Abstract
Purpose
To examine the association between dietary glycaemic index (GI) and dietary glycaemic load (GL) with cardiovascular disease (CVD) risk factors in a rural elderly population.
Methods
A cross-sectional study was conducted in 343 subjects (60–74 years) residing in a Spanish rural area (Priego de Córdoba). Subjects were selected using stratified random sampling. Food intake was assessed using a validated food frequency questionnaire (FFQ). We assigned GI values to each item of the FFQ to estimate dietary GI and GL. Multivariate linear regression models were fitted to assess the association between GI/GL with CVD risk factors (blood glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, apolipoprotein A1, body mass index, waist circumference and blood pressure). The potential modifying effect of sex, smoking status, diabetes and medication has been explored.
Results
A statistically significant inverse association between dietary GI and blood glucose was found in the multivariate model (p = 0.029): for every 10 unit increment of GI, serum glucose levels decreased by 0.2 units. However, statistical significance was lost after controlling for diabetes or hypoglycaemic medication. In the crude model, dietary GL was associated with triglycerides (ß for every 10 GL units increase = 0.70, p = 0.005), but statistical significance was lost in the multivariate model (p = 0.508). No associations were found between dietary GI/GL and the rest of the variables studied.
Conclusions
Neither dietary GI nor GL were associated with CVD risk factors in the study population of Priego de Córdoba. Results obtained suggest the necessity to consider the diagnosis of diabetes in these studies.
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Abbreviations
- ApoA:
-
Apolipoprotein A1
- BMI:
-
Body mass index
- CVD:
-
Cardiovascular disease
- FFQ:
-
Food frequency questionnaire
- GI:
-
Glycaemic index
- GL:
-
Glycaemic load
- HDL-c:
-
High-density lipoprotein cholesterol
- LDL-c:
-
Low-density lipoprotein cholesterol
- MUFAs:
-
Monounsaturated fatty acids
- PUFAs:
-
Polyunsaturated fatty acids
- SFAs:
-
Saturated fatty acids
References
Mendis S, Alwan A (2011) A prioritized research agenda for prevention and control of noncommunicable diseases. World Health Organisation, Geneva
Instituto Nacional de Estadística (2011) Defunciones según causa de muerte. 2011. http://www.ine.es. Accessed 23 June 2011
Serra-Majem L, Román B, Estruch R (2006) Scientific evidence of interventions using the mediterranean diet: a systematic review. Nutr Rev 64(2):S27–S46
Kones R (2011) Primary prevention of coronary heart disease: integration of new data, evolving views, revised goals, and role of rosuvastatin in management. A comprehensive survey. Drug Des Devel Ther 5:325–380
Nicklas TA, O’Neil CE, Fulgoni VL III (2012) Diet quality is inversely related to cardiovascular risk factors in adults. J Nutr 142(12):2112–2118. doi:10.3945/jn.112.164889
Aston LM (2006) Glycaemic index and metabolic disease risk. Proc Nutr Soc 65:125–134
Mann J, McAuley K (2007) Carbohydrates: is the advice to eat less justified for diabetes and cardiovascular health? Curr Opin Lipidol 18(1):9–12
Denova-Gutiérrez E, Huitrón-Bravo G, Talavera JO, Castañón S, Gallegos-Carrido K, Flores Y et al (2010) Dietary glycemic index, dietary glycemic load, blood lipids, and coronary heart disease. J Nutr Metab. doi:10.1155/2010/170680
Burger KN, Beulens JW, Boer JM, Spijkerman AM (2011) Dietary glycemic load and glycemic index and risk of coronary heart disease and stroke in Dutch men and women: the EPIC-MORGEN study. PLoS ONE 6(10):e25955
Jenkins D, Kendall C, Augustin L, Franceschi S, Hamidi M, Marchie A et al (2002) Glycemic index: overview of implications in health and disease. Am J Clin Nutr 76:266S–273S
Du H, van der A DL, van Bakel M, van der Kallen C, Blaak E, van Greevenbroek M et al (2008) Glycemic index and glycemic load in relation to food and nutrient intake and metabolic risk factors in a Dutch population. Am J Clin Nutr 87:655–661
Livesey G, Taylor R, Hulshof T, Howlett J (2008) Glycemic response and health–a systematic review and meta-analysis: the database, study characteristics, and macronutrient intakes. Am J Clin Nutr 87(1):223S–236S
Brand-Miller J, McMillan-Price J, Steinbeck K, Caterson I (2009) Dietary glycemic index: health implications. J Am Coll Nutr 28(Suppl):446S–449S
Ma X-Y, Liu J-P, Song Z-Y (2012) Glycemic load, glycemic index and risk of cardiovascular diseases: meta-analysis of prospective studies. Atherosclerosis 223(2):491–496
Dong JY, Zhang YH, Wang P, Qin LQ (2012) Meta-analysis of dietary glycemic load and glycemic index in relation to risk of coronary heart disease. Am J Cardiol 109(11):1608–1613. doi:10.1016/j.amjcard.2012.01.385
Goff LM, Cowland DE, Hooper L, Frost GS (2013) Low glycaemic index diets and blood lipids: a systematic review and meta-analysis of randomised controlled trials. Nutr Metab Cardiovasc Dis 23(1):1–10. doi:10.1016/j.numecd.2012.06.002
Wolever TMS (2013) Is glycaemic index (GI) a valid measure of carbohydrate quality? Eur J Clin Nutr 67:522–531
Ros Rahola E (1992) Tratamiento dietético de las hiperlipidemias. In: Jarpyo (ed) Manual de las clínicas de lípidos españolas. Sociedad Española de Ateroesclerosis, Barcelona
Mullen BJ, Krantzler NJM, Grivetti LE, Schutz HG, Meiselman HL (1984) Validity of a food frequency questionnaire for the determination of individual food intake. Am J Clin Nutr 39:136–143
Willet WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, Hennekens CH, Speizer FE (1985) Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 122:51–65
Suárez MP, Ruíz-López MD, Olea MF (1993) Raciones por fotografía. Departamento de Nutrición y Bromatología, Facultad de farmacia, Granada
Serge Hercberg, Michèle Deheeger SUVIMAX (1994) Portion alimentaires. Manuel photos pour l´estimation des quantités. Polytechnica, París
Ruiz-López MD, Artacho R (2006) Programa informático para valoración de dietas “Nutrire”. Proyecto de innovación docente. Universidad de Granada, Granada
Stewart A, Marfell-Jones M, Olds T, de Ridder H (2011) International standards for anthropometric assessment. ISAK, Lower Hutt
Louie JC, Flood V, Turner N, Everingham C, Gwynn J (2011) Methodology for adding glycemic index values to 24-hour recalls. Nutrition 27(1):59–64
Atkinson FS, Foster-Powell K, Brand-Miller JC (2008) International tables of glycemic index and glycemic load values: 2008. Diabetes Care 31(12):2281–2283
Wolever TM, Nguyen PM, Chiasson JL, Hunt JA, Josse RG, Palmason C, Rodger NW, Ross SA, Ryan EA, Tan MH (1994) Determinants of diet glycemic index calculated retrospectively from diet records of 342 individuals with non-insulin-dependent diabetes mellitus. Am J Clin Nutr 59(6):1265–1269
Salmeron J, Manson JE, Stampfer MJ, Colditz GA, Wing AL, Willett WC (1997) Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. JAMA 277(6):472–477
Willett WC, Howe GR, Kushi LH (1997) Adjustment for total energy intake in epidemiological studies. Am J Clin Nutr 65(4 Suppl):1220S–1228S
van Bakel MM, Kaaks R, Feskens EJ, Rohrmann S, Welch AA, Pala V et al (2009) Dietary glycaemic index and glycaemic load in the European prospective investigation into cancer and nutrition. Eur J Clin Nutr 63(Suppl 4):S188–S205. doi:10.1038/ejcn.2009.81
Méndez M, Covas MI, Marrugat J, Vila J, Schöder H (2009) Glycemic load, glycemic index, and body mass index in Spanish adults. Am J Clin Nutr 89:316–322
Howlett J, Ashwell M (2008) Glycemic response and health: summary of a workshop. Am J Clin Nutr 87(1):212S–216S
Buyken AE, Flood V, Empson M, Rochtchina E, Barclay AW, Brand-Miller J, Mitchell P (2010) Carbohydrate nutrition and inflammatory disease mortality in older adults. Am J Clin Nutr 92(3):634–643. doi:10.3945/ajcn.2010.29390
Aparicio A, Robles F, López-Sobaler AM, Ortega RM (2013) Dietary glycaemic load and odds of depression in a group of institutionalized elderly people without antidepressant treatment. Eur J Nutr 52(3):1059–1066. doi:10.1007/s00394-012-0412-7
Mirrahimi A, de Souza RJ, Chiavaroli L, Sievenpiper JL, Beyene J, Hanley AJ, Augustin LS, Kendall CW, Jenkins DJ (2012) Associations of glycemic index and load with coronary heart disease events: a systematic review and meta-analysis of prospective cohorts. J Am Heart Assoc. 1(5):e000752. doi:10.1161/JAHA.112.000752
Kristo AS, Matthan NR, Lichtenstein AH (2013) Effect of diets differing in glycemic index and glycemic load on cardiovascular risk factors: review of randomized controlled-feeding trials. Nutrients 5:1071–1080. doi:10.3390/nu5041071
Murakami K, McCaffrey TA, Livingstone MB (2013) Dietary glycaemic index and glycaemic load in relation to food and nutrient intake and indices of body fatness in British children and adolescents. Br J Nutr 110(8):1512–1523
Weickert MO (2012) What dietary modification best improves insulin sensitivity and why? Clin Endocrinol (Oxf) 77(4):508–512. doi:10.1111/j.1365-2265.2012.04450.x
Barba G, Sieri S, Russo MD, Donatiello E, Formisano A, Lauria F et al (2012) Glycaemic index and body fat distribution in children: the results of the ARCA Project. Nutr Metab Cardiovasc Dis 22(1):28–34. doi:10.1016/j.numecd.2010.03.007
Rossi M, Bosetti C, Talamini R, Lagiou P, Negri E, Franceschi S et al (2010) Glycemic index and glycemic load in relation to body mass index and waist to hip ratio. Eur J Nutr 49(8):459–464. doi:10.1007/s00394-010-0104-0
Du H, van der A DL, van Bakel MM, Slimani N, Forouhi NG, Wareham NJ et al (2009) Dietary glycaemic index, glycaemic load and subsequent changes of weight and waist circumference in European men and women. Int J Obes (Lond) 33(11):1280–1288. doi:10.1038/ijo.2009.163
Thomas DE, Elliot EJ, Baur L (2007) Low glycaemic index or low glycaemic load diets for overweight and obesity. Cochrane Database Syst Rev 3(3):CD005105
Brand-Miller J, Buyken AE (2012) The glycemic index issue. Curr Opin Lipidol 23(1):62–67. doi:10.1097/MOL.013e32834ec705
Shikany JM, Tinker LF, Neuhouser ML, Ma Y, Patterson RE, Phillips LS et al (2010) Association of glycemic load with cardiovascular disease risk factors: the Women’s Health Initiative Observational Study. Nutrition 26(6):641–647
Gopinath B, Flood VM, Rochtchina E, Baur LA, Smith W, Mitchell P (2012) Influence of high glycemic index and glycemic load diets on blood pressure during adolescence. Hypertension 59(6):1272–1277
Levitan EB, Cook NR, Stampfer MJ, Ridker PM, Rexrode KM, Buring JE et al (2008) Dietary glycemic index, dietary glycemic load, blood lipids, and C-reactive protein. Metabolism 57(3):437–443
van Dam RM, Visscher AW, Feskens EJ, Verhoef P, Kromhout D (2000) Dietary glycemic index in relation to metabolic risk factors and incidence of coronary heart disease: the Zutphen Elderly Study. Eur J Clin Nutr 54(9):726–731
Oxlund AL, Heitmann BL (2006) Glycaemic index and glycaemic load in relation to blood lipids—6 years of follow-up in adult Danish men and women. Public Health Nutr 9(6):737–745
Ma Y, Li Y, Chiriboga DE, Olendzki BC, Hebert JR, Li W et al (2006) Association between carbohydrate intake and serum lipids. J Am Coll Nutr 25(2):155–163
Bouché C, Rizkalla SW, Luo J, Vidal H, Veronese A, Pacher N et al (2002) Five-week, low-glycemic index diet decreases total fat mass and improves plasma lipid profile in moderately overweight nondiabetic men. Diabetes Care 25:822–828
Mosdøl A, Witte DR, Frost G, Marmot MG, Brunner EJ (2007) Dietary glycemic index and glycemic load are associated with high-density-lipoprotein cholesterol at baseline but not with increased risk of diabetes in the Whitehall II study. Am J Clin Nutr 86(4):988–994
Goletzke J, Buyken AE, Goppinath B, Rochtchina E, Barclay AW, Gheng G, Brand-Miller JC, Mitchell P (2013) Carbohydrate quality is not associated with liver enzyme activity and plasma TAG and HDL concentrations over 5 years in an older population. Br J Nutr 110(5):918–925. doi:10.101017/S0007114512005867
Liu S, Willett WC, Stampfer MJ, Hu FB, Franz M, Sampson L et al (2000) A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Am J Clin Nutr 71(6):1455–1461
Nakashima M, Sakurai M, Nakamura K, Miura K, Yoshita K, Morikawa Y et al (2010) Dietary glycemic index, glycemic load and blood lipid levels in middle-aged Japanese men and women. J Atheroscler Thromb 17(10):1082–1095
Radhika G, Ganesan A, Sathya RM, Sudha V, Mohan V (2009) Dietary carbohydrates, glycemic load and serum high-density lipoprotein cholesterol concentrations among South Indian adults. Eur J Clin Nutr 63(3):413–420
Van Rompay MI, McKeown NM, Castaneda-Sceppa C, Ordovás JM, Tucker KL (2013) Carbohydrate nutrition differs by diabetes status and is associated with dyslipidemia in Boston Puerto Rican adults without diabetes. J Nutr 143(2):182–186
Choi H, Song S, Kim J, Chung J, Yoon J, Paik HY et al (2012) High carbohydrate intake was inversely associated with high-density lipoprotein cholesterol among Korean adults. Nutr Res 32(2):100–106
Slyper A, Jurva J, Pleuss J, Hoffmann R, Gutterman D (2005) Influence of glycemic load on HDL cholesterol in youth. Am J Clin Nutr 81(2):376–379
Huffman FG, Zarini GG, Cooper V (2010) Dietary glycemic index and load in relation to cardiovascular disease risk factors in Cuban American population. Int J Food Sci Nutr 61(7):690–701
Reaven GM (2005) Insulin resistance, the insulin resistance syndrome, and cardiovascular disease. Panminerva Med 47(4):201–210
Acknowledgments
MD R.-L. and R. A. contributed to the design of the study. F. A. collected the data. I. C.-Q. and R. A. analysed data and wrote the draft of the manuscript. E.M. provided expert advice, analysed data and helped in the draft of the manuscript. MD R.-L. and R. A. participated in the critical revision of the paper. All authors contributed to the preparation of the final manuscript and approved the final version. The authors have no conflict of interest to report.
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Castro-Quezada, I., Artacho, R., Molina-Montes, E. et al. Dietary glycaemic index and glycaemic load in a rural elderly population (60–74 years of age) and their relationship with cardiovascular risk factors. Eur J Nutr 54, 523–534 (2015). https://doi.org/10.1007/s00394-014-0733-9
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DOI: https://doi.org/10.1007/s00394-014-0733-9