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Effects on cardiovascular risk factors of a low- vs high-glycemic index Mediterranean diet in high cardiometabolic risk individuals: the MEDGI-Carb study

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Abstract

Background

The role of dietary Glycemic Index (GI), independently of fiber intake, in modulating cardiovascular disease (CVD) risk among non-diabetic individuals has not been fully elucidated.

Objective

To evaluate the effects of a low- versus a high-GI diet, based on a Mediterranean dietary pattern, on cardiometabolic risk factors in individuals at high CVD risk, participating in the MEDGI-Carb intervention study.

Subjects and methods

160 individuals, aged 30–69 years, BMI 25–37 kg/m2, with a waist circumference >102 cm (males) or >88 cm (females) and one feature of the metabolic syndrome, participated in a multi-national (Italy, Sweden, USA) randomized controlled parallel group trial. Participants were assigned to a low GI (< 55) or high-GI MedDiet ( > 70) for 12 weeks. The diets were isoenergetic and similar for available carbohydrate (270 g/d) and fiber (35 g/d) content. Fasting metabolic parameters were evaluated in the whole cohort, while an 8-h triglyceride profile (after standard breakfast and lunch) was evaluated only in the Italian cohort.

Results

Blood pressure and most fasting metabolic parameters improved at the end of the dietary intervention (time effect, p < 0.05 for all); however, no differences were observed between the low- and the high-GI MedDiet groups (time x group effect; p > 0.05 for all). Conversely, the low-GI diet, compared with high-GI diet, significantly reduced the 8-h triglyceride profile (p < 0.017, time*group effect) that was measured only in the Italian cohort. However, it induced a reduction of plasma triglycerides after lunch (tAUC) that was of only borderline statistically significance (p = 0.065).

Conclusions

Consuming a low-GI in comparison with a high-GI MedDiet does not differentially affect the major cardiometabolic risk factors at fasting in individuals at increased cardiometabolic risk. Conversely, it could reduce postprandial plasma triglycerides.

Clinical trial registry number

NCT03410719, (https://clinicaltrials.gov).

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Fig. 1: Eight hour profile of plasma triglyceride concentrations with a breakfast and lunch resembling the Low- or the High-GI MedDiet at baseline and after a 12-week dietary intervention in the Italian cohort.

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Data availability

Additional data are available from the corresponding author on reasonable request.

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Acknowledgements

WWC, GR and RL served as co-principal investigators. The study authors would like to thank all study participants who volunteered their valuable time and attention. We thank Barilla G&R F.lli. SpA, Parma, Italy for providing some of the cereal products for the study participants.

Funding

This research was funded by Barilla International and Barilla USA. The industry was not involved in the study hypothesis/design, execution, analysis, or interpretation.

Author information

Authors and Affiliations

  1. Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy

    Giuseppina Costabile, Marilena Vitale & Gabriele Riccardi

  2. Department of Nutrition Science, Purdue University, West Lafayette, IN, USA

    Robert E. Bergia & Wayne Campbell

  3. Department of Biology and Biological Engineering, Food Science and Nutrition, Chalmers University of Technology, Gothenburg, Sweden

    Therese Hjorth & Rikard Landberg

  4. Institute of Food Sciences, National Research Council, Avellino, Italy

    Rosalba Giacco

Authors
  1. Giuseppina Costabile
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  2. Robert E. Bergia
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  5. Wayne Campbell
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Contributions

Conceptualization, RG, GR, RL and WWC; methodology, GC, REB, WWC, RL and GR; formal analysis, GC; investigation, RG, GC, REB and MV; resources, WWC, RL and GR; data curation, GC, MV, REB and RG; writing—original draft preparation, GC and RG; writing—review and editing, GC, RG, REB, RL and GR; supervision, GR, RL and WWC; project administration, REB, RG, GC and MV; funding acquisition, GR, RL and WWC. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Giuseppina Costabile.

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Competing interests

Gabriele Riccardi is member of the Health and Wellbeing Advisory Board of the Barilla company: remuneration for this activity goes to his University Department. All other authors declare no conflict of interest.

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Informed consent was obtained from all subjects involved in the study.

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Costabile, G., Bergia, R.E., Vitale, M. et al. Effects on cardiovascular risk factors of a low- vs high-glycemic index Mediterranean diet in high cardiometabolic risk individuals: the MEDGI-Carb study. Eur J Clin Nutr (2024). https://doi.org/10.1038/s41430-024-01406-y

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