Dietary glycemic index, glycemic load, and risk of mortality from all causes and cardiovascular diseases: a systematic review and dose-response meta-analysis of prospective cohort studies

Abstract

Background Previous findings on the association of dietary glycemic index (GI) and glycemic load (GL) with mortality are conflicting. Objectives The aim of this study was to summarize earlier findings on the association between dietary GI and GL and the risk of cardiovascular disease (CVD) and all-cause mortality. Methods A comprehensive literature search was performed of electronic databases, including MEDLINE (PubMed), Scopus, ISI Web of Science, EMBASE, and Google scholar, up to September 2018. Prospective cohort studies that reported GI and GL as the exposure and all-cause or CVD mortality as the outcome were included in the analysis. The random-effects model was used to estimate pooled RR and 95% CIs of all-cause and CVD mortality. Results Eighteen cohort studies with a total of 251,497 participants, reporting 14,774 cases of all-cause mortality and 3658 cases of CVD mortality, were included in the present analysis. No significant association was found between dietary GI and all-cause mortality (RR: 1.07; 95% CI: 0.96, 1.19) and CVD mortality (RR: 1.02; 95% CI: 0.87, 1.20). In addition, dietary GL was not associated with all-cause mortality (RR: 1.08; 95% CI: 0.93, 1.27) or CVD mortality (RR: 1.07; 95% CI: 0.92, 1.25). However, the highest dietary GI, in comparison to the lowest one, significantly increased the risk of all-cause mortality in women (RR: 1.17; 95% CI: 1.02, 1.35). No evidence for a nonlinear association between dietary GI or GL and all-cause and CVD mortality was found (P > 0.05). Conclusions This meta-analysis of prospective cohort studies showed no significant association between either dietary GI or GL and all-cause and CVD mortality in men, but a positive association of GI with all-cause mortality in women.

Health benefits of whole grain: effects on dietary carbohydrate quality, the gut microbiome, and consequences of processing

“…Carbohydrates are an essential part of the human diet, but there is some debate on the amount and type of dietary carbohydrate required for health (Dall'Asta et al., 2020; Reynolds et al., 2019; Shahdadian et al., 2019; Willett & Liu, 2019; Zafar et al., 2019), including whether whole‐grain consumption should be favored above consumption of refined grains (Jones et al., 2020; Williams, 2012). Dietary carbohydrates found in cereals encompass the full range of different chemical compounds ranging from complex polysaccharides to smaller oligosaccharides, disaccharides, and monosaccharides each requiring different levels of metabolic processing/digestion and each causing different metabolic responses (Dall'Asta et al., 2020; Tappy, 2018).…”

Prospective cohort study of metabolic syndrome and endometrial cancer survival

“…20 Currently there is no available evidence on the relationship between glycemic load and endometrial cancer recurrence or survival, and a null association has been reported for the relationship between glycemic load and overall survival among women in the general population (RR=1.06, 95% CI=0.90-1.25). 21 There is some evidence that greater adult attained height is associated with increased endometrial cancer risk. The WCRF-CUP reported that for every five cm increase in adult attained height the risk of endometrial cancer increased seven percent (95% CI=3-11%) in a meta-analyses of ten studies.…”

Apple Preload Halved the Postprandial Glycaemic Response of Rice Meal in Healthy Subjects

“…Blood glucose management plays a role in the prevention of diabetes, cardiovascular diseases, obesity, certain cancers, and other diseases such as acne [1][2][3][4]. Among the postprandial glycemic management strategies, increasing attention has been on preload, as mounting evidence indicates that a small load of macro-nutrients ingested at a fixed interval before a meal can result in a milder postprandial glycemic and insulin response, higher postprandial satiety, and lower glycated hemoglobin (HbA1c), inflammatory markers, and serum lipids levels [5][6][7][8].…”