The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein

Wolever, Thomas M. S.; Gibbs, Alison L.; Mehling, Christine C.; Chiasson, Jean‐Louis; Connelly, Philip W.; Josse, Robert G.; Leiter, Lawrence A.; Maheux, Pierre; Rabasa‐Lhoret, Rémi; Rodger, N. W.; Ryan, Edmond A.

doi:10.1093/ajcn/87.1.114

Cited by 288 publications

(286 citation statements)

References 67 publications

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“…Insulin is known to activate the sympathetic nervous system 23 and is a potential mediator of sodium retention and volume expansion and, thus, higher BP. [24][25][26][27] Additional prospective studies of adolescents with larger sample size will, nevertheless, be needed to determine the importance of our observation and to delineate underlying mechanisms.…”

Section: Discussionmentioning

confidence: 98%

Influence of High Glycemic Index and Glycemic Load Diets on Blood Pressure During Adolescence

et al. 2012

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Abstract-We aimed to prospectively examine the association between the glycemic index and glycemic load of foods consumed and the dietary intakes of carbohydrates, sugars, fiber, and principal carbohydrate-containing food groups (eg, breads, cereals, and sugary drinks) with changes in blood pressure during adolescence. A total of 858 students aged 12 years at baseline (422 girls and 436 boys) were examined from 2004 -2005 to 2009 -2011. Dietary data were assessed from validated semiquantitative food frequency questionnaires. Blood pressure was measured using a standard protocol. In girls, after adjusting for age, ethnicity, parental education, parental history of hypertension, baseline height, baseline blood pressure, change in body mass index, and time spent in physical and sedentary activities, each 1-SD (1-SDϭ7.10 g/d) increase in baseline dietary intake of total fiber was associated with a 0. 2,3 Therefore, preventing elevated BP levels in childhood and adolescence may be an important public health measure to limit the overall disease burden caused by hypertension. 4,5 More recently, there are data to suggest that dietary factors, such as high consumption of carbohydrates, including sugars and soft drinks, could adversely influence BP levels. 6 A recent meta-analysis of intervention studies involving adults 7 shows that diets rich in carbohydrates may be associated with slightly higher BP. In contrast, dietary fiber intake was shown to be inversely associated with BP in adults 8 and with reduced risk of incident cardiovascular disease. 9 To the best of our knowledge, the temporal link between carbohydrate nutrition intake and BP has not been explored in an adolescent population.In addition, previous adult studies have demonstrated a direct association of sugar-sweetened beverage consumption with systolic/diastolic BP and direct associations of fructose and glucose intake with BP. 6,10 In addition, the National Health and Nutrition Examination Survey found that, in a sample of 4867 adolescents aged 12 to 18 years, higher sugar-sweetened beverage consumption was associated with higher serum uric acid levels and systolic BP.11 However, this study had a cross-sectional design, and currently there are no prospective data during adolescence examining this relationship.To better understand the effects of carbohydrate nutrition variables on BP during adolescence, we used data available from a 5-year longitudinal study of adolescents in Australia to determine the following: (1) the association between baseline dietary intakes of total carbohydrate, sugars, glycemic index (GI), glycemic load (GL), and fiber with temporal changes in systolic and diastolic BP and mean arterial BP; (2) the relationship between baseline consumption of soft drinks/ cordials and the principal carbohydrate-containing food groups (eg, breads and cereals, potatoes, and energy-dense nutrient-poor sources of carbohydrates, such as cookies and

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Section: Discussionmentioning

confidence: 98%

Influence of High Glycemic Index and Glycemic Load Diets on Blood Pressure During Adolescence

et al. 2012

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“…Participants were aged 35 to 75 years, had HbA 1c ≤130% upper limit of normal, BMI 24 to 40 kg/m 2 , were not using insulin or any hypoglycaemic or anti-hyperglycaemic medication and were otherwise generally healthy. Detailed inclusion and exclusion criteria and the rationale for the sample size are reported elsewhere [1].…”

Section: Study Centresmentioning

confidence: 99%

“…A dietitian provided dietary advice with the aim of attaining 55% of energy from carbohydrate, 15% from protein and 30% from fat, consisting of 8% to 9% saturated fatty acids, 8% to 10% polyunsaturated fatty acids and 15% to 20% MUFA. Two weeks later participants (n=162) were randomly assigned as previously described [1] to one of three diets: High-GI, Low-GI or Low-CHO. Blocks of various sizes were used to enhance allocation concealment.…”

Section: Study Centresmentioning

confidence: 99%

“…We recently compared the effects of altering the amount vs the glycaemic index of dietary carbohydrate for 1 year in type 2 diabetic patients being treated by diet-alone on overall glycaemic control and the plasma glucose concentration at 2 h after 75 g OGTT (2hPCG) [1]. Although HbA 1c did not differ among diets, the results showed a significant adaptation in the OGTT.…”

Section: Introductionmentioning

confidence: 99%

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Low glycaemic index diet and disposition index in type 2 diabetes (the Canadian trial of Carbohydrates in Diabetes): a randomised controlled trial

Wolever

Mehling²,

Chiasson

et al. 2008

Diabetologia

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Aims/hypothesis We recently found that oral glucose tolerance over 1 year in type 2 diabetic patients declined to a significantly lesser degree on a low-glycaemic-index than on a reduced-carbohydrate diet. Here, we examined whether that finding was associated with an improvement in disposition index, an index of beta cell function defined as the product of insulin sensitivity and insulin secretion. Since this is a report of secondary analysis on a previously published trial, the results should be considered as hypothesis-generating. Methods Type 2 diabetic patients treated by diet alone (n=162) were randomised by computer to high-carbohydrate/highglycaemic index (High-GI, n=52), high-carbohydrate/lowglycaemic index (Low-GI, n=56) or low-carbohydrate/ high-monounsaturated-fat (Low-CHO, n= 54) diets for 1 year in a multi-centre, parallel-design clinical trial conducted at University teaching hospitals. At baseline and at 3, 6 and 12 months participants underwent 75 g OGTTs; 27 participants dropped out or were excluded. Indices of insulin sensitivity, insulin secretion and disposition index, derived from the OGTT, were compared among diets. Those assessing the outcomes were blinded to group assignment. Results Neither muscle insulin sensitivity index nor insulinogenic index differed significantly among diets. However, a significant time×diet interaction existed for disposition index (muscle insulin sensitivity index×insulinogenic index) (p=0.036). After 3 months, disposition index tended to be higher on Low-CHO than on Low-GI diets, namely by 0.07 h −1 (95% CI −0.04, 0.18). However, by 12 months this reversed and disposition index became higher on Low-GI than on Low-CHO, namely by 0.12 h −1 (0.01, 0.23; p< 0.05, baseline disposition index 0.23 h −1 ). There were no important adverse effects associated with the treatments. Conclusions/interpretation These results suggest that, in patients with type 2 diabetes on diet alone, a Low-GI diet for 1 year increases disposition index, an index of beta cell function, compared with a Low-CHO diet.

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“…There is some evidence to suggest that choosing foods with a low GI is helpful in managing glycaemic control in type I and type II diabetes, and that low-GI diets may reduce the risk of several chronic diseases (Brand-Miller et al, 2003;Barclay et al, 2008;Jenkins et al, 2008;Wolever et al, 2008a). However, the role for GI in the prevention and treatment of diseases is not entirely clear (Venn and Green, 2007).…”

mentioning

confidence: 99%

The effect of the fat and carbohydrate contents in the evening meal preceding GI testing on GI

et al. 2009

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A crossover study was designed to determine whether the fat and carbohydrate contents of evening meals consumed the night preceding glycaemic index (GI) testing had an effect on the GI. Twenty participants consumed two different evening meals in which the energy contributions from fat, carbohydrate and protein were in the ratio 50:30:15 and 25:60:15, respectively. Each participant completed eight tests that involved two evening meals with different macronutrient compositions followed the next morning by two treatments, glucose beverage or fruit bread, all carried out in duplicate. The GI of fruit bread was determined on the mornings following each of the evening meals. The GIs (95% CI) were 68 (60, 76) and 59 (52, 67) after the highcarbohydrate and high-fat meals, respectively, and were not different (P ¼ 0.11). Thus, varying the fat and carbohydrate contents of the evening meal before GI testing the next morning did not affect the GI.

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The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein

Cited by 288 publications

References 67 publications

Influence of High Glycemic Index and Glycemic Load Diets on Blood Pressure During Adolescence

Influence of High Glycemic Index and Glycemic Load Diets on Blood Pressure During Adolescence

Low glycaemic index diet and disposition index in type 2 diabetes (the Canadian trial of Carbohydrates in Diabetes): a randomised controlled trial

The effect of the fat and carbohydrate contents in the evening meal preceding GI testing on GI

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