Dietary carbohydrates: role of quality and quantity in chronic disease

Ludwig, David S.; Hu, Frank B.; Tappy, Luc; Brand-Miller, Jennie

doi:10.1136/bmj.k2340

Cited by 211 publications

(196 citation statements)

References 93 publications

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“…[1][2][3] Since the concept of glycemic index (GI) was propagated by Jenkins et al, 4 low GI foods have been advocated to improve PPG and thereby manage and prevent type 2 diabetes, obesity and the risk of other cardiometabolic diseases. [5][6][7][8][9] However, recent reviews have shown inconsistent effects of low GI foods in the prevention and management of chronic diseases. [10][11][12] Part of these inconsistencies may be explained by diurnal variations in glucose homeostasis, which is often not considered in epidemiological studies.…”

Section: Introductionmentioning

confidence: 99%

High or low glycemic index (GI) meals at dinner results in greater postprandial glycemia compared with breakfast: a randomized controlled trial

Haldar

Egli

Castro

et al. 2020

BMJ Open Diab Res Care

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IntroductionWhile circadian control of glucose metabolism is well known, how glycemic index (GI) of carbohydrate-rich meals interacts with time of consumption (breakfast or dinner) to influence postprandial (PP) glucose homeostasis is less well established. The objective of the study was to assess markers of PP glucose homeostasis following high or low GI test meals (TM) consumed either at breakfast or at dinner and following consumption of the subsequent standardized meals (SSM).Research design and methodsRandomized crossover trial in 34 healthy, Chinese, elderly volunteers (mean±SEM age, 56.8±0.83 years), who completed 4 separate study sessions per-protocol, consisting of a high-GI breakfast, low-GI breakfast, high-GI dinner and low-GI dinner TM, followed by a SSM at the subsequent eating occasion. Blood samples were taken for 3 hours after each TM and SSM for glucose, insulin, glucagon, free fatty acids (FFA) and triglycerides (TG) measurements.ResultsConsuming TM at dinner produced greater PP glycemia than breakfast both after TM and SSM (both p<0.0001), irrespective of GI. High-GI TM also produced greater PP glycemia than low-GI TM, both after TM and SSM (both p<0.01), irrespective of time of consumption. No interaction between GI and time were found on PP glycemia, indicating parallel, but independent effects. Combined total areas under the curve of TM+SSM for PP glucose (p<0.0001), PP TG (p<0.0001) and PP FFA (p<0.0001) were all greater when TM taken during dinner compared with breakfast.ConclusionsCarbohydrate-rich meals consumed at dinner leads to significantly worse PP glucose homeostasis than when consumed at breakfast, on top of the independent GI effect of the meal. This may have implications to future type 2 diabetes risk. Moreover, future studies investigating GI/glycemic load (GL) and disease risk associations should factor in timing of GL consumption as an additional variable.Trial registration numberNCT02927600.

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Section: Introductionmentioning

confidence: 99%

High or low glycemic index (GI) meals at dinner results in greater postprandial glycemia compared with breakfast: a randomized controlled trial

Haldar

Egli

Castro

et al. 2020

BMJ Open Diab Res Care

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show abstract

“…Em um estudo realizado na Espanha, com mais de 16 mil participantes, os autores observaram que valores elevados do IQC estão mais propensos a ocasionar maior adequação de consumo dos micronutrientes 11 , resultado este similar ao nosso estudo. Um maior IQC está associado a menores valores de índice glicêmico, carga glicêmica e maiores em fibras, características estas inerentes a frutas, hortaliças e nozes, alimentos que são fontes de diversos minerais 1 . Deste modo, o IQC demonstra que a qualidade do carboidrato pode ser mais relevante do que a quantidade, onde um aumento no consumo de grãos integrais, frutas e hortaliças reduzirá efeitos adversos à saúde, aumentando a adequação dos minerais.…”

Section: Discussionunclassified

“…Ao longo dos últimos anos, os estudos vêm ressaltando a importância da avaliação da qualidade da dieta das populações de uma maneira holística, pautados no conceito de que a dieta deve ser considerada de maneira integrada, ao invés de avaliações isoladas de determinados nutrientes 1 .…”

Section: Introductionunclassified

A qualidade dos carboidratos dietéticos está associada à adequação do consumo de minerais: um estudo com mulheres acompanhadas no SUS

Cacau¹,

Meneses²,

Sampaio³

et al. 2020

Braspen J

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Aceito para publicação 14 de setembro de 2019 RESUMO Introdução: As inadequações na ingestão de micronutrientes são um problema emergente em termos de saúde pública. Recentemente, o papel dos macronutrientes foi proposto como fator relacionado à adequação do consumo de vitaminas e minerais. O objetivo deste estudo foi avaliar se a qualidade dos carboidratos da dieta está associada com o consumo adequado de minerais. Método: Estudo transversal realizado com mulheres acompanhadas em um serviço de mastologia do SUS, situado na capital do estado do Ceará. A coleta de dados foi realizada entre os anos de 2016 e 2017. Neste trabalho, foram analisados os dados de consumo alimentar investigados por meio da aplicação em duplicata do recordatório de 24 horas, sendo um deles referente a um dia de final de semana. Os dados obtidos foram digitados na Plataforma Brasil Nutri e lançados no Statistical Analysis System. Os dados foram corrigidos para variância intrapessoal no programa estatístico Multiple Source Method para predição da ingestão habitual. Foram avaliados o consumo de zinco (Zn), selênio (Se), cobre (Cu), manganês (Mn), magnésio (Mg), ferro (Fe) e fósforo (P). Para avaliar a qualidade dos carboidratos, calculou-se o Índice de Qualidade do Carboidrato (IQC). As análises estatísticas foram realizadas no SPPS 20.0 e considerou-se significante valores de p<0,05. O projeto foi aprovado pelo Comitê de Ética em Pesquisas da instituição de origem. Resultados: No total, 648 mulheres foram avaliadas, com idade média de 52,4 ± 9,3 anos. A média do IQC foi de 12 ± 3,1. Maiores pontuações do IQC foram associadas com maior adequação de consumo de Zn (p<0,001), Mn (p<0,001), Mg (p<0,001), Cu (p<0,001), P (p=0,002) e de Fe (p=0,006), mas não para Se (p=0,711). Conclusões: Os achados deste estudo demonstraram que maiores valores de IQC estão associados com maior adequação do consumo dos minerais avaliados, com exceção do selênio.

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“…• High glycemic index These disadvantages may cause negative effects on dental health, potential interactions with various systemic health problems (e.g. insulin resistance, meta-bolic syndrome, diabetes) [8] and obesity.…”

Section: Sugar Alternatives For Confectionerymentioning

confidence: 99%

Confectionery and Child Consumers: Situation and Solution Proposals

Kaya¹

2019

FNS

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The group of child consumers differs significantly from other consumer groups due to the effects of individuals other than themselves on their preferences as well as motivation factors of consumers' food choices. In recent years, the effect of the relationship between nutrition and health on food preferences has increased. The effects of this relationship on protectionist consumer approaches towards children are more visible. It can be stated that communication channels, especially social media, increase the level of this effect. Foods, which are frequently preferred by child consumers due to their taste and pleasure but contain high calorie value and high sugar levels associated with obesity; are among the foods that are frequently discussed. This situation increases the concern of parents about these foods. In this study, consumption characteristics of sugar and confectionery products and potential alternatives to these products are discussed with the aim of due diligence and seeking solutions. It is important to carry out awareness-raising activities on sugar and sugar products not only for children but also for all socioeconomic and age groups, and to develop policies and strategies for this purpose. Computer game-based consumer awareness studies can be used for sugar and confectionery products and for a lively lifestyle in order to provide fast and direct awareness to children. However, first, it is recommended to elaborate due diligence in order to determine the quality and quantity of information and awareness, to identify possible solution proposals with the participation of all stakeholders and to conduct pilot practices based on recommendations. It may be more beneficial to carry out these activities for a specific product and consumer groups rather than the general nutrition and consumer group.

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Dietary carbohydrates: role of quality and quantity in chronic disease

Abstract: David S Ludwig and colleagues examine the links between different types of carbohydrates and health

Cited by 211 publications

References 93 publications

High or low glycemic index (GI) meals at dinner results in greater postprandial glycemia compared with breakfast: a randomized controlled trial

High or low glycemic index (GI) meals at dinner results in greater postprandial glycemia compared with breakfast: a randomized controlled trial

A qualidade dos carboidratos dietéticos está associada à adequação do consumo de minerais: um estudo com mulheres acompanhadas no SUS

Confectionery and Child Consumers: Situation and Solution Proposals

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