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Low glycaemic index diets and blood lipids: a systematic review and meta-analysis of randomised controlled trials.

Abstract

AIMS

Low glycaemic index (GI) diets are beneficial in the management of hyperglycemia. Cardiovascular diseases are the major cause of mortality in diabetes therefore it is important to understand the effects of GI on blood lipids. The aim was to systematically review randomised controlled trials (RCTs) of low GI diets on blood lipids.

DATA SYNTHESIS

We searched OVID Medline, Embase and Cochrane library to March 2012. Random effects meta-analyses were performed on twenty-eight RCTs comparing low- with high GI diets over at least 4 weeks (1272 participants; studies ranged from 6 to 155 participants); one was powered on blood lipids, 3 had adequate allocation concealment. Low GI diets significantly reduced total (-0.13 mmol/l, 95%CI -0.22 to -0.04, P = 0.004, 27 trials, 1441 participants, I(2) = 0%) and LDL-cholesterol (-0.16 mmol/l, 95%CI -0.24 to -0.08, P < 0.0001, 23 trials, 1281 participants, I(2) = 0%) compared with high GI diets and independently of weight loss. Subgroup analyses suggest that reductions in LDL-C are greatest in studies of shortest duration and greatest magnitude of GI reduction. Furthermore, lipid improvements appear greatest and most reliable when the low GI intervention is accompanied by an increase in dietary fibre. Sensitivity analyses, removing studies without adequate allocation concealment, lost statistical significance but retained suggested mean falls of ~0.10 mmol/l in both. There were no effects on HDL-cholesterol (MD -0.03 mmol/l, 95%CI -0.06 to 0.00, I(2) = 0%), or triglycerides (MD 0.01 mmol/l, 95%CI -0.06 to 0.08, I(2) = 0%).

CONCLUSIONS

This meta-analysis provides consistent evidence that low GI diets reduce total and LDL-cholesterol and have no effect on HDL-cholesterol or triglycerides.

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  • Authors+Show Affiliations

    ,

    King's College London, School of Medicine, Division of Diabetes and Nutritional Sciences, London, UK. louise.goff@kcl.ac.uk

    , ,

    Source

    MeSH

    Cardiovascular Diseases
    Cholesterol
    Cholesterol, HDL
    Cholesterol, LDL
    Diet
    Dietary Fats
    Dietary Fiber
    Glycemic Index
    Humans
    Lipids
    MEDLINE
    Randomized Controlled Trials as Topic
    Triglycerides

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    22841185

    Citation

    Goff, L M., et al. "Low Glycaemic Index Diets and Blood Lipids: a Systematic Review and Meta-analysis of Randomised Controlled Trials." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 23, no. 1, 2013, pp. 1-10.
    Goff LM, Cowland DE, Hooper L, et al. Low glycaemic index diets and blood lipids: a systematic review and meta-analysis of randomised controlled trials. Nutr Metab Cardiovasc Dis. 2013;23(1):1-10.
    Goff, L. M., Cowland, D. E., Hooper, L., & Frost, G. S. (2013). Low glycaemic index diets and blood lipids: a systematic review and meta-analysis of randomised controlled trials. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 23(1), pp. 1-10. doi:10.1016/j.numecd.2012.06.002.
    Goff LM, et al. Low Glycaemic Index Diets and Blood Lipids: a Systematic Review and Meta-analysis of Randomised Controlled Trials. Nutr Metab Cardiovasc Dis. 2013;23(1):1-10. PubMed PMID: 22841185.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Low glycaemic index diets and blood lipids: a systematic review and meta-analysis of randomised controlled trials. AU - Goff,L M, AU - Cowland,D E, AU - Hooper,L, AU - Frost,G S, Y1 - 2012/07/25/ PY - 2012/01/17/received PY - 2012/06/12/revised PY - 2012/06/15/accepted PY - 2012/7/31/entrez PY - 2012/7/31/pubmed PY - 2013/7/3/medline SP - 1 EP - 10 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 23 IS - 1 N2 - AIMS: Low glycaemic index (GI) diets are beneficial in the management of hyperglycemia. Cardiovascular diseases are the major cause of mortality in diabetes therefore it is important to understand the effects of GI on blood lipids. The aim was to systematically review randomised controlled trials (RCTs) of low GI diets on blood lipids. DATA SYNTHESIS: We searched OVID Medline, Embase and Cochrane library to March 2012. Random effects meta-analyses were performed on twenty-eight RCTs comparing low- with high GI diets over at least 4 weeks (1272 participants; studies ranged from 6 to 155 participants); one was powered on blood lipids, 3 had adequate allocation concealment. Low GI diets significantly reduced total (-0.13 mmol/l, 95%CI -0.22 to -0.04, P = 0.004, 27 trials, 1441 participants, I(2) = 0%) and LDL-cholesterol (-0.16 mmol/l, 95%CI -0.24 to -0.08, P < 0.0001, 23 trials, 1281 participants, I(2) = 0%) compared with high GI diets and independently of weight loss. Subgroup analyses suggest that reductions in LDL-C are greatest in studies of shortest duration and greatest magnitude of GI reduction. Furthermore, lipid improvements appear greatest and most reliable when the low GI intervention is accompanied by an increase in dietary fibre. Sensitivity analyses, removing studies without adequate allocation concealment, lost statistical significance but retained suggested mean falls of ~0.10 mmol/l in both. There were no effects on HDL-cholesterol (MD -0.03 mmol/l, 95%CI -0.06 to 0.00, I(2) = 0%), or triglycerides (MD 0.01 mmol/l, 95%CI -0.06 to 0.08, I(2) = 0%). CONCLUSIONS: This meta-analysis provides consistent evidence that low GI diets reduce total and LDL-cholesterol and have no effect on HDL-cholesterol or triglycerides. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/22841185/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(12)00152-4 DB - PRIME DP - Unbound Medicine ER -