Faculty of 1000 evaluation for Dietary glycemic index, glycemic load, and risk of coronary heart disease, stroke, and stroke mortality: a systematic review with meta-analysis.

Author(s):  
Venu Menon ◽  
Bhuvnesh Aggarwal
2019 ◽  
Vol 72 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Alireza Sadeghi ◽  
Omid Sadeghi ◽  
Mahmoud Khodadost ◽  
Aliyar Pirouzi ◽  
Banafsheh Hosseini ◽  
...  

Author(s):  
Maryam Kazemi ◽  
Amir Hadi ◽  
Roger A Pierson ◽  
Marla E Lujan ◽  
Gordon A Zello ◽  
...  

ABSTRACT Women with polycystic ovary syndrome (PCOS) exhibit cardiometabolic (e.g., insulin resistance) and associated reproductive disruptions. Lifestyle modification (e.g., diet) is recommended as the first-line therapy to manage PCOS; however, a favorable dietary regimen remains unclear beyond energy restriction. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to summarize evidence on impacts of dietary glycemic index (GI) or glycemic load (GL) on cardiometabolic and reproductive profiles to update the International Evidence-based Guideline for the Assessment and Management of PCOS. Databases of MEDLINE, Cochrane, Web of Science, and Scopus were searched through 30 October 2019, and confirmed on 25 March 2020, to identify RCTs (≥8 wk) comparing the effects of diets with lower (LGI/LGL) and higher (HGI/HGL) GI/GL on glucoregulatory outcomes, lipid profile, anthropometrics, and androgen status in PCOS. The primary outcome was HOMA-IR. Data were pooled by random-effects models and expressed as weighted mean differences and 95% CIs. The risk of bias was assessed by the Cochrane tool. Ten RCTs (n = 403) were eligible. Eight evaluated LGI and 2 LGL diets. LGI diets decreased HOMA-IR (−0.78; −1.20, −0.37; I2 = 86.6%), fasting insulin (−2.39; −4.78, 0.00 μIU/mL; I2 = 76.8%), total cholesterol (−11.13; −18.23, −4.04 mg/dL; I2 = 0.0%), LDL cholesterol (−6.27; −12.01, −0.53 mg/dL; I2 = 0.0%), triglycerides (−14.85; −28.75, −0.95 mg/dL; I2 = 31.0%), waist circumference (−2.81; −4.40, −1.23 cm; I2 = 53.9%), and total testosterone (−0.21; −0.32, −0.09 nmol/L; I2 = 8.6%) compared with HGI diets (all: P ≤ 0.05) without affecting fasting glucose, HDL cholesterol, weight, or free androgen index (all: P ≥ 0.07). Some results were contradictory and only described narratively for 2 RCTs that evaluated LGL diets, since inclusion in meta-analyses was not possible. LGI diets improved glucoregulatory outcomes (HOMA-IR, insulin), lipid profiles, abdominal adiposity, and androgen status, conceivably supporting their inclusion for dietary management of PCOS. Further RCTs should confirm these observations and address whether LGI diets improve more patient-pressing complications, including ovulatory cyclicity, infertility, and cardiovascular disease risk in this high-risk population. This review was registered at www.crd.york.ac.uk/PROSPERO as CRD42020175300.


2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Edgar Denova-Gutiérrez ◽  
Gerardo Huitrón-Bravo ◽  
Juan O. Talavera ◽  
Susana Castañón ◽  
Katia Gallegos-Carrillo ◽  
...  

Objective. To examine the associations of dietary glycemic index (GI) and dietary glycemic load (GL) with blood lipid concentrations and coronary heart disease (CHD) in nondiabetic participants in the Health Worker Cohort Study (HWCS).Materials and Methods. A cross-sectional analysis was performed, using data from adults who participated in the HWCS baseline assessment. We collected information on participants' socio-demographic conditions, dietary patterns and physical activity via self-administered questionnaires. Dietary GI and dietary GL were measured using a validated food frequency questionnaire. Anthropometric and clinical measurements were assessed with standardized procedures. CHD risk was estimated according to the sex-specific Framingham prediction algorithms.Results. IIn the 5,830 individuals aged 20 to 70 who were evaluated, dietary GI and GL were significantly associated with HDL-C, LDL-C, LDL-C/HDL-C ratio, and triglycerides serum levels. Subjects with high dietary GI have a relative risk of 1.56 (CI 95%; 1.13–2.14), and those with high dietary GL have a relative risk of 2.64 (CI 95%; 1.15–6.58) of having an elevated CHD risk than those who had low dietary GI and GL.Conclusions. Our results suggest that high dietary GI and dietary GL could have an unfavorable effect on serum lipid levels, which are in turn associated with a higher CHD risk.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Shanshan Li ◽  
Frank B Hu ◽  
John P Forman ◽  
Eric B Rimm

Introduction: The associations between dietary glycemic index (GI) and glycemic load (GL) with subsequent risk of coronary heart disease (CHD) are inconclusive among men. The association is further complicated by the potential biological interactions between the carbohydrate quality of the diet and factors that may influence underlying insulin resistance. Hypothesis: We hypothesized that long-term exposure to a diet with high GI and GL would be associated with increased CHD risk in a cohort of US men, and the association would be further modified by fiber intake, alcohol consumption and BMI. Methods: We included 37,736 men aged 40–75 years from the Health Professional Follow-up Study, with no previous diagnosis of CHD, cancer, or type 2 diabetes. We confirmed 3,121 total incident CHD cases during 22 years of follow-up. Cox proportional hazard models were used to adjust for covariates. Results: After adjusting for lifestyle and dietary covariates, the hazard ratio (RR) and 95% confidence intervals comparing men in the highest vs. the lowest quintile was 1.16 (1.04, 1.31; p for trend=0.03) for dietary GI, and 1.09 (0.94, 1.27; p for trend =0.16) for GL. We found a significant effect modification by fiber intake (p=0.02); The associations between GL and CHD risk were strongest among participants in the lowest tertile of fiber intake (RR= 1.00, 1.00, 0.93, 1.11 and 1.16 with increasing quintiles of GL; RR=1.00, 0.68, 0.79, 0.73 and 0.76 for participants in the highest tertile of fiber intake). The association between GL and CHD was stronger among men with body mass index (BMI) greater than 25 kg/m2 than normal weight men, even though the test for interaction was only marginally significant (RR=1.00, 1.03, 1.05, 1.10, and 1.16 for increasing quintles of GL among men with BMI≥25 kg/m2 and RR= 1.00, 0.92, 0.96, 1.09 and 1.04 for men with BMI<25 kg/m2, p for interaction=0.09). Alcohol intake did not modify the association of GL with CHD (p for interaction=0.44). Conclusion: We observed a significantly increased risk of CHD with high GI diet and a modestly elevated association between GL and CHD among men with low fiber intakes or who were overweight or obese. No effect modification by alcohol was observed, but we did find that the association between GL and CHD was more pronounced among those with lower fiber intake or higher BMI.


2020 ◽  
Vol 112 (3) ◽  
pp. 631-643 ◽  
Author(s):  
Sabina Sieri ◽  
Claudia Agnoli ◽  
Sara Grioni ◽  
Elisabete Weiderpass ◽  
Amalia Mattiello ◽  
...  

ABSTRACT Background High carbohydrate intake raises blood triglycerides, glucose, and insulin; reduces HDLs; and may increase risk of coronary heart disease (CHD). Epidemiological studies indicate that high dietary glycemic index (GI) and glycemic load (GL) are associated with increased CHD risk. Objectives The aim of this study was to determine whether dietary GI, GL, and available carbohydrates are associated with CHD risk in both sexes. Methods This large prospective study—the European Prospective Investigation into Cancer and Nutrition—consisted of 338,325 participants who completed a dietary questionnaire. HRs with 95% CIs for a CHD event, in relation to intake of GI, GL, and carbohydrates, were estimated using covariate-adjusted Cox proportional hazard models. Results After 12.8 y (median), 6378 participants had experienced a CHD event. High GL was associated with greater CHD risk [HR 1.16 (95% CI: 1.02, 1.31) highest vs. lowest quintile, p-trend 0.035; HR 1.18 (95% CI: 1.07, 1.29) per 50 g/day of GL intake]. The association between GL and CHD risk was evident in subjects with BMI (in kg/m2) ≥25 [HR: 1.22 (95% CI: 1.11, 1.35) per 50 g/d] but not in those with BMI &lt;25 [HR: 1.09 (95% CI: 0.98, 1.22) per 50 g/d) (P-interaction = 0.022). The GL–CHD association did not differ between men [HR: 1.19 (95% CI: 1.08, 1.30) per 50 g/d] and women [HR: 1.22 (95% CI: 1.07, 1.40) per 50 g/d] (test for interaction not significant). GI was associated with CHD risk only in the continuous model [HR: 1.04 (95% CI: 1.00, 1.08) per 5 units/d]. High available carbohydrate was associated with greater CHD risk [HR: 1.11 (95% CI: 1.03, 1.18) per 50 g/d]. High sugar intake was associated with greater CHD risk [HR: 1.09 (95% CI: 1.02, 1.17) per 50 g/d]. Conclusions This large pan-European study provides robust additional support for the hypothesis that a diet that induces a high glucose response is associated with greater CHD risk.


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