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Glycemic index, glycemic load, and chronic disease risk--a meta-analysis of observational studies.
Am J Clin Nutr 2008; 87(3):627-37AJ

Abstract

BACKGROUND

Inconsistent findings from observational studies have prolonged the controversy over the effects of dietary glycemic index (GI) and glycemic load (GL) on the risk of certain chronic diseases.

OBJECTIVE

The objective was to evaluate the association between GI, GL, and chronic disease risk with the use of meta-analysis techniques.

DESIGN

A systematic review of published reports identified a total of 37 prospective cohort studies of GI and GL and chronic disease risk. Studies were stratified further according to the validity of the tools used to assess dietary intake. Rate ratios (RRs) were estimated in a Cox proportional hazards model and combined by using a random-effects model.

RESULTS

From 4 to 20 y of follow-up across studies, a total of 40 129 incident cases were identified. For the comparison between the highest and lowest quantiles of GI and GL, significant positive associations were found in fully adjusted models of validated studies for type 2 diabetes (GI RR = 1.40, 95% CI: 1.23, 1.59; GL RR = 1.27, 95% CI: 1.12, 1.45), coronary heart disease (GI RR = 1.25, 95% CI: 1.00, 1.56), gallbladder disease (GI RR = 1.26, 95% CI: 1.13, 1.40; GL RR = 1.41, 95% CI: 1.25, 1.60), breast cancer (GI RR = 1.08, 95% CI: 1.02, 1.16), and all diseases combined (GI RR = 1.14, 95% CI: 1.09, 1.19; GL RR = 1.09, 95% CI: 1.04, 1.15).

CONCLUSIONS

Low-GI and/or low-GL diets are independently associated with a reduced risk of certain chronic diseases. In diabetes and heart disease, the protection is comparable with that seen for whole grain and high fiber intakes. The findings support the hypothesis that higher postprandial glycemia is a universal mechanism for disease progression.

Authors+Show Affiliations

Human Nutrition Unit, University of Sydney, Sydney, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

18326601

Citation

Barclay, Alan W., et al. "Glycemic Index, Glycemic Load, and Chronic Disease Risk--a Meta-analysis of Observational Studies." The American Journal of Clinical Nutrition, vol. 87, no. 3, 2008, pp. 627-37.
Barclay AW, Petocz P, McMillan-Price J, et al. Glycemic index, glycemic load, and chronic disease risk--a meta-analysis of observational studies. Am J Clin Nutr. 2008;87(3):627-37.
Barclay, A. W., Petocz, P., McMillan-Price, J., Flood, V. M., Prvan, T., Mitchell, P., & Brand-Miller, J. C. (2008). Glycemic index, glycemic load, and chronic disease risk--a meta-analysis of observational studies. The American Journal of Clinical Nutrition, 87(3), pp. 627-37.
Barclay AW, et al. Glycemic Index, Glycemic Load, and Chronic Disease Risk--a Meta-analysis of Observational Studies. Am J Clin Nutr. 2008;87(3):627-37. PubMed PMID: 18326601.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glycemic index, glycemic load, and chronic disease risk--a meta-analysis of observational studies. AU - Barclay,Alan W, AU - Petocz,Peter, AU - McMillan-Price,Joanna, AU - Flood,Victoria M, AU - Prvan,Tania, AU - Mitchell,Paul, AU - Brand-Miller,Jennie C, PY - 2008/3/11/pubmed PY - 2008/4/16/medline PY - 2008/3/11/entrez SP - 627 EP - 37 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 87 IS - 3 N2 - BACKGROUND: Inconsistent findings from observational studies have prolonged the controversy over the effects of dietary glycemic index (GI) and glycemic load (GL) on the risk of certain chronic diseases. OBJECTIVE: The objective was to evaluate the association between GI, GL, and chronic disease risk with the use of meta-analysis techniques. DESIGN: A systematic review of published reports identified a total of 37 prospective cohort studies of GI and GL and chronic disease risk. Studies were stratified further according to the validity of the tools used to assess dietary intake. Rate ratios (RRs) were estimated in a Cox proportional hazards model and combined by using a random-effects model. RESULTS: From 4 to 20 y of follow-up across studies, a total of 40 129 incident cases were identified. For the comparison between the highest and lowest quantiles of GI and GL, significant positive associations were found in fully adjusted models of validated studies for type 2 diabetes (GI RR = 1.40, 95% CI: 1.23, 1.59; GL RR = 1.27, 95% CI: 1.12, 1.45), coronary heart disease (GI RR = 1.25, 95% CI: 1.00, 1.56), gallbladder disease (GI RR = 1.26, 95% CI: 1.13, 1.40; GL RR = 1.41, 95% CI: 1.25, 1.60), breast cancer (GI RR = 1.08, 95% CI: 1.02, 1.16), and all diseases combined (GI RR = 1.14, 95% CI: 1.09, 1.19; GL RR = 1.09, 95% CI: 1.04, 1.15). CONCLUSIONS: Low-GI and/or low-GL diets are independently associated with a reduced risk of certain chronic diseases. In diabetes and heart disease, the protection is comparable with that seen for whole grain and high fiber intakes. The findings support the hypothesis that higher postprandial glycemia is a universal mechanism for disease progression. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/18326601/Glycemic_index_glycemic_load_and_chronic_disease_risk__a_meta_analysis_of_observational_studies_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/87.3.627 DB - PRIME DP - Unbound Medicine ER -