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Dietary Glycemic Index, Glycemic Load, and Digestible Carbohydrate Intake Are Not Associated with Risk of Type 2 Diabetes in Eight European Countries

Sluijs, Ivonne; Beulens, Joline W. J.; van der Schouw, Yvonne T.; van der A, Daphne L.; Buckland, Genevieve; Kuijsten, Anneleen; Schulze, Matthias B.; Amiano, Pilar; Ardanaz, Eva and Balkau, Beverley, et al. (2013) In Journal of Nutrition 143(1). p.93-99
Abstract
The association of glycemic index (GI) and glycemic load (GL) with the risk of type 2 diabetes remains unclear. We investigated associations of dietary GI, GL, and digestible carbohydrate with incident type 2 diabetes. We performed a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition Study, including a random subcohort (n = 16,835) and incident type 2 diabetes cases (n = 12,403). The median follow-up time was 12 y. Baseline dietary intakes were assessed using country-specific dietary questionnaires. Country-specific HR were calculated and pooled using random effects meta-analysis. Dietary GI, GL, and digestible carbohydrate in the subcohort were (mean +/- SD) 56 +/- 4, 127 +/- 23, and 226 +/-... (More)
The association of glycemic index (GI) and glycemic load (GL) with the risk of type 2 diabetes remains unclear. We investigated associations of dietary GI, GL, and digestible carbohydrate with incident type 2 diabetes. We performed a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition Study, including a random subcohort (n = 16,835) and incident type 2 diabetes cases (n = 12,403). The median follow-up time was 12 y. Baseline dietary intakes were assessed using country-specific dietary questionnaires. Country-specific HR were calculated and pooled using random effects meta-analysis. Dietary GI, GL, and digestible carbohydrate in the subcohort were (mean +/- SD) 56 +/- 4, 127 +/- 23, and 226 +/- 36 g/d, respectively. After adjustment for confounders, GI and GL were not associated with incident diabetes [HR highest vs. lowest quartile (HRQ4) for GI: 1.05 (95% CI = 0.96, 1.16); HRQ4 for GL: 1.07 (95% CI = 0.95, 1.20)]. Digestible carbohydrate intake was not associated with incident diabetes [HRQ4: 0.98(95% CI = 0.86, 1.10)]. In additional analyses, we found that discrepancies in the GI value assignment to foods possibly explain differences in GI associations with diabetes within the same study population. In conclusion, an expansion of the GI tables and systematic GI value assignment to foods may be needed to improve the validity of GI values derived in such studies, after which GI associations may need reevaluation. Our study shows that digestible carbohydrate intake is not associated with diabetes risk and suggests that diabetes risk with high-GI and -GL diets may be more modest than initial studies suggested. J. Nutr. 143: 93-99, 2013. (Less)
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@article{a2aab7bb-5eb4-4a7f-a40f-6678e307bd97,
  abstract     = {The association of glycemic index (GI) and glycemic load (GL) with the risk of type 2 diabetes remains unclear. We investigated associations of dietary GI, GL, and digestible carbohydrate with incident type 2 diabetes. We performed a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition Study, including a random subcohort (n = 16,835) and incident type 2 diabetes cases (n = 12,403). The median follow-up time was 12 y. Baseline dietary intakes were assessed using country-specific dietary questionnaires. Country-specific HR were calculated and pooled using random effects meta-analysis. Dietary GI, GL, and digestible carbohydrate in the subcohort were (mean +/- SD) 56 +/- 4, 127 +/- 23, and 226 +/- 36 g/d, respectively. After adjustment for confounders, GI and GL were not associated with incident diabetes [HR highest vs. lowest quartile (HRQ4) for GI: 1.05 (95% CI = 0.96, 1.16); HRQ4 for GL: 1.07 (95% CI = 0.95, 1.20)]. Digestible carbohydrate intake was not associated with incident diabetes [HRQ4: 0.98(95% CI = 0.86, 1.10)]. In additional analyses, we found that discrepancies in the GI value assignment to foods possibly explain differences in GI associations with diabetes within the same study population. In conclusion, an expansion of the GI tables and systematic GI value assignment to foods may be needed to improve the validity of GI values derived in such studies, after which GI associations may need reevaluation. Our study shows that digestible carbohydrate intake is not associated with diabetes risk and suggests that diabetes risk with high-GI and -GL diets may be more modest than initial studies suggested. J. Nutr. 143: 93-99, 2013.},
  author       = {Sluijs, Ivonne and Beulens, Joline W. J. and van der Schouw, Yvonne T. and van der A, Daphne L. and Buckland, Genevieve and Kuijsten, Anneleen and Schulze, Matthias B. and Amiano, Pilar and Ardanaz, Eva and Balkau, Beverley and Boeing, Heiner and Gavrila, Diana and Grote, Verena A. and Key, Timothy J. and Li, Kuanrong and Nilsson, Peter and Overvad, Kim and Palli, Domenico and Panico, Salvatore and Quiros, J. R. and Rolandsson, Olov and Roswall, Nina and Sacerdote, Carlotta and Sanchez, Maria-Jose and Sieri, Sabina and Slimani, Nadia and Spijkerman, Annemieke M. W. and Tjonneland, Anne and Tumino, Rosario and Sharp, Stephen J. and Langenberg, Claudia and Feskens, Edith J. M. and Forouhi, Nita G. and Riboli, Elio and Wareham, Nicholas J.},
  issn         = {1541-6100},
  language     = {eng},
  number       = {1},
  pages        = {93--99},
  publisher    = {American Society for Nutrition},
  series       = {Journal of Nutrition},
  title        = {Dietary Glycemic Index, Glycemic Load, and Digestible Carbohydrate Intake Are Not Associated with Risk of Type 2 Diabetes in Eight European Countries},
  url          = {http://dx.doi.org/10.3945/jn.112.165605},
  volume       = {143},
  year         = {2013},
}