Relevance of the Glycemic Index and Glycemic Load for Body Weight, Diabetes, and Cardiovascular Disease

Abstract

Despite initial enthusiasm, the relationship between glycemic index (GI) and glycemic response (GR) and disease prevention remains unclear. This review examines evidence from randomized, controlled trials and observational studies in humans for short-term (e.g., satiety) and long-term (e.g., weight, cardiovascular disease, and type 2 diabetes) health effects associated with different types of GI diets. A systematic PubMed search was conducted of studies published between 2006 and 2018 with key words glycemic index, glycemic load, diabetes, cardiovascular disease, body weight, satiety, and obesity. Criteria for inclusion for observational studies and randomized intervention studies were set. The search yielded 445 articles, of which 73 met inclusion criteria. Results suggest an equivocal relationship between GI/GR and disease outcome. The strongest intervention studies typically find little relationship among GI/GR and physiological measures of disease risk. Even for observational studies, the relationship between GI/GR and disease outcomes is limited. Thus, it is unlikely that the GI of a food or diet is linked to disease risk or health outcomes. Other measures of dietary quality, such as fiber or whole grains may be more likely to predict health outcomes. Interest in food patterns as predictors of health benefits may be more fruitful for research to inform dietary guidance.

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

“…This observation may partly explain some of the heterogeneity and inconsistencies in the GI-disease associations between various studies. 10 Clinical Care/Education/Nutrition In support of our findings, a recent study comparing the response with a low GI dinner (taken at 8.00 pm) and breakfast (taken at 8.00 am) in a young non-diabetic population also found that the glucose iAUC at dinner was significantly greater than breakfast. 28 In their study, Leung et al kept the duration of the prior fasting period identical for both conditions, hence excluding the potential confounding role of the intermeal duration factor.…”

“…[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. In fact, there has been a recent renaissance in research surrounding the circadian control of metabolism.…”

Characterizing the Retinal Phenotype in the High-Fat Diet and Western Diet Mouse Models of Prediabetes

“…LFDs promote insulin resistance, and while most of the research has been performed in humans, these findings may have relevance to murine studies. LFD, typically considered a high carbohydrate diet, is known to promote inflammation [74][75][76]. A recent study compared ERGs in HFD fed rats, Streptozotocin (STZ) rats and type 2 diabetes (T2D) rats at 6 months to controls.…”

Mens sana in corpore sano: Does the Glycemic Index Have a Role to Play?

“…Several studies have highlighted the role of a low-GI diet in insulin sensitivity, vascular system function, and weight management [ 21 ]. Recommendations in diabetic patients to help control their blood glucose level represent one of the most important applications of GI/GL indexes, despite some caveats in their interpretation.…”