TY - JOUR
T1 - Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes
T2 - A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies
AU - Livesey, Geoffrey
AU - Taylor, Richard
AU - Livesey, Helen F.
AU - Buyken, Anette E.
AU - Jenkins, David J. A.
AU - Augustin, Livia Silvia Adriana
AU - Sievenpiper, John L.
AU - Barclay, Alan W.
AU - Liu, Simin
AU - Wolever, Thomas M.S.
AU - Willett, Walter C.
AU - Brighenti, Furio
AU - Salas-Salvadó, Jordi
AU - Björck, Inger
AU - Rizkalla, Salwa W.
AU - Riccardi, Gabriele
AU - Vecchia, Carlo La
AU - Ceriello, Antonio
AU - Trichopoulou, Antonia
AU - Poli, Andrea
AU - Astrup, Arne
AU - Kendall, Cyril W.C.
AU - van Ginkel, Marie-Ann
AU - Baer-Sinnott, Sara
AU - Brand-Miller, Jennie C.
PY - 2019/6/5
Y1 - 2019/6/5
N2 - Published meta-analyses indicate significant but inconsistent incident type-2 diabetes (T2D)-dietary glycemic index (GI) and glycemic load (GL) risk ratios or risk relations (RR). It is now over a decade ago that a published meta-analysis used a predefined standard to identify valid studies. Considering valid studies only, and using random effects dose–response meta-analysis (DRM) while withdrawing spurious results (p < 0.05), we ascertained whether these relations would support nutrition guidance, specifically for an RR > 1.20 with a lower 95% confidence limit >1.10 across typical intakes (approximately 10th to 90th percentiles of population intakes). The combined T2D–GI RR was 1.27 (1.15–1.40) (p < 0.001, n = 10 studies) per 10 units GI, while that for the T2D–GL RR was 1.26 (1.15–1.37) (p < 0.001, n = 15) per 80 g/d GL in a 2000 kcal (8400 kJ) diet. The corresponding global DRM using restricted cubic splines were 1.87 (1.56–2.25) (p < 0.001, n = 10) and 1.89 (1.66–2.16) (p < 0.001, n = 15) from 47.6 to 76.1 units GI and 73 to 257 g/d GL in a 2000 kcal diet, respectively. In conclusion, among adults initially in good health, diets higher in GI or GL were robustly associated with incident T2D. Together with mechanistic and other data, this supports that consideration should be given to these dietary risk factors in nutrition advice. Concerning the public health relevance at the global level, our evidence indicates that GI and GL are substantial food markers predicting the development of T2D worldwide, for persons of European ancestry and of East Asian ancestry.
AB - Published meta-analyses indicate significant but inconsistent incident type-2 diabetes (T2D)-dietary glycemic index (GI) and glycemic load (GL) risk ratios or risk relations (RR). It is now over a decade ago that a published meta-analysis used a predefined standard to identify valid studies. Considering valid studies only, and using random effects dose–response meta-analysis (DRM) while withdrawing spurious results (p < 0.05), we ascertained whether these relations would support nutrition guidance, specifically for an RR > 1.20 with a lower 95% confidence limit >1.10 across typical intakes (approximately 10th to 90th percentiles of population intakes). The combined T2D–GI RR was 1.27 (1.15–1.40) (p < 0.001, n = 10 studies) per 10 units GI, while that for the T2D–GL RR was 1.26 (1.15–1.37) (p < 0.001, n = 15) per 80 g/d GL in a 2000 kcal (8400 kJ) diet. The corresponding global DRM using restricted cubic splines were 1.87 (1.56–2.25) (p < 0.001, n = 10) and 1.89 (1.66–2.16) (p < 0.001, n = 15) from 47.6 to 76.1 units GI and 73 to 257 g/d GL in a 2000 kcal diet, respectively. In conclusion, among adults initially in good health, diets higher in GI or GL were robustly associated with incident T2D. Together with mechanistic and other data, this supports that consideration should be given to these dietary risk factors in nutrition advice. Concerning the public health relevance at the global level, our evidence indicates that GI and GL are substantial food markers predicting the development of T2D worldwide, for persons of European ancestry and of East Asian ancestry.
U2 - 10.3390/nu11061280
DO - 10.3390/nu11061280
M3 - Article
SN - 2072-6643
VL - 11
JO - Nutrients
JF - Nutrients
IS - 6
M1 - 1280
ER -