Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-28T12:04:05.108Z Has data issue: false hasContentIssue false

Glycaemic index and metabolic disease risk

Published online by Cambridge University Press:  07 March 2007

Louise M. Aston*
Affiliation:
MRC Collaborative Centre for Human Nutrition Research, Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge CB1 9NL, UK
*
Corresponding author: Louise Aston, fax +44 1223 437515, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

There is growing evidence that the type of carbohydrate consumed is important in relation to metabolic disease risk, and there is currently particular interest in the role of low-glycaemic-index (GI) foods. Observational studies have associated low-GI diets with decreased risk of type 2 diabetes and CHD, and improvements in various metabolic risk factors have been seen in some intervention studies. However, findings have been mixed and inconsistent. There are a number of plausible mechanisms for the effects of these foods on disease risk, which arise from the differing metabolic responses to low- and high-GI foods, with low-GI foods resulting in reductions in hyperglycaemia, hyperinsulinaemia and late postprandial circulating NEFA levels. Low-GI foods may also increase satiety and delay the return of hunger compared with high-GI foods, which could translate into reduced energy intake at later time points. However, the impact of a low-GI diet on body weight is controversial, with many studies confounded by dietary manipulations that differ in aspects other than GI. There is currently much interest in GI from scientists, health professionals and the public, but more research is needed before clear conclusions can be drawn about relationships with metabolic disease risk.

Type
Postgraduate Symposium
Copyright
Copyright © The Nutrition Society 2006

References

Agus, MS, Swain, JF, Larson, CL, Eckert, EA & Ludwig, DS (2000) Dietary composition and physiologic adaptations to energy restriction. American Journal of Clinical Nutrition 71 901907.CrossRefGoogle ScholarPubMed
AOAC International (1995) Total, soluble and insoluble dietary fiber in foods. AOAC official method 991.43. Official Methods of Analysis, 16th edition. Gathersburg, MD: AOAC International.Google Scholar
Augustin, LS, Franceschi, S, Jenkins, DJ, Kendall, CW, La Vecchia, C (2002) Glycemic index in chronic disease: a review. European Journal of Clinical Nutrition 56 10491071.CrossRefGoogle ScholarPubMed
Björck, I, Liljeberg, H, Östman, E (2000) Low glycaemic-index foods. British Journal of Nutrition 83 Suppl. 1 S149S155CrossRefGoogle ScholarPubMed
Bouché, C, Rizkalla, SW, Luo, J, Vidal, H, Veronese, A, Pacher, N, Fouquet, C, Lang, V & Slama, G (2002) Five-week, low-glycemic index diet decreases total fat mass and improves plasma lipid profile in moderately overweight nondiabetic men. Diabetes Care 25 822828.CrossRefGoogle ScholarPubMed
Brand-Miller, JC (1994) Importance of glycemic index in diabetes. American Journal of Clinical Nutrition 59 747S752S.CrossRefGoogle Scholar
Brand-Miller, JC, Holt, SH, Pawlak, DB & McMillan, J (2002) Glycemic index and obesity. American Journal of Clinical Nutrition 76 281S285S.CrossRefGoogle ScholarPubMed
Burton-Freeman, B, Davis, PA & Schneeman, BO (2002) Plasma cholecystokinin is associated with subjective measures of satiety in women. American Journal of Clinical Nutrition 76 659667.CrossRefGoogle ScholarPubMed
Ceriello, A (2000) Oxidative stress and glycemic regulation. Metabolism 49 2729.CrossRefGoogle ScholarPubMed
Collier, GR, Wolever, TM, Wong, GS & Josse, RG (1986) Prediction of glycemic response to mixed meals in noninsulin-dependent diabetic subjects. American Journal of Clinical Nutrition 44 349352.CrossRefGoogle ScholarPubMed
Coutinho, M, Gerstein, HC, Wang, Y & Yusuf, S (1999) The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care 22 233240.CrossRefGoogle ScholarPubMed
Davy, BM & Melby, CL (2003) The effect of fiber-rich carbohydrates on features of Syndrome X. Journal of the American Dietetic Association 103 8696.CrossRefGoogle ScholarPubMed
Díaz, EO, Galgani, JE, Aguirre, CA, Atwater, IJ & Burrows, R (2005) Effect of glycemic index on whole-body substrate oxidation in obese women. International Journal of Obesity 29 108114.CrossRefGoogle ScholarPubMed
Department of Health (1994). Nutritional Aspects of Cardiovascular Disease. Report on Health and Social Subjects no. 46. London: H. M. Stationery Office.Google Scholar
Ebbeling, CB, Leidig, MM, Sinclair, KB, Seger-Shippee, LG, Feldman, HA & Ludwig, DS (2005) Effects of an ad libitum low-glycemic load diet on cardiovascular disease risk factors in obese young adults. American Journal of Clinical Nutrition 81 976982.CrossRefGoogle ScholarPubMed
Englyst, KN, Vinoy, S, Englyst, HN & Lang, V (2003) Glycaemic index of cereal products explained by their content of rapidly and slowly available glucose. British Journal of Nutrition 89 329340.CrossRefGoogle ScholarPubMed
Flint, A, Raben, A, Blundell, JE & Astrup, A (2000) Reproducibility, power and validity of visual analogue scales in assessment of appetite sensations in single test meal studies. International Journal of Obesity and Related Metabolic Disorders 24 3848.CrossRefGoogle ScholarPubMed
Fontvieille, AM, Rizkalla, SW, Penfornis, A, Acosta, M, Bornet, FR & Slama, G (1992) The use of low glycaemic index foods improves metabolic control of diabetic patients over five weeks. Diabetic Medicine 9 444450.CrossRefGoogle ScholarPubMed
Food and Agriculture Organization/World Health Organization (1998) Carbohydrates in Human Nutrition. Report of a Joint FAO/WHO Expert Consultation. FAO Food and Nutrition Paper no. 66. Rome: FAO.Google Scholar
Foster-Powell, K, Holt, SH, Brand-Miller, JC (2002) International table of glycemic index and glycemic load values: 2002. American Journal of Clinical Nutrition 76 556.CrossRefGoogle ScholarPubMed
Frape, DL, Williams, NR, Carpenter, KL, Freeman, MA, Palmer, CR & Fletcher, RJ (2000) Insulin response and changes in composition of non-esterified fatty acids in blood plasma of middle-aged men following isoenergetic fatty and carbohydrate breakfasts. British Journal of Nutrition 84 737745.CrossRefGoogle ScholarPubMed
Frayn, KN (2001) Adipose tissue and the insulin resistance syndrome. Proceedings of the Nutrition Society 60 375380.CrossRefGoogle ScholarPubMed
Frost, G, Keogh, B, Smith, D, Akinsanya, K & Leeds, A (1996) The effect of low-glycemic carbohydrate on insulin and glucose response in vivo and in vitro in patients with coronary heart disease. Metabolism 45 669672.CrossRefGoogle ScholarPubMed
Frost, G, Leeds, A, Trew, G, Margara, R & Dornhorst, A (1998) Insulin sensitivity in women at risk of coronary heart disease and the effect of a low glycemic diet. Metabolism 47 12451251.CrossRefGoogle ScholarPubMed
Frost, G, Leeds, AA, Dore, CJ, Madeiros, S, Brading, S & Dornhorst, A (1999) Glycaemic index as a determinant of serum HDL-cholesterol concentration. Lancet 353 10451048.CrossRefGoogle ScholarPubMed
Goldstein, BJ (2002) Insulin resistance as the core defect in type 2 diabetes mellitus. American Journal of Cardiology 90 3G10G.CrossRefGoogle ScholarPubMed
Granfeldt, Y, Drews, A & Bjorck, I (1995) Arepas made from high amylose corn flour produce favorably low glucose and insulin responses in healthy humans. Journal of Nutrition 125 459465.Google ScholarPubMed
Hermansen, K, Rasmussen, O, Gregersen, S & Larsen, S (1992) Influence of ripeness of banana on the blood glucose and insulin response in type 2 diabetic subjects. Diabetic Medicine 9 739743.CrossRefGoogle ScholarPubMed
Holt, SH & Miller, JB (1994) Particle size, satiety and the glycaemic response. European Journal of Clinical Nutrition 48 496502.Google ScholarPubMed
Järvi, AE, Karlstrom, BE, Granfeldt, YE, Bjorck, IE, Asp, NG & Vessby, BO (1999) Improved glycemic control and lipid profile and normalized fibrinolytic activity on a low-glycemic index diet in type 2 diabetic patients. Diabetes Care 22 1018.CrossRefGoogle ScholarPubMed
Jenkins, DJ, Wesson, V, Wolever, TM, Jenkins, AL, Kalmusky, J, Guidici, S, Csima, A, Josse, RG & Wong, GS (1988) Wholemeal versus wholegrain breads: proportion of whole or cracked grain and the glycaemic response. British Medical Journal 297 958960.CrossRefGoogle ScholarPubMed
Jenkins, DJ, Wolever, TM, Taylor, RH, Barker, H, Fielden, H, Baldwin, JM, Bowling, AC, Newman, HC, Jenkins, AL & Goff, DV (1981) Glycemic index of foods: a physiological basis for carbohydrate exchange. American Journal of Clinical Nutrition 34 362366.CrossRefGoogle Scholar
Jenkins, DJ, Wolever, TM, Taylor, RH, Griffiths, C, Krzeminska, K, Lawrie, JA, Bennett, CM, Goff, DV, Sarson, DL & Bloom, SR (1982) Slow release dietary carbohydrate improves second meal tolerance. American Journal of Clinical Nutrition 35 13391346.CrossRefGoogle ScholarPubMed
Juntunen, KS, Laaksonen, DE, Poutanen, KS, Niskanen, LK & Mykkanen, HM (2003) High-fiber rye bread and insulin secretion and sensitivity in healthy postmenopausal women. American Journal of Clinical Nutrition 77 385391.CrossRefGoogle ScholarPubMed
Juntunen, KS, Niskanen, LK, Liukkonen, KH, Poutanen, KS, Holst, JJ & Mykkanen, HM (2002) Postprandial glucose, insulin, and incretin responses to grain products in healthy subjects. American Journal of Clinical Nutrition 75 254262.CrossRefGoogle ScholarPubMed
Kelley, DE, Goodpaster, BH & Storlien, L (2002) Muscle triglyceride and insulin resistance. Annual Review of Nutrition 22 325346.CrossRefGoogle ScholarPubMed
Kelly, S, Frost, G, Whittaker, V & Summerbell, C (2004) Low Glycaemic Index Diets for Coronary Heart Disease. The Cochrane Database of Systematic Reviews 2004, Issue 4. Chichester, West Sussex: John Wiley & Sons Ltd.Google Scholar
Kiens, B & Richter, EA (1996) Types of carbohydrate in an ordinary diet affect insulin action and muscle substrates in humans. American Journal of Clinical Nutrition 63 4753.CrossRefGoogle Scholar
Larsen, HN, Rasmussen, OW, Rasmussen, PH, Alstrup, KK, Biswas, SK, Tetens, I, Thilsted, SH & Hermansen, K (2000) Glycaemic index of parboiled rice depends on the severity of processing: study in type 2 diabetic subjects. European Journal of Clinical Nutrition 54 380385.CrossRefGoogle ScholarPubMed
Lau, C, Faerch, K, Glumer, C, Tetens, I, Pedersen, O, Carstensen, B, Jorgensen, T, Borch-Johnsen, K (2005) Dietary glycemic index, glycemic load, fiber, simple sugars, and insulin resistance: the Inter99 study. Diabetes Care 28 13971403.CrossRefGoogle ScholarPubMed
Liljeberg, H, Björck, I (2000) Effects of a low-glycaemic index spaghetti meal on glucose tolerance and lipaemia at a subsequent meal in healthy subjects. European Journal of Clinical Nutrition 54 2428.CrossRefGoogle Scholar
Liljeberg, HG, Akerberg, AK, Björck, IM (1999) Effect of the glycemic index and content of indigestible carbohydrates of cereal-based breakfast meals on glucose tolerance at lunch in healthy subjects. American Journal of Clinical Nutrition 69 647655.CrossRefGoogle ScholarPubMed
Liu, S, Manson, JE, Buring, JE, Stampfer, MJ, Willett, WC & Ridker, PM (2002) Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women. American Journal of Clinical Nutrition 75 492498.CrossRefGoogle ScholarPubMed
Liu, S, Manson, JE, Stampfer, MJ, Holmes, MD, Hu, FB, Hankinson, SE & Willett, WC (2001) Dietary glycemic load assessed by food-frequency questionnaire in relation to plasma high-density-lipoprotein cholesterol and fasting plasma triacylglycerols in postmenopausal women. American Journal of Clinical Nutrition 73 560566.CrossRefGoogle ScholarPubMed
Liu, S, Willett, WC, Stampfer, MJ, Hu, FB, Franz, M, Sampson, L, Hennekens, CH & Manson, JE (2000) A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. American Journal of Clinical Nutrition 71 14551461.CrossRefGoogle ScholarPubMed
Ludwig, DS (2002) The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. Journal of the American Medical Association 287 24142423.CrossRefGoogle ScholarPubMed
Ludwig, DS, Majzoub, JA, Al-Zahrani, A, Dallal, GE, Blanco, I & Roberts, SB (1999) High glycemic index foods, overeating, and obesity. Pediatrics 103 E26.CrossRefGoogle ScholarPubMed
Luscombe, ND, Noakes, M & Clifton, PM (1999) Diets high and low in glycemic index versus high monounsaturated fat diets: effects on glucose and lipid metabolism in NIDDM. European Journal of Clinical Nutrition 53 473478.CrossRefGoogle ScholarPubMed
McKeown, NM, Meigs, JB, Liu, S, Saltzman, E, Wilson, PW & Jacques, PF (2004) Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. Diabetes Care 27 538546.CrossRefGoogle ScholarPubMed
Meyer, KA, Kushi, LH, Jacobs, DR Jr, Slavin, J, Sellers, TA & Folsom, AR (2000) Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. American Journal of Clinical Nutrition 71 921930.CrossRefGoogle ScholarPubMed
Office of National Statistics (2002) The National Diet and Nutrition Survey: Adults Aged 16–64 Years. Types and Quantities of Foods Consumed. Norwich: The Stationery Office.Google Scholar
Östman, EM, Liljeberg Elmstahl, HG & Bjorck, IM (2001) Inconsistency between glycemic and insulinemic responses to regular and fermented milk products. American Journal of Clinical Nutrition 74 96100.CrossRefGoogle ScholarPubMed
Pawlak, DB, Ebbeling, CB & Ludwig, DS (2002) Should obese patients be counselled to follow a low-glycaemic index diet? Yes. Obesity Reviews 3 235243.CrossRefGoogle ScholarPubMed
Pereira, MA, Swain, J, Goldfine, AB, Rifai, N & Ludwig, DS (2004) Effects of a low-glycemic load diet on resting energy expenditure and heart disease risk factors during weight loss. Journal of the American Medical Association 292 24822490.CrossRefGoogle ScholarPubMed
Petersen, KF & Shulman, GI (2002) Pathogenesis of skeletal muscle insulin resistance in type 2 diabetes mellitus. American Journal of Cardiology 90 11G18G.CrossRefGoogle ScholarPubMed
Raben, A (2002) Should obese patients be counselled to follow a low-glycaemic index diet? No. Obesity Reviews 3 245256.CrossRefGoogle ScholarPubMed
Raben, A, Holst, JJ, Madsen, J & Astrup, A (2001) Diurnal metabolic profiles after 14 d of an ad libitum high-starch, high-sucrose, or high-fat diet in normal-weight never-obese and postobese women. American Journal of Clinical Nutrition 73 177189.CrossRefGoogle ScholarPubMed
Raben, A, Macdonald, I & Astrup, A (1997) Replacement of dietary fat by sucrose or starch: effects on 14 d ad libitum energy intake, energy expenditure and body weight in formerly obese and never-obese subjects. International Journal of Obesity and Related Metabolic Disorders 21 846859.CrossRefGoogle ScholarPubMed
RISCK (2005) The RISCK Study–www.risck.org.ukGoogle Scholar
Roberts, SB (2000) High-glycemic index foods, hunger, and obesity: is there a connection. Nutrition Reviews 58 163169.CrossRefGoogle ScholarPubMed
Salmerón, J, Ascherio, A, Rimm, EB, Colditz, GA, Spiegelman, D, Jenkins, DJ, Stampfer, MJ, Wing, AL, Willett, WC (1997 a) Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care 20 545550.CrossRefGoogle ScholarPubMed
Salmerón, J, Manson, JE, Stampfer, MJ, Colditz, GA, Wing, AL & Willett, WC (1997 b) Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. Journal of the American Medical Association 277 472477.CrossRefGoogle ScholarPubMed
Sloth, B, Krog-Mikkelsen, I, Flint, A, Tetens, I, Bjorck, I, Vinoy, S, Elmstahl, H, Astrup, A, Lang, V & Raben, A (2004) No difference in body weight decrease between a low-glycemic-index and a high-glycemic-index diet but reduced LDL cholesterol after 10-wk ad libitum intake of the low-glycemic-index diet. American Journal of Clinical Nutrition 80 337347.CrossRefGoogle Scholar
Soh, NL, Brand-Miller, J (1999) The glycaemic index of potatoes: the effect of variety, cooking method and maturity. European Journal of Clinical Nutrition 53 249254.CrossRefGoogle ScholarPubMed
Spieth, LE, Harnish, JD, Lenders, CM, Raezer, LB, Pereira, MA, Hangen, SJ & Ludwig, DS (2000) A low-glycemic index diet in the treatment of pediatric obesity. Archives of Pediatrics and Adolescent Medicine 154 947951.CrossRefGoogle ScholarPubMed
The Diogenes Project (2005) The Diogenes Project. Targeting the obesity problem: seeking new insights and routes to prevention–www.diogenes-eu.org.Google Scholar
Tsihlias, EB, Gibbs, AL, McBurney, MI & Wolever, TM (2000) Comparison of high- and low-glycemic-index breakfast cereals with monounsaturated fat in the long-term dietary management of type 2 diabetes. American Journal of Clinical Nutrition 72 439449.CrossRefGoogle ScholarPubMed
van Dam, RM, Visscher, AW, Feskens, EJ, Verhoef, P & Kromhout, D (2000) Dietary glycemic index in relation to metabolic risk factors and incidence of coronary heart disease: the Zutphen Elderly Study. European Journal of Clinical Nutrition 54 726731.CrossRefGoogle ScholarPubMed
World Health Organization (2002) The World Health Report 2002: Reducing Risks, Promoting Healthy Life. Geneva: WHO.Google Scholar
World Health Organization (2003) The World Health Report 2003: Shaping the Future. Geneva: WHO.Google Scholar
Willett, W, Manson, J & Liu, S (2002) Glycemic index, glycemic load, and risk of type 2 diabetes. American Journal of Clinical Nutrition 76 274S280S.CrossRefGoogle ScholarPubMed
Wolever, TM (2000) Dietary carbohydrates and insulin action in humans. British Journal of Nutrition 83 Suppl. 1 S97S102.CrossRefGoogle ScholarPubMed
Wolever, TM, Bentum-Williams, A & Jenkins, DJ (1995) Physiological modulation of plasma free fatty acid concentrations by diet. Metabolic implications in nondiabetic subjects. Diabetes Care 18 962970.CrossRefGoogle ScholarPubMed
Wolever, TM, Jenkins, DJ, Vuksan, V, Jenkins, AL, Wong, GS & Josse, RG (1992) Beneficial effect of low-glycemic index diet in overweight NIDDM subjects. Diabetes Care 15 562564.CrossRefGoogle ScholarPubMed
Wolever, TM & Mehling, C (2002) High-carbohydrate-low-glycaemic index dietary advice improves glucose disposition index in subjects with impaired glucose tolerance. British Journal of Nutrition 87 477487.CrossRefGoogle ScholarPubMed