The Role of Glycemic Index and Glycemic Load In Cardiovascular Disease And Its Risk Factors: A Review of The Recent Literature

  • Arash Mirrahimi
  • Laura Chiavaroli
  • Korbua Srichaikul
  • Livia S. A. Augustin
  • John L. Sievenpiper
  • Cyril W. C. Kendall
  • David J. A. Jenkins
Part of the following topical collections:
  1. Topical Collection on Nutrition


A number of meta-analyses of cohort studies have assessed the impact of glycemic load (GL) and glycemic index (GI) on cardiovascular outcomes. The picture that emerges is that for women, a significant association appears to exist between the consumption of high GL/GI diets and increased cardiovascular disease (CVD) risk. This association appears to be stronger in those with greater adiposity and possibly in those with diabetes, although these findings are not uniform. There is also an indication that raised CRP levels may be reduced, which has special implications for women whose CRP levels, as an emerging CVD risk factor, may be higher than men. For men, the situation is not as clear-cut. Although some studies show association, the meta-analyses have not demonstrated a significant direct association with CVD, despite current evidence that risk factors, including LDL-C, may be reduced on low-GI diets. Moreover, in a recent meta-analysis, increases in dietary GL have been associated with increased risk of diabetes, another CVD risk factor, in both men and women. Studies in men expressing relative risk of CVD in relation to GL and GI, with corresponding confidence intervals, are needed to provide the necessary power for future meta-analyses on this topic.


Glycemic index Glycemic load Cardiovascular disease risk Review 


Conflicts of Interest

Arash Mirrahimi has received research support from the Canadian Institutes of Health Research (CIHR). Laura Chiavaroli works as a casual Clinical Research Coordinator at GI Laboratories, Toronto, Canada. Korbua Srichaikul has received research support from the CIHR. Livia Augustin has received funding from Saskatchewan Pulse Growers, Pulse Canada, and Agri-Culture and Agri-Food Canada (AAFC). John Sievenpiper has received research support from the CIHR, Calorie Control Council, the Coca-Cola Company (investigator initiated, unrestricted grant), Pulse Canada, and The International Tree Nut Council Nutrition Research & Education Foundation. He has received travel funding, speaker fees, and/or honoraria from the American Heart Association (AHA), American Society for Nutrition (ASN), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH), Canadian Diabetes Association (CDA), Canadian Nutrition Society (CNS), Calorie Control Council, Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD), International Life Sciences Institute (ILSI) North America, International Life Sciences Institute (ILSI) Brazil, Abbott Laboratories, Pulse Canada, Dr. Pepper Snapple Group, and The Coca-Cola Company. He is on the Clinical Practice Guidelines Expert Committee for Nutrition Therapy of both the Canadian Diabetes Association (CDA) and European Association for the study of Diabetes (EASD), as well as on the American Society for Nutrition (ASN) writing panel for a scientific statement on the metabolic and nutritional effects of fructose, sucrose and high fructose corn syrup. He is an unpaid scientific advisor for the International Life Science Institute (ILSI) North America, Food, Nutrition, and Safety Program (FNSP). His wife is an employee of Unilever Canada. Cyril Kendall has received research grants, travel funding, consultant fees, or honoraria or has served on the scientific advisory board for Abbott, the Advanced Food Materials Network (AFMNet), the Almond Board of California, the American Peanut Council, American Pistachio Growers, Barilla, the California Strawberry Commission, Canadian Institutes of Health Research, the Canola Council of Canada, Danone, General Mills, Hain Celestial, the International Tree Nut Council, Kellogg’s, Loblaw Brands, Ltd., Oldways, Orafti, Paramount Farms, Pulse Canada, Saskatchewan Pulse Growers, Solae, and Unilever. David Jenkins has served on the Scientific Advisory Board of Sanitarium Company, AAFC, Canadian Agriculture Policy Institute (CAPI), the California Strawberry Commission, Loblaw Supermarket, Herbal Life International, Nutritional Fundamental for Health, Pacific Health Laboratories, Metagenics, Bayer Consumer Care, Orafti, Dean Foods, Kellogg’s, Quaker Oats, Procter & Gamble, Coca-Cola, NuVal Griffin Hospital, Abbott, Pulse Canada, Saskatchewan Pulse Growers, and the Canola Council of Canada; he has received honoraria for scientific advice from the Sanitarium Company, Orafti, the Almond Board of California, the American Peanut Council, International Tree Nut Council Nutrition Research and Education Foundation and the Peanut Institute, Herbal Life International, Pacific Health Laboratories, Nutritional Fundamental for Health, Barilla, Metagenics, Bayer Consumer Care, Unilever Canada and Netherlands, Solae, Oldways, Kellogg’s, Quaker Oats, Procter & Gamble, Coca-Cola, NuVal Griffin Hospital, Abbott, the Canola Council of Canada, Dean Foods, the California Strawberry Commission, Haine Celestial, Pepsi, and the Alpro Foundation; he has been on the speakers panel for the Almond Board of California; received research grants from Saskatchewan Pulse Growers, the Agricultural Bioproducts Innovation Program (ABIP) through the Pulse Research Network (PURENet), AFMNet, Loblaw, Unilever, Barilla, the Almond Board of California, Coca-Cola, Solae, Haine Celestial, Sanitarium Company, Orafti, the International Tree Nut Council Nutrition Research and Education Foundation and the Peanut Institute, the Canola and Flax Councils of Canada, the Calorie Control Council, the Canadian Institutes of Health Research, the Canada Foundation for Innovation, and the Ontario Research Fund; and has received travel support to meetings from the Solae, Sanitarium Company, Orafti, AFMNet, Coca-Cola, The Canola and Flax Councils of Canada, Oldways Preservation Trust, Kellogg’s, Quaker Oats, Griffin Hospital, Abbott Laboratories, Dean Foods, the California Strawberry Commission, the American Peanut Council, Herbal Life International, Nutritional Fundamental for Health, Metagenics, Bayer Consumer Care, AAFC, CAPI, Pepsi, the Almond Board of California, Unilever, the Alpro Foundation, the International Tree Nut Council, Barilla, Pulse Canada, and the Saskatchewan Pulse Growers. David Jenkins' wife is a director of Glycemic Index Laboratories, Toronto, Ontario, Canada.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Arash Mirrahimi
    • 1
    • 2
    • 3
  • Laura Chiavaroli
    • 1
    • 2
  • Korbua Srichaikul
    • 1
    • 2
    • 4
  • Livia S. A. Augustin
    • 1
    • 2
  • John L. Sievenpiper
    • 1
    • 5
  • Cyril W. C. Kendall
    • 1
    • 2
    • 6
  • David J. A. Jenkins
    • 1
    • 2
    • 7
    • 8
  1. 1.Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoUSA
  2. 2.Department of Nutritional Sciences, Faculty of MedicineUniversity of TorontoTorontoUSA
  3. 3.School of Medicine, Faculty of Health SciencesQueen’s UniversityKingstonUSA
  4. 4.Faculty of MedicineUniversity of OttawaOttawaUSA
  5. 5.Department of Pathology and Molecular Medicine, Faculty of Health SciencesMcMaster UniversityHamiltonUSA
  6. 6.College of Pharmacy and NutritionUniversity of SaskatchewanSaskatoonUSA
  7. 7.Department of Medicine, Faculty of MedicineUniversity of TorontoTorontoUSA
  8. 8.Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoUSA

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