Glycemic Index, Glycemic Load, and Cereal Fiber Intake and Risk of Type 2 Diabetes in US Black Women

Abstract

Background: Previous studies of carbohydrate quality and risk of type 2 diabetes mellitus have yielded inconsistent findings. Because diet is in part culturally determined, a study of dietary factors in US black women is of interest. Methods: We used data from the Black Women's Health Study, a prospective cohort study of 59 000 US black women, to examine the association of glycemic load, glycemic index, and cereal fiber with risk of type 2 diabetes. Diet was assessed at baseline in 1995 with a modified version of the National Cancer Institute-Block food frequency questionnaire. Results: During 8 years of follow-up, there were 1938 incident cases of diabetes. Cox proportional hazards models were used to estimate incidence rate ratios (IRRs) for quintiles of dietary factors, while controlling for lifestyle and dietary factors. Glycemic index was positively associated with the risk of diabetes: the IRR for the highest quintile relative to the lowest was 1.23 (95% confidence interval [CI], 1.05-1.44). Cereal fiber intake was inversely associated with risk of diabetes, with an IRR of 0.82 (95% CI, 0.70-0.96) for the highest vs lowest quintiles of intake. Stronger associations were seen among women with a body mass index (calculated as weight in kilograms divided by height in meters squared) lower than 25: IRRs for the highest vs lowest quintile were 1.91 (95% CI, 1.16-3.16) for glycemic index (P value for interaction, .12) and 0.41 (95% CI, 0.24-0.72) for cereal fiber intake (P value for interaction, .05). Conclusion: Increasing cereal fiber in the diet may be an effective means of reducing the risk of type 2 diabetes, a disease that has reached epidemic proportions in black women.

The relationship between nutritional status, functional capacity, and health-related quality of life in older adults with type 2 diabetes: A pilot explanatory study

“…Previous work has identified many dietetic problems in older adults with T2DM (28,29) and our finding on nutritional status (85.7% at risk of being malnourished) support this previous work. In this specific population, malnutrtional status is related to the glycemic control, such the glycemic index of nutrients (28,29) or reduced Zinc and Vitamin C levels (30). The poor nutritional status exhibited by those with T2DM is a barrier to gaining muscle tissue and strength, which may be also related to poor insulin tissue sensitivity (10).…”

“…Similar impairments may be a possible explanation for the lower functional capacity reported by our participants, which has been also reported to play an important role in HRQoL among T2DM patients (9). Previous work has identified many dietetic problems in older adults with T2DM (28,29) and our finding on nutritional status (85.7% at risk of being malnourished) support this previous work. In this specific population, malnutrtional status is related to the glycemic control, such the glycemic index of nutrients (28,29) or reduced Zinc and Vitamin C levels (30).…”

Dietary Factors in Fasting Blood Glucose Levels and Weight Gain in Female Sprague Dawley Rats

“…The Shanghai Women's Health Study concluded that women whose diets had the highest glycemic index were 21 percent more likely to develop type 2 diabetes than women whose diets had the lowest glycemic index [14]. Similar findings were reported in the Black Women's Health Study [15]. A diet program that manages the glycemic load aims to avoid sustained blood-sugar spikes and can help avoid onset of type 2 diabetes.…”

Association between dietary glycemic index, glycemic load, and high-sensitivity C-reactive protein

“…However, the two studies Table 3 Regression coefficients predicting log high-sensitivity C-reactive protein from linear mixed models Table 4 Regression coefficients predicting log high-sensitivity C-reactive protein from multivariable linear mixed models controlled for age, BMI, and smoking in the analysis, although residual confounding by these factors is still possible. In a recent publication examining the association of GI, GL, and cereal fiber intake with risk of type 2 diabetes in a cohort of United States black women, risk of diabetes was not statistically significantly associated with GL [26]. The investigators explained that it can be difficult to study GL because of its high correlation with total carbohydrate intake, because cereal fiber intake increased with quintiles of GL, whereas whole grains (a major source of cereal fiber) contributed to GL.…”