intervention ( n = 23) or the control group ( n = 23). Intervention participants attended 6 weekly 1-hr educational sessions comprising presentations, demonstration, and discussions. Control participants received standard care. Data were collected via questionnaires at pre- and postintervention and at 3-month follow-up, and blood was drawn at preintervention and 3-month follow-up.

Results:

Participants in the intervention group had significant improvement in OP knowledge, F(2, 43) = 11.504, p < .001; OP self-efficacy, F(2, 43) = 6.915, p = .003; dietary calcium intake, F(2, 43) = 7.856, p = .002; level of PA, F(2, 43) = 4.787, p = .011; diabetes self-care activities, F(2, 43) = 14.009, p < .001; diabetes self-efficacy, F(2, 43) = 19.722, p < .001; and glycemic control (A1C level; t = 2.809, p = .010) compared to the control group at the 3-month follow-up.

Conclusion:

The results demonstrate the effectiveness of OP prevention education based on self-efficacy theory among Chinese adults with type 2 diabetes.

Dietary glycemic index is associated with less favorable anthropometric and metabolic profiles in polycystic ovary syndrome women with different phenotypes

OBJECTIVE

To compare glycemic index (GI) in the usual diet of polycystic ovary syndrome (PCOS) and control women and to investigate whether dietary GI is associated with body composition and anthropometric and metabolic variables across PCOS phenotypes.

DESIGN

Cross-sectional study.

SETTING

University hospital outpatient clinic.

PATIENT(S)

Sixty-one women with PCOS and 44 nonhirsute women with ovulatory cycles.

INTERVENTION(S)

Metabolic work-up, biochemical and hormonal assays, assessment of body composition and rest metabolic rate, physical activity (pedometer), and food consumption (food frequency questionnaire).

MAIN OUTCOME MEASURE(S)

GI, glycemic load, dietary intake, and hormone and metabolic profile in PCOS versus control and in PCOS women stratified by tertiles of GI and PCOS phenotype.

RESULT(S)

Mean age was 23.7 ± 6.3 years. Participants with PCOS had higher body fat percentage, fasting insulin, insulin resistance, lipid accumulation product, and androgen levels compared with control women. PCOS and control women in the highest tertile of GI had higher body mass index and waist circumference than those in the lowest tertile. Dietary GI was higher in the classic PCOS group. Obesity and this more severe PCOS phenotype explained 28.3% of variance in dietary GI.

CONCLUSION(S)

Dietary GI is increased in the classic PCOS phenotype and associated with a less favorable anthropometric and metabolic profile. Obesity and classic PCOS phenotype are age-independent predictors of higher dietary GI.

Associations of dietary glycaemic index and glycaemic load with food and nutrient intake and general and central obesity in British adults

Inconsistent associations between dietary glycaemic index (GI) and glycaemic load (GL) and body fatness may be partly due to differences in the underlying dietary patterns or energy under-reporting. In the present study, we examined the cross-sectional associations of dietary GI and GL with food and nutrient intake and general and central obesity, accounting for energy under-reporting. The subjects were 1487 British adults aged 19-64 years. Dietary intake was assessed using a 7 d weighed dietary record. Breads and potatoes were the positive predictive foods for dietary GI, while fruit, other cereals and dairy products were the negative predictors. These foods were similarly identified in the analysis of only acceptable reporters (AR; ratio of reported energy intake:estimated energy requirement within 0·665-1·335) and under-reporters (UR; ratio < 0·665). Dietary GL was closely correlated with carbohydrate intake. Multiple linear regression analyses showed that dietary GI was independently associated with a higher risk of general obesity (BMI ≥ 30 kg/m²) and central obesity (waist circumference ≥ 102 cm in men and ≥ 88 cm in women). Dietary GL was also associated with general (only women) and central obesity. Similarly, in the analysis of AR, the GI showed positive associations with general and central obesity, and, only in women, the GL showed positive associations with general and central obesity. Conversely, in the analysis of UR, the associations were generally weaker and many of them failed to reach statistical significance. In conclusion, we found independent positive associations of dietary GI and GL with general and central obesity in British adults.

Dietary glycemic index and glycemic load in relation to changes in body composition measures during adolescence: Northern Ireland Young Hearts Study

BACKGROUND

Epidemiologic evidence on the influence of dietary glycemic index (GI) and glycemic load (GL) on the development of obesity is limited.

OBJECTIVE

This prospective study examined the associations between dietary GI and GL and changes in body composition measures during adolescence.

DESIGN

In a representative sample of Northern Irish adolescents aged 12 years at baseline and 15 years at follow-up (n=426), dietary intake was assessed by a diet history interview. Body composition measures included body mass index (BMI; kg m(-2)), BMI z-score, sum of four skinfold thicknesses, percentage body fat, fat mass index (FMI; kg m(-2)) and fat-free mass index (kg m(-2)).

RESULTS

After adjustment for potential confounding factors, baseline GI was associated with increased change in FMI. Mean (95% confidence interval) values of changes in FMI according to tertiles of baseline GI were 0.41 (0.25, 0.57), 0.42 (0.26, 0.58) and 0.67 (0.51, 0.83) kg m(-2), respectively (P for trend=0.03). There was no significant association of baseline GI with changes in other body composition measures (P for trend≥0.054). Conversely, baseline GL showed no association with changes in any of the measures (P for trend≥0.41). Furthermore, changes in GI or GL were not associated with changes in any of the measures (P for trend≥0.16).

CONCLUSION

Dietary GI at age 12 years was independently associated with increased change in FMI between ages 12 and 15 years in a representative sample from Northern Ireland, whereas dietary GL showed no association with changes in any of the body composition measures examined.

Dietary glycaemic index and glycaemic load in relation to food and nutrient intake and indices of body fatness in British children and adolescents

The diversity of the associations of dietary glycaemic index (GI) and glycaemic load (GL) with dietary intake and body fatness observed in epidemiological studies may be partly due to the differences in underlying dietary intake patterns. We examined the cross-sectional associations of dietary GI and GL with food and nutrient intakes and indices of body fatness in 818 children aged 4–10 years and 818 adolescents aged 11–18 years in Britain, based on the data from the National Diet and Nutrition Survey. Dietary intake was assessed using a 7 d weighed dietary record. Overweight was defined as BMI ≥ 85th percentile of the age- and sex-specific British growth reference data. Central obesity was defined as waist:height ratio (WHtR) ≥ 0·5 (adolescents only). Breads, breakfast cereals and potatoes were the positive predictive food groups for dietary GI, while dairy products, fruit juice, other cereals and fruit were the negative predictors. Dietary GL was closely correlated with carbohydrate intake. Dietary GI showed no associations with overweight or central obesity. Conversely, dietary GL showed an independent association with a higher risk of overweight in children and a higher risk of central obesity (but not overweight) in adolescents. However, dietary GI and GL were not associated with BMI z-score in children and adolescents or WHtR in adolescents. In conclusion, the present study showed that dietary GL was independently associated with overweight in children and with central obesity in adolescents. Nevertheless, given no associations when body fatness measures were treated as continuous variables, the results must be interpreted cautiously.

The association between dietary intake of white rice and central obesity in obese adults

BACKGROUND

Obesity has become one of the most important and the fastest growing health and nutritional problem, not only in developed but also in developing countries. White rice consumption causes an increase in postprandial blood glucose and could be a probable reason for obesity. This study was conducted to investigate the association between intake of white rice and central obesity in an Iranian population.

METHODS

In the present cross-sectional study, a total of 212 subjects were selected based on convenience non-random sampling procedure. Expert interviewers collected socio-demographic and dietary intake data by a face to face method.

RESULTS

We failed to find any significant association between frequency of white rice consumption and body mass index or waist circumference, neither in crude model nor in adjusted models.

CONCLUSION

Although there was no significant association between white rice intake and obesity factors in our study, more studies are necessary with larger population and better design.

Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803

BACKGROUND

The influence of glycemic load and related measures on survival among colon cancer patients remains largely unknown.

METHODS

We conducted a prospective, observational study of 1011 stage III colon cancer patients reporting dietary intake during and 6 months after participation in an adjuvant chemotherapy trial. We examined the influence of glycemic load, glycemic index, fructose, and carbohydrate intakes on cancer recurrence and mortality using Cox proportional hazards regression; all tests of statistical significance were two-sided.

RESULTS

Stage III colon cancer patients in the highest quintile of dietary glycemic load experienced an adjusted hazard ratio (HR) for disease-free survival of 1.79 (95% confidence interval [CI] = 1.29 to 2.48), compared with those in the lowest quintile (P (trend) across quintiles <.001). Increased glycemic load was associated with similar detriments in recurrence-free (P (trend) across quintiles <.001) and overall survival (P (trend) across quintiles <.001). These associations differed statistically significant by body mass index (BMI) (P (interaction) =.01). Whereas glycemic load was not associated with disease-free survival in patients with BMI < 25kg/m(2), higher glycemic load was statistically significant associated with worse disease-free survival among overweight or obese participants (BMI ≥ 25kg/m(2); HR = 2.26; 95% CI = 1.53 to 3.32; P (trend) across quintiles <.001). Increasing total carbohydrate intake was similarly associated with inferior disease-free, recurrence-free, and overall survival (P (trend) across quintiles <.001).

CONCLUSION

Higher dietary glycemic load and total carbohydrate intake were statistically significant associated with an increased risk of recurrence and mortality in stage III colon cancer patients. These findings support the role of energy balance factors in colon cancer progression and may offer potential opportunities to improve patient survival.

Could nutrition prevent the onset of dementia? Current evidence from epidemiological and intervention studies

SUMMARY Cardiovascular and metabolic risk factors for cognitive decline and dementia, such as hypertension, diabetes, metabolic syndrome and obesity, may be modified by diet. Moreover, several classes of nutrients, including long-chain ω-3 polyunsaturated fatty acids, antioxidants (i.e., vitamins C and E, carotenoids and polyphenols) and vitamins B and D can lower inflammation and oxidative stress associated with neurodegeneration, in addition to specific neuroprotective effects. However, most randomized clinical trials of supplementation with high doses of single nutrients have been disappointing. Healthy dietary patterns, such as the Mediterranean diet, combine several classes of nutrients that could work in synergy to slow down cognitive decline. Healthy dietary habits at midlife could contribute to decrease the risk of late-life dementia.

Olive oil consumption, BMI, and risk of obesity in Spanish adults

BACKGROUND

Olive oil is an energy-dense food frequently consumed in south European countries with increasingly high obesity prevalence. Evidence of the impact of olive oil consumption on BMI and the risk of obesity is limited. We analyzed this association taking into consideration the problem of energy underreporting.

METHODS

Cross-sectional data on 6,352 Spanish adults were analyzed. Dietary intake was assessed using a validated food frequency questionnaire. Height and weight were measured.

RESULTS

Higher olive oil consumption was not associated with energy compensation in the overall diet. Olive oil consumption was positively associated (p < 0.004) with BMI in non-energy-adjusted multivariate linear regression models. Statistical significance of this association disappeared after controlling for energy intake in plausible energy intake reporters. The obesity risk increased for olive oil consumption of more than 2 tablespoons/day in both plausible energy intake reporters (odds ratio 1.30 (95% CI 1.01-1.70)) and energy intake underreporters (odds ratio 3.06 (95% CI 2.15-4.35)). This association was not significant after additional adjustment for energy intake (odds ratio 1.19 (95% CI 0.91-1.56)) in plausible energy intake reporters.

CONCLUSION

Olive oil intake did not affect BMI and the risk of obesity after adjustment for total energy intake in plausible energy intake reporters. The lack of energy intake compensation for olive oil consumption might explain the positive associations in models not adjusted for energy.

Pulse consumption, satiety, and weight management

The prevalence of obesity has reached epidemic proportions, making finding effective solutions to reduce obesity a public health priority. One part of the solution could be for individuals to increase consumption of nonoilseed pulses (dry beans, peas, chickpeas, and lentils), because they have nutritional attributes thought to benefit weight control, including slowly digestible carbohydrates, high fiber and protein contents, and moderate energy density. Observational studies consistently show an inverse relationship between pulse consumption and BMI or risk for obesity, but many do not control for potentially confounding dietary and other lifestyle factors. Short-term (≤1 d) experimental studies using meals controlled for energy, but not those controlled for available carbohydrate, show that pulse consumption increases satiety over 2-4 h, suggesting that at least part of the effect of pulses on satiety is mediated by available carbohydrate amount or composition. Randomized controlled trials generally support a beneficial effect of pulses on weight loss when pulse consumption is coupled with energy restriction, but not without energy restriction. However, few randomized trials have been conducted and most were short term (3-8 wk for whole pulses and 4-12 wk for pulse extracts). Overall, there is some indication of a beneficial effect of pulses on short-term satiety and weight loss during intentional energy restriction, but more studies are needed in this area, particularly those that are longer term (≥1 y), investigate the optimal amount of pulses to consume for weight control, and include behavioral elements to help overcome barriers to pulse consumption.

Serum levels of matrix metalloproteinase-10 are associated with the severity of atherosclerosis in patients with chronic kidney disease

Cardiovascular disease is the leading cause of mortality in chronic kidney disease (CKD). As matrix metalloproteinases have a major role in atherosclerosis, we hypothesized that alterations in metalloproteinases-8, -10 and their tissue inhibitor-1 can be associated with the severity of atherosclerosis in patients with kidney disease. This was evaluated in a cross-sectional, observational study of 111 patients with stages I-V kidney disease, 217 patients on dialysis and 50 healthy controls. The severity of atherosclerosis was estimated with the atherosclerosis score (AS), combining the results of ankle-brachial index and carotid ultrasound. Serum levels of the two metalloproteinases and tissue inhibitor-1 were measured by enzyme-linked immunosorbent assay and were significantly increased in patients with kidney disease compared with the healthy controls, and higher in patients on dialysis than in earlier stages of CKD. The severity of the AS was also more prevalent in the dialysis group, in which serum levels of both metalloproteinases and tissue inhibitor-1 were significantly higher. After multivariate analysis, metalloproteinase-10, dialysis, C-reactive protein, age, and male gender were associated with increased risk of atherosclerosis. Thus, patients with CKD exhibit elevated levels of circulating metalloproteinase-10, and this was independently associated with the severity of atherosclerosis and may represent a new biomarker of atherosclerotic diseases.

Dietary determinants of changes in waist circumference adjusted for body mass index - a proxy measure of visceral adiposity

Background

Given the recognized health effects of visceral fat, the understanding of how diet can modulate changes in the phenotype “waist circumference for a given body mass index (WC_BMI)”, a proxy measure of visceral adiposity, is deemed necessary. Hence, the objective of the present study was to assess the association between dietary factors and prospective changes in visceral adiposity as measured by changes in the phenotype WC_BMI.

Methods and Findings

We analyzed data from 48,631 men and women from 5 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Anthropometric measurements were obtained at baseline and after a median follow-up time of 5.5 years. WC_BMI was defined as the residuals of waist circumference regressed on body mass index, and annual change in WC_BMI (ΔWC_BMI, cm/y) was defined as the difference between residuals at follow-up and baseline, divided by follow-up time. The association between energy, energy density (ED), macronutrients, alcohol, glycemic index (GI), glycemic load (GL), fibre and ΔWC_BMI was modelled using centre-specific adjusted linear regression, and random-effects meta-analyses to obtain pooled estimates. Men and women with higher ED and GI diets showed significant increases in their WC_BMI, compared to those with lower ED and GI [1 kcal/g greater ED predicted a ΔWC_BMI of 0.09 cm (95% CI 0.05 to 0.13) in men and 0.15 cm (95% CI 0.09 to 0.21) in women; 10 units greater GI predicted a ΔWC_BMI of 0.07 cm (95% CI 0.03 to 0.12) in men and 0.06 cm (95% CI 0.03 to 0.10) in women]. Among women, lower fibre intake, higher GL, and higher alcohol consumption also predicted a higher ΔWC_BMI.

Conclusions

Results of this study suggest that a diet with low GI and ED may prevent visceral adiposity, defined as the prospective changes in WC_BMI. Additional effects may be obtained among women of low alcohol, low GL, and high fibre intake.

Use of the glycemic index for weight loss and glycemic control: a review of recent evidence

This article summarizes current findings regarding the use of low-glycemic index (GI) diets for weight loss and type 2 diabetes control. Results from cross-sectional studies evaluating the association between dietary GI and body mass index had equivocal results, especially when dietary fiber was included in the model. Of five prospective cohort studies, two reported increased risk of type 2 diabetes diagnosis with higher dietary GI or glycemic load (GL). Risk of type 2 diabetes appeared to have a stronger association with carbohydrate intake or GL than with GI. Evidence from intervention studies using a low-GI approach for weight loss produced inconsistent results, especially for longer-term studies. In intervention studies with type 2 diabetes patients, consumption of a low-GI diet resulted in lower hemoglobin A1c concentrations in participants of shorter-term studies. Recent evidence adds to the controversy regarding the effectiveness of consuming low-GI diets for glycemic control and weight reduction.

Dietary starch type affects body weight and glycemic control in freely fed but not energy-restricted obese rats

This study comprised 2 experiments that tested the hypothesis that a high-amylose starch diet (AMO) would improve body weight and glycemic control relative to a high-amylopectin starch diet (AMN) in rats with diet-induced obesity. After inducing obesity with a high-fat and -energy diet (Expt. 1), male Sprague-Dawley rats (n = 46) were divided into 4 groups and given free or restricted access to either an AMN or an AMO diet for 4 wk (Expt. 2). After 3 wk, rats from each group underwent an oral glucose tolerance test. At the end of the experiment, food-deprived rats were killed by decapitation and blood and tissues were collected for analyses. AMO led to lower total energy intake, weight gain, fat pad mass, and glycemic response but higher insulin sensitivity index than AMN, only when consumed ad libitum (AL) (P < 0.05). AMO led to higher glucagon-like peptide-1 and peptide YY responses and mRNA levels, independent of feeding paradigm (P < 0.01). The mRNA levels of key neuropeptide systems involved in the regulation of food intake were affected only by energy restriction. On the other hand, AMO resulted in higher expression of uncoupling protein-1 in the brown adipose tissue than AMN in rats that consumed food AL (P < 0.05). The effects of AMO appear to be mediated by its high resistant starch content rather than its glycemic index. We conclude that starches high in AMO can be effective in weight and glycemic control in obesity.