Search

Background: There is debate over whether the glycaemic index of foods relates to chronic disease. We aimed to assess the associations between glycaemic index (GI) and glycaemic load (GL) and type 2 diabetes, cardiovascular disease, diabetes-related cancers, and all-cause mortality. Methods: We did a meta-analysis of large cohorts (≥100 000 participants) identified from the Richard Doll Consortium. We searched the Cochrane Library, MEDLINE, PubMed, Embase, Web of Science, and Scopus for cohorts that prospectively examined associations between GI or GL and chronic disease outcomes published from database inception to Aug 4, 2023. Full-article review and extraction of summary estimates data were conducted by three independent reviewers. Primary outcomes were incident type 2 diabetes, total cardiovascular disease (including mortality), diabetes-related cancers (ie, bladder, breast, colorectal, endometrial, hepatic, pancreatic, and non-Hodgkin lymphoma), and all-cause mortality. We assessed comparisons between the lowest and highest quantiles of GI and GL, adjusting for dietary factors, and pooling their most adjusted relative risk (RR) estimates using a fixed-effects model. We also assessed associations between diets high in fibre and whole grains and the four main outcomes. The study protocol is registered with PROSPERO, CRD42023394689. Findings: From ten prospective large cohorts (six from the USA, one from Europe, two from Asia, and one international), we identified a total of 48 studies reporting associations between GI or GL and the outcomes of interest: 34 (71%) on various cancers, nine (19%) on cardiovascular disease, five (10%) on type 2 diabetes, and three (6%) on all-cause mortality. Consumption of high GI foods was associated with an increased incidence of type 2 diabetes (RR 1·27 [95% CI 1·21–1·34]; p<0·0001), total cardiovascular disease (1·15 [1·11–1·19]; p<0·0001), diabetes-related cancer (1·05 [1·02–1·08]; p=0·0010), and all-cause mortality (1·0

Dietary glycemic index (GI) and glycemic load (GL) are associated with cardiome-tabolic health in children and adolescents, with potential distinct effects in people with increased BMI. DNA methylation (DNAm) may mediate these effects. Thus, we conducted meta-analyses of epigenome-wide association studies (EWAS) between dietary GI and GL and blood DNAm of children and adolescents. RESEARCH DESIGN AND METHODS We calculated dietary GI and GL and performed EWAS in children and adolescents (age range: 4.5–17 years) from six cohorts (N = 1,187). We performed stratified analyses of participants with normal weight (n = 801) or overweight or obesity (n = 386). We performed look-ups for the identified cytosine–phosphate–guanine (CpG) sites (false discovery rate [FDR] < 0.05) with tissue-specific gene expression of 832 blood and 223 subcutaneous adipose tissue samples from children and adolescents. RESULTS Dietary GL was positively associated with DNAm of cg20274553 (FDR < 0.05), anno-tated to WDR27. Several CpGs were identified in the normal-weight (GI: 85; GL: 17) and overweight or obese (GI: 136; GL: 298; FDR < 0.05) strata, and none overlapped between strata. In participants with overweight or obesity, identified CpGs were related to RNA expression of genes associated with impaired metabolism (e.g., FRAT1, CSF3). CONCLUSIONS We identified 537 associations between dietary GI and GL and blood DNAm, mainly in children and adolescents with overweight or obesity. High-GI and/or-GL diets may influence epigenetic gene regulation and thereby promote metabolic derangements in young people with increased BMI.

The consumption of food items containing digestible carbohydrates in food products leads to postprandial increases in blood glucose levels and glycemic responses. The extent to which these occur depends on many factors, including concentration and type of carbohydrate, but also other physicochemical properties of the food matrix, which determine the rate of uptake of monosaccharides into the bloodstream, including product structure and factors affecting gastric emptying. For milk, control of postprandial glycemic responses appears to be multifaceted, including a controlled rate of gastric emptying, a rate of glucose and galactose uptake into the bloodstream controlled by enzymatic hydrolysis, as well as stimulated insulin secretion to enhance uptake of blood glucose from the bloodstream. Altogether, this allows milk to deliver comparatively high levels of carbohydrate with limited glycemic responses. For plant-based drinks positioned as milk alternatives, however, compositional differences (including carbohydrate type and concentration) as well as matrix factors limiting control over gastric emptying and insulin secretion can, in some cases, lead to much stronger glycemic responses, which are undesirable in relation to non-communicable diseases, such as type-2 diabetes. This review discusses glycemic responses to milk and plant-based drinks from this perspective, focusing on mechanistic insights and food matrix effects.

According to the International Diabetes Federation, 15,7 million Brazilians suffer from Diabetes. Known as a disease closely related to diet and especially with carbohydrate consumption, knowledge about glycemic index and glycemic load has been widely disseminated and used in nutritional orientation. Both the glycemic index and glycemic load are concepts that generate different opinions experts and health organizations. Given this, this work through a qualitative review aims to present the concepts and clinical recommendations on glycemic index and glycemic load. In short, glycemic index and glycemic load are important tools in the nutritional guidance process, with a significant effect on glycemic control., Segundo dados da International Diabetes Federation, 15,7 milhões de brasileiros são portadores de Diabetes. Por ser uma doença relacionada com a dieta e principalmente com o consumo de carboidratos, os conhecimentos sobre índice glicêmico e carga glicêmica tem sido amplamente difundidos e utilizados na orientação nutricional. Tanto o índice glicêmico quanto a carga glicêmica são conceitos que geram diferentes opiniões por parte de especialistas e organizações de saúde. Diante disto, este trabalho através de uma revisão qualitativa tem por objetivos apresentar os conceitos e as recomendações clínicas sobre índice glicêmico e carga glicêmica. Em suma, índice glicêmico e carga glicêmica apresentam-se como instrumentos importantes no processo de orientação nutricional, com efeito significativo sobre o controle glicêmico.

Background: Modisco (modified dried milk and coconut oil) is a processed food in liquid form that contains high energy and protein. Provision of high-calorie, high-protein supplementary food is necessary for nutritionally vulnerable age groups who have problems with digestion. The development of the modisco formulation made from pumpkin into processed steamed cakes and cookies based on the modisco formulation aims to improve taste and increase the length of time of storage before consumption. The addition of pumpkin as a source of fiber in processed steamed cakes and cookies is a choice of low glycemic index and glycemic load snacks. Objectives: This study conducted to describe the glycemic index and glycemic load of processed steamed cakes and cookies using the ingredients of the modified pumpkin (Cucurbita moschata Durch) formulation. Methods: The design of this study was an experimental in vitro vivo design. The in vitro study was carried out by making steamed cakes and cookies with the main ingredients of the modisco III formula with several formulations, then the best formula was selected to be given as an in vivo treatment. The respondent in this study were 10 Ngudi Waluyo students aged 17-25 years, who had a normal Body Mass Index (18.5 to 22.9 kg/m2), normal pre-prandial blood sugar (70-100 mg/dl), and never suffered from diabetes mellitus. The respondents were previously fast at night for 10 hours at least, and do not strenuous activities during preparation for blood collection. The first blood collection was taken at 0 minutes, carried out at 7 am through the fingertips (peripheral blood) carried out by the nurse, then the respondents were given steamed cakes to one group and cookies to the other group, each of 50 grams. Blood collection was continued at 30, 60, 90, and 120 minutes. Blood sugar levels were measured using a gluco-test. The blood glucose data obtained was then analyzed to determine the glycemic index and glycemic load of processed steamed c, Latar Belakang: Modisco (modified dried milk and coconut oil) merupakan makanan cair tinggi kalori serta protein yang dapat dijadikan sebagai alternatif makanan tambahan. Modifikasi formula modisco dengan penambahan labu kuning dan produk baru bolu kukus dan cookies berbasis modisco dimaksudkan untuk menambah variasi serta menambah masa guna dan pakai. Penambahan labu kuning sebagai sumber serat pada produk bolu kukus dan cookies dapat dijadikan alternatif kudapan rendah indeks glikemik dan beban glikemik. Tujuan: Penelitian ini bertujuan untuk mendeskripsikan indeks glikemik dan beban glikemik bolu kukus dan cookies berbahan dasar modisco labu kuning (Cucurbita moschata Durch). Metode: Penelitian ini menggunakan design eksperimental invivo invitro. Subyek dalam penelitian ini adalah mahasiswa Ngudi Waluyo, responden berjumlah 10 orang dengan kriteria inklusi rentang usia 17-25 tahun, memiliki IMT normal (18.5-22.9 kg/m2), Gula Darah Puasa (GDP) 70-100 mg/dl, dan tidak memilki riwayat Diabetes Melitus (DM). Responden diminta melakukan puasa pada malam hari selama 10-12 jam dan tidak melakukan aktivitas berat selama persiapan penelitian. Responden diberikan bolu kukus atau cookies  sebanyak 50 gram, setelah itu diambil darahnya melalui ujung jari. Pemeriksaan glukosa darah dilakukan pada pagi hari selama 2 jam berurutan dengan interval tertentu. Data glukosa darah yang diperoleh kemudian diolah untuk mendapatkan nilai indeks glikemik dan beban glikemiknya. Hasil: Produk bolu kukus memiliki nilai indeks glikemik 23.00% dan beban glikemik 5.75, sedangkan pada produk cookies memiliki nilai indeks glikemik 38.9% dan beban glikemik 9.75. Simpulan: Nilai indeks glikemik dan beban glikemik produk bolu kukus dan cookies formula modisco labu kuning masuk dalam kategori rendah

Background: Palm sugar (Arenga pinnata) is believed to benefit people with diabetes mellitus since they believe it has a low glycemic index. However, the total carbohydrates in palm sugar, particularly sucrose, are high. Thus, offering palm sugar to diabetic people still needs further studies. Objectives: The purpose of this study was to examine differences in the glycemic response, glycemic index, and glycemic load of palm sugar compared to cane sugar. Methods: This study used an experimental design. Measurement of the oral glucose tolerance test (OGTT) through the finger-prick capillary blood test method. The main materials in this study were commercial white cane sugar as reference food and traditional palm sugar product of Lebak District, Banten Province, as a test food. Reference food and test food were provided equivalent to 50 g available carbohydrate dissolved in 250 ml mineral water subjected to 5 men and 5 women. The glycemic response was determined by the area under the curve (AUC) of the trapezoid method. The difference in glycemic response between the reference food and the test food was assessed using the independent sample t-test. Results: The peak of the increase in blood glucose occurred at 30 minutes. There was no difference in glycemic response between the reference food and the test food (p-value 0.685). The palm sugar glycemic index was 98.71 and was categorized into the high glycemic index category. Meanwhile, the glycemic load of palm sugar and cane sugar was 11.80 and 12.22, those categorized into the medium glycemic load category. Conclusions: No differences in glycemic response between palm sugar and cane sugar. The glycemic index of palm sugar was considered high and was not different from cane sugar. The glycemic load of palm sugar and cane sugar was classified as moderate due to the small serving size. Using palm sugar less than cane sugar was expected to provide a lower glycemic response, glycemic index, and glycemic load., Background: Palm sugar (Arenga pinnata) is believed to benefit people with diabetes mellitus since they believe it has a low glycemic index. However, the total carbohydrates in palm sugar, particularly sucrose, are high. Thus, offering palm sugar to diabetic people still needs further studies.Objectives: The purpose of this study was to examine differences in the glycemic response, glycemic index, and glycemic load of palm sugar compared to cane sugar.Methods: This study used an experimental design. Measurement of the oral glucose tolerance test (OGTT) through the finger-prick capillary blood test method. The main materials in this study were commercial white cane sugar as reference food and traditional palm sugar product of Lebak District, Banten Province, as a test food. Reference food and test food were provided equivalent to 50 g available carbohydrate dissolved in 250 ml mineral water subjected to 5 men and 5 women. The glycemic response was determined by the area under the curve (AUC) of the trapezoid method. The difference in glycemic response between the reference food and the test food was assessed using the independent sample t-test.Results: The peak of the increase in blood glucose occurred at 30 minutes. There was no difference in glycemic response between the reference food and the test food (p-value 0.685). The palm sugar glycemic index was 98.71 and was categorized into the high GI category. Meanwhile, the glycemic load of palm sugar and cane sugar was 11.80 and 12.22, those categorized into the medium GL category.Conclusions: No differences in glycemic response between palm sugar and cane sugar. The glycemic index of palm sugar was considered high and was not significantly different from cane sugar. The glycemic load of palm sugar and cane sugar was classified as moderate due to the small serving size. Using palm sugar less than cane sugar was expected to provide a lower glycemic response, glycemic index, and glycemic load.

Background & aims: The association of quantity and quality of carbohydrate sources with appetite during long-term weight-loss maintenance (WLM) after intentional weight loss (WL) is unclear. We aimed to investigate longitudinal associations of quantity and quality of carbohydrate sources with changes in subjective appetite sensations during WLM.Methods: This secondary analysis evaluated longitudinal data from the 3-year WLM phase of the PREVIEW study, a 2 × 2 factorial (diet-physical activity arms), multi-center, randomized trial. 1279 individuals with overweight or obesity and prediabetes (25-70 years; BMI≥25 kg m-2) were included. Individuals were merged into 1 group to assess longitudinal associations of yearly changes in appetite sensations. Quantity and quality of carbohydrate sources including total carbohydrate, glycemic index (GI), glycemic load (GL), and total dietary fiber were assessed via 4-day food diaries at 4 timepoints (26, 52, 104, and 156 weeks) during WLM. Visual analog scales were used to assess appetite sensations in the previous week.Results: During WLM, participants consumed on average 160.6 (25th, 75th percentiles 131.1, 195.8) g·day-1 of total carbohydrate, with GI 53.8 (48.7, 58.8) and GL 85.3 (67.2, 108.9) g day-1, and 22.3 (17.6, 27.3) g·day-1 of dietary fiber. In the available-case analysis, multivariable-adjusted linear mixed models with repeated measures showed that each 30-g increment in total carbohydrate was associated with increases in hunger (1.36 mm year-1, 95% CI 0.77, 1.95, P < 0.001), desire to eat (1.10 mm year-1, 0.59, 1.60, P < 0.001), desire to eat something sweet (0.99 mm year-1, 0.30, 1.68, P = 0.005), and weight regain (0.20%·year-1, 0.03, 0.36, P = 0.022). Increasing GI was associated with weight regain, but not associated with increases in appetite sensatio

Background & aims: The association of quantity and quality of carbohydrate sources with appetite during long-term weight-loss maintenance (WLM) after intentional weight loss (WL) is unclear. We aimed to investigate longitudinal associations of quantity and quality of carbohydrate sources with changes in subjective appetite sensations during WLM.Methods: This secondary analysis evaluated longitudinal data from the 3-year WLM phase of the PREVIEW study, a 2 × 2 factorial (diet-physical activity arms), multi-center, randomized trial. 1279 individuals with overweight or obesity and prediabetes (25-70 years; BMI≥25 kg m-2) were included. Individuals were merged into 1 group to assess longitudinal associations of yearly changes in appetite sensations. Quantity and quality of carbohydrate sources including total carbohydrate, glycemic index (GI), glycemic load (GL), and total dietary fiber were assessed via 4-day food diaries at 4 timepoints (26, 52, 104, and 156 weeks) during WLM. Visual analog scales were used to assess appetite sensations in the previous week.Results: During WLM, participants consumed on average 160.6 (25th, 75th percentiles 131.1, 195.8) g·day-1 of total carbohydrate, with GI 53.8 (48.7, 58.8) and GL 85.3 (67.2, 108.9) g day-1, and 22.3 (17.6, 27.3) g·day-1 of dietary fiber. In the available-case analysis, multivariable-adjusted linear mixed models with repeated measures showed that each 30-g increment in total carbohydrate was associated with increases in hunger (1.36 mm year-1, 95% CI 0.77, 1.95, P < 0.001), desire to eat (1.10 mm year-1, 0.59, 1.60, P < 0.001), desire to eat something sweet (0.99 mm year-1, 0.30, 1.68, P = 0.005), and weight regain (0.20%·year-1, 0.03, 0.36, P = 0.022). Increasing GI was associated with weight regain, but not associated with increases in appetite sensatio

The increased prevalence of obese, pregnant women who have a higher risk of glucose intolerance warrants the need for nutritional interventions to improve maternal glucose homeostasis. In this study, the effect of a low-glycemic load (GL) (n = 28) was compared to a high-GL (n = 34) dietary intervention during the second half of pregnancy in obese women (body mass index (BMI) > 30 or a body fat >35%). Anthropometric and metabolic parameters were assessed at baseline (20 week) and at 28 and 34 weeks gestation. For the primary outcome 3h-glucose-iAUC (3h-incremental area under the curve), mean between-group differences were non-significant at every study timepoint (p = 0.6, 0.3, and 0.8 at 20, 28, and 34 weeks, respectively) and also assessing the mean change over the study period (p = 0.6). Furthermore, there was no statistically significant difference between the two intervention groups for any of the other examined outcomes (p ≥ 0.07). In the pooled cohort, there was no significant effect of dietary GL on any metabolic or anthropometric outcome (p ≥ 0.2). A post hoc analysis comparing the study women to a cohort of overweight or obese pregnant women who received only routine care showed that the non-study women were more likely to gain excess weight (p = 0.046) and to deliver large-for-gestational-age (LGA) (p = 0.01) or macrosomic (p = 0.006) infants. Thus, a low-GL diet consumed during the last half of pregnancy did not improve pregnancy outcomes in obese women, but in comparison to non-study women, dietary counseling reduced the risk of adverse outcomes.

The increased prevalence of obese, pregnant women who have a higher risk of glucose intolerance warrants the need for nutritional interventions to improve maternal glucose homeostasis. In this study, the effect of a low-glycemic load (GL) (n = 28) was compared to a high-GL (n = 34) dietary intervention during the second half of pregnancy in obese women (body mass index (BMI) > 30 or a body fat >35%). Anthropometric and metabolic parameters were assessed at baseline (20 week) and at 28 and 34 weeks gestation. For the primary outcome 3h-glucose-iAUC (3h-incremental area under the curve), mean between-group differences were non-significant at every study timepoint (p = 0.6, 0.3, and 0.8 at 20, 28, and 34 weeks, respectively) and also assessing the mean change over the study period (p = 0.6). Furthermore, there was no statistically significant difference between the two intervention groups for any of the other examined outcomes (p ≥ 0.07). In the pooled cohort, there was no significant effect of dietary GL on any metabolic or anthropometric outcome (p ≥ 0.2). A post hoc analysis comparing the study women to a cohort of overweight or obese pregnant women who received only routine care showed that the non-study women were more likely to gain excess weight (p = 0.046) and to deliver large-for-gestational-age (LGA) (p = 0.01) or macrosomic (p = 0.006) infants. Thus, a low-GL diet consumed during the last half of pregnancy did not improve pregnancy outcomes in obese women, but in comparison to non-study women, dietary counseling reduced the risk of adverse outcomes.

BackgroundPancreatic cancer risk is increasing in countries with high consumption of Western dietary patterns and rising obesity rates. We examined the hypothesis that specific dietary patterns reflecting hyperinsulinemia (empirical dietary index for hyperinsulinemia; EDIH), systemic inflammation (empirical dietary inflammatory pattern; EDIP), and postprandial glycemia [glycemic index (GI); glycemic load (GL)] are associated with pancreatic cancer risk, including the potential modifying role of type 2 diabetes (T2D) and body mass index (BMI).MethodsWe calculated dietary scores from baseline (1993-1998) food frequency questionnaires among 129,241 women, 50-79 years-old in the Women's Health Initiative. We used multivariable-adjusted Cox regression to estimate HRs and 95% confidence intervals (95% CI) for pancreatic cancer risk.ResultsDuring a median 19.9 years of follow-up, 850 pancreatic cancer cases were diagnosed. We observed no association between dietary scores and pancreatic cancer risk overall. However, risk was elevated among participants with longstanding T2D (present >3 years before pancreatic cancer diagnosis) for EDIH. For each 1 SD increment in dietary score, the HRs (95% CIs) were: EDIH, 1.33 (1.06-1.66); EDIP, 1.26 (0.98-1.63); GI, 1.26 (0.96-1.67); and GL, 1.23 (0.96-1.57); although interactions were not significant (all P interaction >0.05). Separately, we observed inverse associations between GI [0.86 (0.76-0.96), P interaction = 0.0068] and GL [0.83 (0.73-0.93), P interaction = 0.0075], with pancreatic cancer risk among normal-weight women.ConclusionsWe observed no overall association between the dietary patterns evaluated and pancreatic cancer risk, although women with T2D appeared to have greater cancer risk.ImpactThe elevated risk for hyperinsulinemic diets among women with longstanding T2D and the inverse association among normal-weight women warrant further examination.

OBJECTIVE To inform the update of the European Association for the Study of Diabetes clinical practice guidelines for nutrition therapy. DESIGN Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES Medline, Embase, and the Cochrane Library searched up to 13 May 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials of three or more weeks investigating the effect of diets with low glycaemic index (GI)/glycaemic load (GL) in diabetes. OUTCOME AND MEASURES The primary outcome was glycated haemoglobin (HbA1c). Secondary outcomes included other markers of glycaemic control (fasting glucose, fasting insulin); blood lipids (low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL-C, apo B, triglycerides); adiposity (body weight, BMI, waist circumference), blood pressure (systolic blood pressure (SBP) and diastolic blood pressure (DBP)), and inflammation (C reactive protein (CRP)). DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and assessed risk of bias. Data were pooled by random effects models. GRADE (grading of recommendations assessment, development, and evaluation) was used to assess the certainty of evidence. RESULTS 29 trial comparisons were identified in 1617 participants with type 1 and 2 diabetes who were predominantly middle aged, overweight, or obese with moderately controlled type 2 diabetes treated by hyperglycaemia drugs or insulin. Low GI/GL dietary patterns reduced HbA1c in comparison with higher GI/GL control diets (mean difference & minus;0.31% (95% confidence interval & minus;0.42 to & minus;0.19%), P < 0.001; substantial heterogeneity, I2=75%, P < 0.001). Reductions occurred also in fasting glucose, LDL-C, non-HDL-C, apo B, triglycerides, bod

Objective: To relate food consumption according to glycemic index and glycemic load with the percentage of body fat in women between 20 and 59 years of age in the Guacima de Alajuela in 2020. Methodology: Non-experimental, cross-sectional study, type descriptive and correlational. It is carried out with 100 women from 20 to 59 years of age from the Guacima de Alajuela. For dietary evaluation, a frequency of food consumption is used and anthropometric measurements are taken to assess BMI, percentage of body fat and cardiovascular risk. Results: 73% of women present high percentages of body fat. Most women have a daily food intake of high glycemic load (59%) and a moderate glycemic index (62%), their consumption represented mostly by women with a high percentage of body fat. The three most consumed foods daily are white rice, table sugar and beans, mostly consumed by women with percentages of body fat above the appropriate range. Conclusion: There is an association between daily food consumption according to glycemic load and the percentage of body fat, but no association is found according to the glycemic index, therefore, maintaining high glycemic load diets may contribute to high percentages of body fat., Objetivo: Relacionar el consumo de alimentos según índice glucémico y carga glucémica con el porcentaje de grasa corporal en mujeres de 20 a 59 años de edad de la Guácima de Alajuela en el 2020. Metodología: Estudio no experimental, de corte transversal, tipo descriptivo y correlacional. Se realiza con 100 mujeres de 20 a 59 años de edad de la Guácima de Alajuela. Para la evaluación dietética se utiliza una frecuencia de consumo de alimentos y se toman las mediciones antropométricas para valorar el IMC, porcentaje de grasa corporal y riesgo cardiovascular. Resultados: El 73% de las mujeres presenta porcentajes de grasa corporal elevados. La mayoría de las mujeres tiene un consumo de alimentos diario de alta carga glucémica (59%) y de moderado índice glucémico (62%), representado su consumo en su mayoría por mujeres con porcentaje de grasa corporal elevado. Los tres alimentos más consumidos diariamente son el arroz blanco, el azúcar de mesa y los frijoles, mayormente consumidos por las mujeres con porcentajes de grasa corporal por encima del rango adecuado. Conclusión: Existe asociación entre el consumo diario de alimentos según carga glucémica y el porcentaje de grasa corporal, pero, no se encuentra asociación según el índice glucémico, por lo que, mantener dietas de alta carga glucémica quizás pueda contribuir con porcentajes de grasa corporal elevados.

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/m(2)) >= 25 [HR: 1.22 (95% CI: 1.11, 1.35) per 50 g/d] but not in those with BMI <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.

High dietary glycaemic index (GI) and glycaemic load (GL) may increase cancer risk. However, limited information was available on GI and/or GL and head and neck cancer (HNC) risk. We conducted a pooled analysis on 8 case-control studies (4081 HNC cases; 7407 controls) from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) of HNC, and its subsites, from fixed- or mixed-effects logistic models including centre-specific quartiles of GI or GL. GI, but not GL, had a weak positive association with HNC (ORQ4 vs. Q1 = 1.16; 95% CI = 1.02-1.31). In subsites, we found a positive association between GI and laryngeal cancer (ORQ4 vs. Q1 = 1.60; 95% CI = 1.30-1.96) and an inverse association between GL and oropharyngeal cancer (ORQ4 vs. Q1 = 0.78; 95% CI = 0.63-0.97). This pooled analysis indicates a modest positive association between GI and HNC, mainly driven by laryngeal cancer.

High dietary glycaemic index (GI) and glycaemic load (GL) may increase cancer risk. However, limited information was available on GI and/or GL and head and neck cancer (HNC) risk. We conducted a pooled analysis on 8 case-control studies (4081 HNC cases; 7407 controls) from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) of HNC, and its subsites, from fixed- or mixed-effects logistic models including centre-specific quartiles of GI or GL. GI, but not GL, had a weak positive association with HNC (ORQ4 vs. Q1 = 1.16; 95% CI = 1.02-1.31). In subsites, we found a positive association between GI and laryngeal cancer (ORQ4 vs. Q1 = 1.60; 95% CI = 1.30-1.96) and an inverse association between GL and oropharyngeal cancer (ORQ4 vs. Q1 = 0.78; 95% CI = 0.63-0.97). This pooled analysis indicates a modest positive association between GI and HNC, mainly driven by laryngeal cancer.

Dietary intake potentially modifies the prevalence or severity of asthma. The prevalence of asthma is higher in women with polycystic ovary syndrome (PCOS); it is not known if diet confounds or modifies the association between asthma and PCOS. The aims of this study were: (i) To determine if the association of PCOS and asthma is independent of dietary pattern and (ii) to determine if dietary pattern modifies the association between PCOS and asthma. Women in this study were from the Australian Longitudinal Study on Women's Health (ALSWH) cohort born between 1973 to 1978 and aged 18 to 23 years (n = 7382). Logistic regression was used to assess the association between PCOS and asthma, adjusting for the following: (i) Potential confounders identified a priori and (ii) dietary patterns (z-score) identified by principle component analysis. In the adjusted analysis, women with PCOS were more likely to have asthma than the women without PCOS (OR 1.35 and 95% CI, 1.02 and 1.78). This relationship was not altered by further adjustment for dietary patterns (non-core food, meats and takeaway, or Mediterranean-style pattern). In the interaction analysis, only the women consuming less than the median intake of non-core foods (i.e., lower intake of discretionary or unhealthy foods) and with PCOS were more likely to have asthma (OR 1.91 and 95% CI, 1.29 and 2.82). Dietary intake did not confound the relationship between PCOS and asthma. Other mechanistic pathways are likely responsible for the asthma and PCOS association, and further studies assessing factors such as oral contraceptive use and sex steroid hormones warrant investigation.Copyright © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Dietary intake potentially modifies the prevalence or severity of asthma. The prevalence of asthma is higher in women with polycystic ovary syndrome (PCOS); it is not known if diet confounds or modifies the association between asthma and PCOS. The aims of this study were: (i) To determine if the association of PCOS and asthma is independent of dietary pattern and (ii) to determine if dietary pattern modifies the association between PCOS and asthma. Women in this study were from the Australian Longitudinal Study on Women's Health (ALSWH) cohort born between 1973 to 1978 and aged 18 to 23 years (n = 7382). Logistic regression was used to assess the association between PCOS and asthma, adjusting for the following: (i) Potential confounders identified a priori and (ii) dietary patterns (z-score) identified by principle component analysis. In the adjusted analysis, women with PCOS were more likely to have asthma than the women without PCOS (OR 1.35 and 95% CI, 1.02 and 1.78). This relationship was not altered by further adjustment for dietary patterns (non-core food, meats and takeaway, or Mediterranean-style pattern). In the interaction analysis, only the women consuming less than the median intake of non-core foods (i.e., lower intake of discretionary or unhealthy foods) and with PCOS were more likely to have asthma (OR 1.91 and 95% CI, 1.29 and 2.82). Dietary intake did not confound the relationship between PCOS and asthma. Other mechanistic pathways are likely responsible for the asthma and PCOS association, and further studies assessing factors such as oral contraceptive use and sex steroid hormones warrant investigation.Copyright © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

High dietary glycaemic index (GI) and glycaemic load (GL) may increase cancer risk. However, limited information was available on GI and/or GL and head and neck cancer (HNC) risk. We conducted a pooled analysis on 8 case-control studies (4081 HNC cases; 7407 controls) from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) of HNC, and its subsites, from fixed- or mixed-effects logistic models including centre-specific quartiles of GI or GL. GI, but not GL, had a weak positive association with HNC (ORQ4 vs. Q1 = 1.16; 95% CI = 1.02-1.31). In subsites, we found a positive association between GI and laryngeal cancer (ORQ4 vs. Q1 = 1.60; 95% CI = 1.30-1.96) and an inverse association between GL and oropharyngeal cancer (ORQ4 vs. Q1 = 0.78; 95% CI = 0.63-0.97). This pooled analysis indicates a modest positive association between GI and HNC, mainly driven by laryngeal cancer.

BackgroundAlthough there is some evidence of positive associations between both the glycemic index (GI) and glycemic load (GL) with cancer risk, the relationships with lung cancer risk remain largely unexplored. We evaluated the associations between GI and GL with lung cancer.MethodsThe analyses were performed using data from a population-based case-control study recruited between 1999 and 2004 in Los Angeles County. Dietary factors were collected from 593 incident lung cancer cases and 1026 controls using a modified food frequency questionnaire. GI and GL were estimated using a food composition table. Adjusted odds ratios (ORs) and 95 % confidence intervals (CI) were estimated using unconditional logistic regression adjusting for potential confounders.ResultsDietary GI was positively associated with lung cancer (OR for upper vs. lower tertile = 1.62; 95 % CI: 1.17, 2.25). For histologic subtypes, positive associations were observed between GI and adenocarcinoma (OR for upper vs. lower tertile = 1.82; 95 % CI: 1.22, 2.70) and small cell carcinoma (OR for upper vs. lower tertile = 2.68; 95 % CI: 1.25, 5.74). No clear association between GL and lung cancer was observed.ConclusionThese findings suggest that high dietary GI was associated with increased lung cancer risk, and the positive associations were observed for both lung adenocarcinoma and small cell lung carcinoma. Replication in an independent dataset is merited for a broader interpretation of our results.

BackgroundPrevious studies have shown mixed results on the association between carbohydrate intake and insomnia. However, any influence that refined carbohydrates have on risk of insomnia is likely commensurate with their relative contribution to the overall diet, so studies are needed that measure overall dietary glycemic index (GI), glycemic load, and intakes of specific types of carbohydrates.ObjectiveWe hypothesized that higher GI and glycemic load would be associated with greater odds of insomnia prevalence and incidence.MethodsThis was a prospective cohort study with postmenopausal women who participated in the Women's Health Initiative Observational Study, investigating the relations of GI, glycemic load, other carbohydrate measures (added sugars, starch, total carbohydrate), dietary fiber, and specific carbohydrate-containing foods (whole grains, nonwhole/refined grains, nonjuice fruits, vegetables, dairy products) with odds of insomnia at baseline (between 1994 and 1998; n = 77,860) and after 3 y of follow-up (between 1997 and 2001; n = 53,069).ResultsIn cross-sectional and longitudinal analyses, higher dietary GI was associated with increasing odds of prevalent (fifth compared with first quintile OR: 1.11; CI: 1.05, 1.16; P-trend = 0.0014) and incident (fifth compared with first quintile OR: 1.16; CI: 1.08, 1.25; P-trend < 0.0001) insomnia in fully adjusted models. Higher intakes of dietary added sugars, starch, and nonwhole/refined grains were each associated with higher odds of incident insomnia. By contrast, higher nonjuice fruit and vegetable intakes were significantly associated with lower odds of incident insomnia. Also, higher intakes of dietary fiber, whole grains, nonjuice fruit, and vegetables were significantly associated with lower odds of prevalent insomnia.ConclusionsThe results suggest that high-GI diets could be a risk factor for insomnia in postmenopausal women. Substitution of high-GI foods with

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 <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.

Background: Prepregnancy diabetes, especially when severely dysregulated, is associated with an increased risk of congenital heart defects in offspring. This suggests that glucose plays a role in embryonic heart development. Objective: The aim was to investigate the association between midpregnancy dietary glycemic index (GI), glycemic load (GL), and sugar-sweetened beverages and the risk of congenital heart defects in the offspring. Methods: Offspring of mothers from the Danish National Birth Cohort who filled out a food-frequency questionnaire (FFQ) covering midpregnancy dietary intake were included. Individual-level information on GI and GL, offspring congenital heart defects, and health and lifestyle covariates was linked. The association between GI and GL and offspring congenital heart defects was estimated by logistic regression. Further, we evaluated whether maternal intake of sugar-sweetened drinks increased the risk of offspring congenital heart defects. Results: In total, 66,387 offspring of women who responded to the FFQ were included; among offspring, 543 had a congenital heart defect. The adjusted OR (aOR) of congenital heart defects among offspring of mothers belonging to the highest versus the lowest GI quintile was 1.02 (95% CI: 0.78, 1.34; P-trend = 0.86). Results were similar for GL (aOR: 0.95; 95% CI: 0.72, 1.24). A high intake of sugar-sweetened carbonated beverages was associated with a statistically significant increased risk of offspring congenital heart defects (highest vs lowest intake-aOR: 2.41; 95% CI: 1.26, 4.64; P-trend = 0.03). No association was found with other types of beverages. Conclusions: The study does not support an association between a high GI and GL in midpregnancy and increased offspring risk of congenital heart defects. Nevertheless, a statistically significant association between sugar-sweetened carbonated beverages and a moderately increased risk of offspring congenital heart defects was observed.

AIM: Ethnic Chinese women are one of the populations at high risk of gestational diabetes mellitus (GDM) internationally. This systematic review aimed to determine which dietary intervention strategies were found to be effective in improving glycaemic control and pregnancy outcomes among ethnic Chinese women with GDM. METHOD(S): The review protocol was registered with PROSPERO (CRD42016043585). Eight English and four Chinese language databases were searched for randomised controlled trials and cohort studies of dietary intervention among ethnic Chinese women with GDM. Review Manager 5.3 and GRADE criteria were used in meta-analysis and assessment of quality of evidence. RESULT(S): Included studies comprised 3944 women in 29 eligible studies. Compared to standard treatment, low glycaemic index (GI) diets, low glycaemic load (GL) diets and fibre-enriched diets were associated with a reduction in fasting plasma glucose, 2-hour plasma glucose and HbA1c, and improved neonatal outcomes. Low GL diets were associated with reduced caesarean section risk. CONCLUSION(S): In ethnic Chinese women with GDM, low GI diets, low GL diets and fibre-enriched diets were associated with improved glycaemic control and pregnancy outcomes. Given the lack of direct comparison of these three diets, future direct comparison trials are necessary to determine optimal dietary intervention strategies.Copyright © 2019 The Authors. Nutrition & Dietetics published by John Wiley & Sons Australia, Ltd on behalf of Dietitians Association of Australia.

AIM: Ethnic Chinese women are one of the populations at high risk of gestational diabetes mellitus (GDM) internationally. This systematic review aimed to determine which dietary intervention strategies were found to be effective in improving glycaemic control and pregnancy outcomes among ethnic Chinese women with GDM. METHOD(S): The review protocol was registered with PROSPERO (CRD42016043585). Eight English and four Chinese language databases were searched for randomised controlled trials and cohort studies of dietary intervention among ethnic Chinese women with GDM. Review Manager 5.3 and GRADE criteria were used in meta-analysis and assessment of quality of evidence. RESULT(S): Included studies comprised 3944 women in 29 eligible studies. Compared to standard treatment, low glycaemic index (GI) diets, low glycaemic load (GL) diets and fibre-enriched diets were associated with a reduction in fasting plasma glucose, 2-hour plasma glucose and HbA1c, and improved neonatal outcomes. Low GL diets were associated with reduced caesarean section risk. CONCLUSION(S): In ethnic Chinese women with GDM, low GI diets, low GL diets and fibre-enriched diets were associated with improved glycaemic control and pregnancy outcomes. Given the lack of direct comparison of these three diets, future direct comparison trials are necessary to determine optimal dietary intervention strategies.Copyright © 2019 The Authors. Nutrition & Dietetics published by John Wiley & Sons Australia, Ltd on behalf of Dietitians Association of Australia.

While dietary factors are important modifiable risk factors for type 2 diabetes (T2D), the causal role of carbohydrate quality in nutrition remains controversial. Dietary glycemic index (GI) and glycemic load (GL) have been examined in relation to the risk of T2D in multiple prospective cohort studies. Previous meta-analyses indicate significant relations but consideration of causality has been minimal. Here, the results of our recent meta-analyses of prospective cohort studies of 4 to 26-y follow-up are interpreted in the context of the nine Bradford-Hill criteria for causality, that is: (1) Strength of Association, (2) Consistency, (3) Specificity, (4) Temporality, (5) Biological Gradient, (6) Plausibility, (7) Experimental evidence, (8) Analogy, and (9) Coherence. These criteria necessitated referral to a body of literature wider than prospective cohort studies alone, especially in criteria 6 to 9. In this analysis, all nine of the Hill’s criteria were met for GI and GL indicating that we can be confident of a role for GI and GL as causal factors contributing to incident T2D. In addition, neither dietary fiber nor cereal fiber nor wholegrain were found to be reliable or eective surrogate measures of GI or GL. Finally, our cost–benefit analysis suggests food and nutrition advice favors lower GI or GL and would produce significant potential cost savings in national healthcare budgets. The high confidence in causal associations for incident T2D is sucient to consider inclusion of GI and GL in food and nutrient-based recommendations.

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.

While dietary factors are important modifiable risk factors for type 2 diabetes (T2D), the causal role of carbohydrate quality in nutrition remains controversial. Dietary glycemic index (GI) and glycemic load (GL) have been examined in relation to the risk of T2D in multiple prospective cohort studies. Previous meta-analyses indicate significant relations but consideration of causality has been minimal. Here, the results of our recent meta-analyses of prospective cohort studies of 4 to 26-y follow-up are interpreted in the context of the nine Bradford-Hill criteria for causality, that is: (1) Strength of Association, (2) Consistency, (3) Specificity, (4) Temporality, (5) Biological Gradient, (6) Plausibility, (7) Experimental evidence, (8) Analogy, and (9) Coherence. These criteria necessitated referral to a body of literature wider than prospective cohort studies alone, especially in criteria 6 to 9. In this analysis, all nine of the Hill’s criteria were met for GI and GL indicating that we can be confident of a role for GI and GL as causal factors contributing to incident T2D. In addition, neither dietary fiber nor cereal fiber nor wholegrain were found to be reliable or eective surrogate measures of GI or GL. Finally, our cost–benefit analysis suggests food and nutrition advice favors lower GI or GL and would produce significant potential cost savings in national healthcare budgets. The high confidence in causal associations for incident T2D is sucient to consider inclusion of GI and GL in food and nutrient-based recommendations.

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.

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 nowover a decade ago that a published meta-analysis used a predefined standard to identify validstudies. Considering valid studies only, and using random effects dose-response meta-analysis(DRM) while withdrawing spurious results (p < 0.05), we ascertained whether these relationswould 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). Thecombined T2D-GI RR was 1.27 (1.15-1.40) (p < 0.001, n = 10 studies) per 10 units GI, while that forthe 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 2000kcal diet, respectively. In conclusion, among adults initially in good health, diets higher in GI or GLwere robustly associated with incident T2D. Together with mechanistic and other data, thissupports 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 GLare substantial food markers predicting the development of T2D worldwide, for persons ofEuropean ancestry and of East Asian ancestry.

Background: Although some evidence suggests a link between high dietary sugar, glycemic index (GI), and glycemic load (GL) with increased cancer risk, the relationship with the risk of lung and UADT cancers and their interactions with glucose metabolism-related genetic variants remains largely unexplored. In addition, the contributions of GI and GL from different food sources have not yet been studied. Objective and Methods: We aimed to evaluate the associations of GI, GL and glucose metabolism-related genetic variants with lung cancer and UADT cancer susceptibility in a Los Angeles (LA) population-based case-control study. In this study population, we also evaluated novel interactions between glucose metabolism-related genetic variants, GI, GL, tobacco smoking and alcohol drinking for the susceptibility of lung cancer and UADT cancers. At the global level, we conducted a pooled analysis using the dataset from the International Head and Neck Cancer Epidemiology (INHANCE) consortium to assess the associations by gender, tobacco smoking, alcohol drinking intensity and histological types of head and neck cancer (HNC), specifically for oral cavity and pharyngeal cancer (OPC) and laryngeal cancer (LC). Results: In the LA population-based case-control study, an increased odds of lung cancer with high GI diet and a reduced odds of UADT cancer with high sugar diet were observed. Furthermore, the effect of GI, GL and sugar might be source-dependent and modulated by smoking status. In addition, genetic variants in the pathway of glucose metabolism may modify the susceptibility of lung and UADT cancers. In the pooled analysis of eight case–control studies within the INHANCE consortium, we found elevated odds of HNC and laryngeal cancer with a high GI diet, and decreased odds of oral and pharyngeal cancer with a high GL diet. Conclusion: These results confirm the associations between a high GI diet and increased susceptibility of lung and laryngeal cancer. In addition, the asso

Background: Although some evidence suggests a link between high dietary sugar, glycemic index (GI), and glycemic load (GL) with increased cancer risk, the relationship with the risk of lung and UADT cancers and their interactions with glucose metabolism-related genetic variants remains largely unexplored. In addition, the contributions of GI and GL from different food sources have not yet been studied. Objective and Methods: We aimed to evaluate the associations of GI, GL and glucose metabolism-related genetic variants with lung cancer and UADT cancer susceptibility in a Los Angeles (LA) population-based case-control study. In this study population, we also evaluated novel interactions between glucose metabolism-related genetic variants, GI, GL, tobacco smoking and alcohol drinking for the susceptibility of lung cancer and UADT cancers. At the global level, we conducted a pooled analysis using the dataset from the International Head and Neck Cancer Epidemiology (INHANCE) consortium to assess the associations by gender, tobacco smoking, alcohol drinking intensity and histological types of head and neck cancer (HNC), specifically for oral cavity and pharyngeal cancer (OPC) and laryngeal cancer (LC). Results: In the LA population-based case-control study, an increased odds of lung cancer with high GI diet and a reduced odds of UADT cancer with high sugar diet were observed. Furthermore, the effect of GI, GL and sugar might be source-dependent and modulated by smoking status. In addition, genetic variants in the pathway of glucose metabolism may modify the susceptibility of lung and UADT cancers. In the pooled analysis of eight case–control studies within the INHANCE consortium, we found elevated odds of HNC and laryngeal cancer with a high GI diet, and decreased odds of oral and pharyngeal cancer with a high GL diet. Conclusion: These results confirm the associations between a high GI diet and increased susceptibility of lung and laryngeal cancer. In addition, the asso

Background: Although some evidence suggests a link between high dietary sugar, glycemic index (GI), and glycemic load (GL) with increased cancer risk, the relationship with the risk of lung and UADT cancers and their interactions with glucose metabolism-related genetic variants remains largely unexplored. In addition, the contributions of GI and GL from different food sources have not yet been studied. Objective and Methods: We aimed to evaluate the associations of GI, GL and glucose metabolism-related genetic variants with lung cancer and UADT cancer susceptibility in a Los Angeles (LA) population-based case-control study. In this study population, we also evaluated novel interactions between glucose metabolism-related genetic variants, GI, GL, tobacco smoking and alcohol drinking for the susceptibility of lung cancer and UADT cancers. At the global level, we conducted a pooled analysis using the dataset from the International Head and Neck Cancer Epidemiology (INHANCE) consortium to assess the associations by gender, tobacco smoking, alcohol drinking intensity and histological types of head and neck cancer (HNC), specifically for oral cavity and pharyngeal cancer (OPC) and laryngeal cancer (LC). Results: In the LA population-based case-control study, an increased odds of lung cancer with high GI diet and a reduced odds of UADT cancer with high sugar diet were observed. Furthermore, the effect of GI, GL and sugar might be source-dependent and modulated by smoking status. In addition, genetic variants in the pathway of glucose metabolism may modify the susceptibility of lung and UADT cancers. In the pooled analysis of eight case–control studies within the INHANCE consortium, we found elevated odds of HNC and laryngeal cancer with a high GI diet, and decreased odds of oral and pharyngeal cancer with a high GL diet. Conclusion: These results confirm the associations between a high GI diet and increased susceptibility of lung and laryngeal cancer. In addition, the asso

PurposeCarbohydrate intake increases postprandial insulin secretion and may affect breast density, a strong risk factor for breast cancer, early in life. We examined associations of adolescent and early adulthood intakes of total carbohydrates, glycemic index/load, fiber, and simple sugars with breast density among 182 young women.MethodsDiet was assessed using three 24-h recalls at each of five Dietary Intervention Study in Children (DISC) clinic visits when participants were age 10-19 years and at the DISC06 Follow-Up Study clinic visit when participants were age 25-29 years. Associations between energy-adjusted carbohydrates and MRI-measured percent dense breast volume (%DBV) and absolute dense breast volume (ADBV) at 25-29 years were quantified using multivariable-adjusted mixed-effects linear models.ResultsAdolescent sucrose intakes and premenarcheal total carbohydrates intakes were modestly associated with higher %DBV (mean %DBVQ1 vs Q4, 16.6 vs 23.5% for sucrose; and 17.2 vs 22.3% for premenarcheal total carbohydrates, all Ptrend ≤ 0.02), but not with ADBV. However, adolescent intakes of fiber and fructose were not associated with %DBV and ADBV. Early adulthood intakes of total carbohydrates, glycemic index/load, fiber, and simple sugars were not associated with %DBV and ADBV.ConclusionsInsulinemic carbohydrate diet during puberty may be associated with adulthood breast density, but our findings need replication in larger studies. Clinical Trials Registration ClinicalTrials.gov Identifier, NCT00458588 April 9, 2007; NCT00000459 October 27, 1999.

Background: Regular breakfast consumption is associated with better health status and healthier food intake throughout the day, but this association is a complex interaction of several factors. Objective: This study aimed to investigate the effect of nutritional and cognitive-perceived characteristics of breakfast on metabolic and behavioral variables related to food intake. Methods: The study was a randomized, crossover, controlled trial, with 4 experimental conditions consisting of 3 isoenergetic breakfasts and 1 energy-free control meal. Breakfasts had similar nutritional profiles but differed for glycemic index (GI), glycemic load (GL), and perceived healthiness, satiety, palatability, or energy content. Fifteen healthy normalweight men [means ± SDs; age: 24 ± 2 y; body mass index (BMI; kg/m2) 23.4 ± 1.6] underwent each experimental condition in random order during 4 different weeks, separated by ≥1-wk washout. On the third day of each intervention week, postprandial blood variables (with insulin as primary outcome), satiety ratings, and food intake during an ad libitum lunch consumed 4 h after breakfast (secondary outcomes) were measured for each experimental condition. Results: A main effect of time, treatment, and time × treatment was found for postprandial insulin, glucose, and nonesterified fatty acids (P < 0.001 for all) after having the 3 iso-energetic breakfasts or the energy-free control one. Postprandial satiety was similar for the 3 energy-containing breakfasts, but higher when compared with the energy-free control (P < 0.001). No difference in energy intake was observed for the ad libitum lunch, whereas prolonged breakfast skipping was compensated by an increase (around +10%) in the average energy intake during the rest of the day, resulting in no differences in the total daily energy intake among the 4 conditions. Conclusions: Although other advantages might exist for breakfasts based on low-GI/low-GL foods, our findings support the hypothesis

Objective. To study the association between the metabolic syndrome (MS) and the glycemic load (GL) of food intake among obese children and adolescents seen in consultation by the endocrinology team in a pediatric referral hospital in Lima, Peru. Population and Method. Cross-sectional study among obese children and adolescents (body mass index ≥ 95 percentile), 10-15 years old. The MS was classified according to criteria of the International Diabetes Federation. A 24 hour reminder was used, and the overall and per meal GL was calculated. The association between the GL tertiles (comparison with the lower tertile) and the MS was assessed using prevalence ratios adjusted by demographic outcome measures, family history, physical activity and total carbohydrate consumption in Poisson regression models with a robust variance. Results. Out of 273 obese children and adolescents, 52.4% were male and 94.9% did not engage in any physical activity. Glycemic load median value was 213 (164.8-287.4) and the daily calorie intake value was 2275 (1851-3024) kcal, consisting mainly of carbohydrates (62%). MS prevalence was 22.3%; the most prevalent components were abdominal obesity (81.7%) and low values of high density lipoprotein (HDL) (63.7%). Lastly, an association was observed between a high consumption of GL and the risk of developing MS (aRP 4.5; 95% CI: 1.3-15.3). Conclusions. There is an association between a high consumption of GL and the presence of MS among obese children and adolescents., Revisión por pares

Objetivo: Evaluar la asociación entre síndrome metabólico (SM) y carga glicémica (CG) de la ingesta alimentaria en niños y adolescentes obesos atendidos en consulta endocrinológica de un hospital de referencia pediátrica en Lima, Perú. Pacientes y método: Estudio transversal en niños y adolescentes obesos (IMC ≥ percentil 95) de 10 a 15 años. Se utilizó los criterios de la International Diabetes Federation (IDF) para la clasificación de SM. Se aplicó recordatorio de 24 horas y se calculó la CG total y por tiempos de comida. Se evaluó la asociación entre los terciles de CG (comparación contra el inferior) y SM usando razones de prevalencia ajustadas (RPa) por variables demográficas, familiares, actividad física y consumo total de carbohidratos en modelos de regresión de Poisson con varianza robusta. Resultados: De 273 niños y adolescentes obesos, 52,4% fueron varones, 94,9% fueron físicamente inactivos y el IMC promedio fue 27,2 kg/m2. La mediana de carga glicémica fue de 213,3 (p25-p75:164,8 – 287,35) y de 2275 kcal (p25-p75: 1851,05 – 3024) de ingesta calórica diaria, dado principalmente por carbohidratos (62%).La prevalencia de SM fue de 22,3%, los componentes más prevalentes fueron la obesidad abdominal (81,7%) y el HDL bajo (63,7%). Se encontró asociación entre el consumo elevado de CG y el riesgo a presentar SM (RPa: 4,5; IC95%:1,3-15,31). Conclusiones: Existe asociación entre el alto consumo de CG y la presencia de SM en niños y adolescentes con obesidad., Objective: Evaluate the association between metabolic syndrome (MS) and glycemic load (GL) of the food intake in obese children and adolescents attended in endocrinology consultation of a pediatric referral hospital in Lima, Peru. Patients and methods: Cross-sectional study in obese (BMI ≥ 95 percentile) children and adolescents between 10 to 15 years old. MS was classified according to the International Diabetes Federation (IDF). 24- hours recall was applied and calculated the GL total and by meal. The association between the tertiles of GL (comparison against the lower) and MS was found using adjusted prevalence ratios (RPa) for demographic variables, family, physical activity and total carbohydrates intake by Poisson regression models with robust variance. Results: 273 obese children and adolescents were recruited, 52.4% were male and 94.9% were physically inactive and IMC average was 27, 2 kg/m2. The median of GL was 213, 3 (164, 8 – 287, 35: 122, 6) and 2275 kcal (1851, 05 – 3024: 1172, 9) for daily caloric intake, mainly due of carbohydrates (62%). The prevalence of MS was 22, 3%, the components more relevant were abdominal obesity (81,7%) and low HDL (63,7%). The association between a high consumption of CG and the risk having MS (Rpa: 4,5; IC95%: 1,3-15,31) Conclusions: There is an association between the high intake of GL and the presence of MS., Tesis

AIMS: To determine the glycemic index and the glycemic load of diets usually offered by hospitals to patients with diabetes mellitus. METHODS: A cross-sectional study evaluated menus served to diabetic inpatients of hospitals in the city of Curitiba, Parana, Brazil. Analyzing the menus, we determined the energy content, macronutrients, glycemic index and glycemic load of the meals offered to the patients. RESULTS: Five general hospitals of the city participated in the study and 10 menus for diabetes were evaluated. The structure of the menus was different mainly in the quantitative supply of fruits and milk. Diets ranged from 1317.6 to 2013.2 kcal, with 18.9 to 27.6% of proteins, 21.9 to 29.4% of lipids, 48.2 to 53.3% of carbohydrates and 24.7 to 33.6 g of fibers. Daily glycemic index ranged from 47 to 57% and daily glycemic load from 81 to 109%. CONCLUSIONS: All offered diets were hyperproteic, normolipid and normoglicidic. However, inadequate levels of glycemic load were observed in all the evaluated menus, although with adequate levels of glycemic index. It is necessary to review the diet plans elaborated for diabetics, aiming at the best dietary treatment for this population., OBJETIVOS: Determinar o índice glicêmico e a carga glicêmica de dietas habitualmente oferecidas nos hospitais para pacientes com diabetes mellitus. MÉTODOS: Um estudo transversal avaliou cardápios servidos para pacientes diabéticos internados em hospitais da cidade de Curitiba, Paraná, Brasil. Analisando os cardápios, determinou-se teor energético, de macronutrientes, índice glicêmico e carga glicêmica das refeições ofertadas aos pacientes. RESULTADOS: Participaram do estudo cinco hospitais gerais da cidade e foram avaliados 10 cardápios de dieta para diabetes. A estrutura dos cardápios diferenciou-se principalmente na oferta quantitativa de frutas e leite. As dietas variaram entre 1317,6 a 2013,2 kcal, com 18,9 a 27,6% de proteínas, 21,9 a 29,4% de lipídios, 48,2 a 53,3% de carboidratos e 24,7 a 33,6 g de fibras. O índice glicêmico diário variou de 47 a 57% e a carga glicêmica diária entre 81 e 109%. CONCLUSÕES: Todas as dietas ofertadas foram hiperproteicas, normolipídicas e normoglicídicas. Entretanto, observaram-se níveis inadequados de carga glicêmica em todos os cardápios avaliados, embora com níveis adequados de índice glicêmico. Faz-se necessária a revisão dos planos alimentares elaborados para diabéticos, visando o melhor tratamento dietoterápico a essa população.

Objective. To study the association between the metabolic syndrome (MS) and the glycemic load (GL) of food intake among obese children and adolescents seen in consultation by the endocrinology team in a pediatric referral hospital in Lima, Peru. Population and Method. Cross-sectional study among obese children and adolescents (body mass index ≥ 95 percentile), 10-15 years old. The MS was classified according to criteria of the International Diabetes Federation. A 24 hour reminder was used, and the overall and per meal GL was calculated. The association between the GL tertiles (comparison with the lower tertile) and the MS was assessed using prevalence ratios adjusted by demographic outcome measures, family history, physical activity and total carbohydrate consumption in Poisson regression models with a robust variance. Results. Out of 273 obese children and adolescents, 52.4% were male and 94.9% did not engage in any physical activity. Glycemic load median value was 213 (164.8-287.4) and the daily calorie intake value was 2275 (1851-3024) kcal, consisting mainly of carbohydrates (62%). MS prevalence was 22.3%; the most prevalent components were abdominal obesity (81.7%) and low values of high density lipoprotein (HDL) (63.7%). Lastly, an association was observed between a high consumption of GL and the risk of developing MS (aRP 4.5; 95% CI: 1.3-15.3). Conclusions. There is an association between a high consumption of GL and the presence of MS among obese children and adolescents., Revisión por pares

Objetivo: Evaluar la asociación entre síndrome metabólico (SM) y carga glicémica (CG) de la ingesta alimentaria en niños y adolescentes obesos atendidos en consulta endocrinológica de un hospital de referencia pediátrica en Lima, Perú. Pacientes y método: Estudio transversal en niños y adolescentes obesos (IMC ≥ percentil 95) de 10 a 15 años. Se utilizó los criterios de la International Diabetes Federation (IDF) para la clasificación de SM. Se aplicó recordatorio de 24 horas y se calculó la CG total y por tiempos de comida. Se evaluó la asociación entre los terciles de CG (comparación contra el inferior) y SM usando razones de prevalencia ajustadas (RPa) por variables demográficas, familiares, actividad física y consumo total de carbohidratos en modelos de regresión de Poisson con varianza robusta. Resultados: De 273 niños y adolescentes obesos, 52,4% fueron varones, 94,9% fueron físicamente inactivos y el IMC promedio fue 27,2 kg/m2. La mediana de carga glicémica fue de 213,3 (p25-p75:164,8 – 287,35) y de 2275 kcal (p25-p75: 1851,05 – 3024) de ingesta calórica diaria, dado principalmente por carbohidratos (62%).La prevalencia de SM fue de 22,3%, los componentes más prevalentes fueron la obesidad abdominal (81,7%) y el HDL bajo (63,7%). Se encontró asociación entre el consumo elevado de CG y el riesgo a presentar SM (RPa: 4,5; IC95%:1,3-15,31). Conclusiones: Existe asociación entre el alto consumo de CG y la presencia de SM en niños y adolescentes con obesidad., Objective: Evaluate the association between metabolic syndrome (MS) and glycemic load (GL) of the food intake in obese children and adolescents attended in endocrinology consultation of a pediatric referral hospital in Lima, Peru. Patients and methods: Cross-sectional study in obese (BMI ≥ 95 percentile) children and adolescents between 10 to 15 years old. MS was classified according to the International Diabetes Federation (IDF). 24- hours recall was applied and calculated the GL total and by meal. The association between the tertiles of GL (comparison against the lower) and MS was found using adjusted prevalence ratios (RPa) for demographic variables, family, physical activity and total carbohydrates intake by Poisson regression models with robust variance. Results: 273 obese children and adolescents were recruited, 52.4% were male and 94.9% were physically inactive and IMC average was 27, 2 kg/m2. The median of GL was 213, 3 (164, 8 – 287, 35: 122, 6) and 2275 kcal (1851, 05 – 3024: 1172, 9) for daily caloric intake, mainly due of carbohydrates (62%). The prevalence of MS was 22, 3%, the components more relevant were abdominal obesity (81,7%) and low HDL (63,7%). The association between a high consumption of CG and the risk having MS (Rpa: 4,5; IC95%: 1,3-15,31) Conclusions: There is an association between the high intake of GL and the presence of MS., Tesis

Background: Which diet is optimal for weight loss and maintenance remains controversial and implies that no diet fits all patients.Objective: We studied concentrations of fasting plasma glucose (FPG) and fasting insulin (FI) as prognostic markers for successful weight loss and maintenance through diets with different glycemic loads or different fiber and whole-grain content, assessed in 3 randomized trials of overweight participants.Design: After an 8-wk weight loss, participants in the DiOGenes (Diet, Obesity, and Genes) trial consumed ad libitum for 26 wk a diet with either a high or a low glycemic load. Participants in the Optimal well-being, development and health for Danish children through a healthy New Nordic Diet (OPUS) Supermarket intervention (SHOPUS) trial consumed ad libitum for 26 wk the New Nordic Diet, which is high in fiber and whole grains, or a control diet. Participants in the NUGENOB (Nutrient-Gene Interactions in Human Obesity) trial consumed a hypocaloric low-fat and high-carbohydrate or a high-fat and low-carbohydrate diet for 10 wk. On the basis of FPG before treatment, participants were categorized as normoglycemic (FPG <5.6 mmol/L), prediabetic (FPG 5.6-6.9 mmol/L), or diabetic (FPG ≥7.0 mmol/L). Modifications of the dietary effects of FPG and FI before treatment were examined with linear mixed models.Results: In the DiOGenes trial, prediabetic individuals regained a mean of 5.83 kg (95% CI: 3.34, 8.32 kg; P < 0.001) more on the high- than on the low-glycemic load diet, whereas normoglycemic individuals regained a mean of 1.44 kg (95% CI: 0.48, 2.41 kg; P = 0.003) more [mean group difference: 4.39 kg (95% CI: 1.76, 7.02 kg); P = 0.001]. In SHOPUS, prediabetic individuals lost a mean of 6.04 kg (95% CI: 4.05, 8.02 kg; P < 0.001) more on the New Nordic Diet than on the control diet, whereas normoglycemic individuals lost a mean of 2.20 kg (95% CI: 1.21, 3.18 kg; P < 0.001) more [mean group difference: 3.84 kg (95% CI: 1.62, 6.0

The objective of this study was to evaluate the prospective associations between dietary glycemic index (GI) and glycemic load (GL) and the risk for invasive breast cancer incidence in postmenopausal women at high cardiovascular disease (CVD) risk. This study was conducted within the framework of the PREvención con DIeta MEDiterránea (PREDIMED) study, a nutritional intervention trial for primary cardiovascular prevention. We included 4010 women aged between 60 and 80 years who were initially free from breast cancer but at high risk for CVD disease. Dietary information was collected using a validated 137-item food frequency questionnaire. We assigned GI values using the International Tables of GI and GL values. Cases were ascertained through yearly consultation of medical records and through consultation of the National Death Index. Only cases confirmed by results from cytology tests or histological evaluation were included. We estimated multivariable-adjusted hazard ratios for invasive breast cancer risk across tertiles of energy-adjusted dietary GI/GL using Cox regression models. We repeated our analyses using yearly repeated measures of GI/GL intakes. No associations were found between baseline dietary GI/GL and invasive breast cancer incidence. The multivariable hazard ratio and 95% confidence interval (CI) for the top tertile of dietary GI was 1.02 (95% CI: 0.42-2.46) and for dietary GL was 1.00 (95% CI: 0.44-2.30) when compared with the bottom tertile. Repeated-measures analyses yielded similar results. In sensitivity analyses, no significant associations were observed for women with obesity or diabetes. Dietary GI and GL did not appear to be associated with an increased risk for invasive breast cancer in postmenopausal women at high CVD risk.

The objective of this study was to evaluate the prospective associations between dietary glycemic index (GI) and glycemic load (GL) and the risk for invasive breast cancer incidence in postmenopausal women at high cardiovascular disease (CVD) risk. This study was conducted within the framework of the PREvención con DIeta MEDiterránea (PREDIMED) study, a nutritional intervention trial for primary cardiovascular prevention. We included 4010 women aged between 60 and 80 years who were initially free from breast cancer but at high risk for CVD disease. Dietary information was collected using a validated 137-item food frequency questionnaire. We assigned GI values using the International Tables of GI and GL values. Cases were ascertained through yearly consultation of medical records and through consultation of the National Death Index. Only cases confirmed by results from cytology tests or histological evaluation were included. We estimated multivariable-adjusted hazard ratios for invasive breast cancer risk across tertiles of energy-adjusted dietary GI/GL using Cox regression models. We repeated our analyses using yearly repeated measures of GI/GL intakes. No associations were found between baseline dietary GI/GL and invasive breast cancer incidence. The multivariable hazard ratio and 95% confidence interval (CI) for the top tertile of dietary GI was 1.02 (95% CI: 0.42–2.46) and for dietary GL was 1.00 (95% CI: 0.44–2.30) when compared with the bottom tertile. Repeated-measures analyses yielded similar results. In sensitivity analyses, no significant associations were observed for women with obesity or diabetes. Dietary GI and GL did not appear to be associated with an increased risk for invasive breast cancer in postmenopausal women at high CVD risk.

Background and aim: The glycemic index (GI) and glycemic load (GL) are useful parameters in the nutritional classification of carbohydrate foods. Diets characterized by a low GI and/or a low GL have been repeatedly and independently associated with decreased risk of diabetes and other chronic diseases. The aim of this study is to report the GI and GL value of carbohydrate-rich foods available on the Italian market and mostly consumed in Italy. Methods and results: GI values were determined according to FAO/WHO (1997) and ISO (2010). Overall, the 141 commercial foods that were analyzed represent food categories that are the source of >80% carbohydrate intake in Italy. The food items chosen were based mainly on the market share of the brand within each food category and grouped into 13 food categories: 1) beverages: fermented milk drink, juice, smoothie, soft drink; 2) biscuits; 3) breads; 4) bread substitutes; 5) breakfast cereals; 6) cakes and snacks; 7) candy and confectionery; 8) cereals; 9) desserts and ice-creams; 10) marmalade and jam; 11) pasta; 12) pizza; 13) sugar and sweetener. Conclusion: This database of commercial Italian foods partly overcomes the lack of information on GI and GL of local foods, contributing to a better understanding of the association between GI/GL and health and providing a more informed choice to Italian consumers and health practitioners.