Greenwood, DC orcid.org/0000-0001-7035-3096, Threapleton, DE orcid.org/0000-0002-5884-3372, Evans, CEL orcid.org/0000-0002-4065-4397 et al. (4 more authors) (2013) Glycemic index, glycemic load, carbohydrates, and type 2 diabetes: systematic review and dose-response meta-analysis of prospective studies. Diabetes Care, 36 (12). pp. 4166-4171. ISSN 0149-5992
Abstract
OBJECTIVE. Diets with high glycemic index (GI), with high glycemic load (GL), or high in all carbohydrates may predispose to higher blood glucose and insulin concentrations, glucose intolerance, and risk of type 2 diabetes. We aimed to conduct a systematic literature review and doseGÇôresponse meta-analysis of evidence from prospective cohorts.RESEARCH DESIGN AND METHODS. We searched the Cochrane Library, MEDLINE, MEDLINE in-process, Embase, CAB Abstracts, ISI Web of Science, and BIOSIS for prospective studies of GI, GL, and total carbohydrates in relation to risk of type 2 diabetes up to 17 July 2012. Data were extracted from 24 publications on 21 cohort studies. Studies using different exposure categories were combined on the same scale using linear and nonlinear doseGÇôresponse trends. Summary relative risks (RRs) were estimated using random-effects meta-analysis.RESULTS. The summary RR was 1.08 per 5 GI units (95% CI 1.02GÇô1.15; P = 0.01), 1.03 per 20 GL units (95% CI 1.00GÇô1.05; P = 0.02), and 0.97 per 50 g/day of carbohydrate (95% CI 0.90GÇô1.06; P = 0.5). Dose-response trends were linear for GI and GL but more complex for total carbohydrate intake. Heterogeneity was high for all exposures (I2 >50%), partly accounted for by different covariate adjustment and length of follow-up.CONCLUSIONS. Included studies were observational and should be interpreted cautiously. However, our findings are consistent with protective effects of low dietary GI and GL, quantifying the range of intakes associated with lower risk. Future research could focus on the type of sugars and other carbohydrates associated with greatest risk.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2013, American Diabetes Association.Uploaded in accordance with the publisher's self-archiving policy. This is an author-created, uncopyedited electronic version of an article accepted for publication in Diabetes. The American Diabetes Association (ADA), publisher of Diabetes, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version is available in an issue of Diabetes in print and online at http://diabetes.diabetesjournals.org. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Biological Sciences (Leeds) > School of Biomedical Sciences (Leeds) The University of Leeds > Faculty of Environment (Leeds) > School of Food Science and Nutrition (Leeds) > FSN Nutrition and Public Health (Leeds) The University of Leeds > Faculty of Engineering & Physical Sciences (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Nuffield Centre for International Health and Development (Leeds) |
Funding Information: | Funder Grant number Food Standards Agency SACN 01 004 Food Standards Agency SACN 01 004 |
Depositing User: | Symplectic Publications |
Date Deposited: | 06 Dec 2013 10:48 |
Last Modified: | 20 Jun 2021 08:37 |
Published Version: | http://dx.doi.org/10.2337/dc13-0325 |
Status: | Published |
Publisher: | American Diabetes Association |
Identification Number: | 10.2337/dc13-0325 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:77109 |