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Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: Assessment of Causal Relations
- Source :
- Nutrients, Vol 11, Iss 6, p 1436 (2019), Nutrients, Livesey, G, Taylor, R, Livesey, H F, Buyken, A E, Jenkins, D J A, Augustin, L S A, Sievenpiper, J L, Barclay, A W, Liu, S, Wolever, T M S, Willett, W C, Brighenti, F, Salas-Salvadó, J, Björck, I, Rizkalla, S W, Riccardi, G, La Vecchia, C, Ceriello, A, Trichopoulou, A, Poli, A, Astrup, A, Kendall, C W C, Ha, M-A, Baer-Sinnott, S & Brand-Miller, J 2019, ' Dietary glycemic index and load and the risk of type 2 diabetes: Assessment of causal relations ', Nutrients, vol. 11, no. 6, 1436 . https://doi.org/10.3390/nu11061436
- Publication Year :
- 2019
- Publisher :
- MDPI AG, 2019.
-
Abstract
- 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 effective 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 sufficient to consider inclusion of GI and GL in food and nutrient-based recommendations.
- Subjects :
- Blood Glucose
Causation
Epidemiology
Review
Type 2 diabetes
causation
0302 clinical medicine
cohort studies
Risk Factors
Glycemic load
Faculty of Science
Glycemic index
030212 general & internal medicine
Prospective cohort study
2. Zero hunger
Public health
Nutrition and Dietetics
diabetes
alcohol
Incidence
Diabetes
public health
Prognosis
dietary fiber
Dietary fiber
Causality
3. Good health
Meta-analysis
Cohort studies
epidemiology
Alcohol
lcsh:Nutrition. Foods and food supply
Cohort study
lcsh:TX341-641
030209 endocrinology & metabolism
Context (language use)
Risk Assessment
03 medical and health sciences
Environmental health
glycemic load
medicine
Animals
Humans
business.industry
medicine.disease
Diet
meta-analysis
Diabetes Mellitus, Type 2
glycemic index
business
Biomarkers
Food Science
Subjects
Details
- ISSN :
- 20726643
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Nutrients
- Accession number :
- edsair.doi.dedup.....739cc0c0392c73e5bfeda30f9dc59ebf