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Castro-Quezada I, Núñez-Ortega PE, Flores-Guillén E, García-Miranda R, Irecta-Nájera CA, Solís-Hernández R, Medina-Gómez C, Ochoa-Díaz-López H. Glycemic Index, Glycemic Load and Dyslipidemia in Adolescents from Chiapas, Mexico. Nutrients 2024; 16:1483. [PMID: 38794721 PMCID: PMC11124452 DOI: 10.3390/nu16101483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/12/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Cardiovascular disease risk throughout the life course is increased by abnormal blood lipid levels in youth. The dietary glycemic index (GI) and glycemic load (GL) during adolescence might be related to abnormal blood lipids. This study aimed to analyze the association between dietary GI, GL and dyslipidemia in adolescents from two marginalized regions of Chiapas, Mexico. A cross-sectional study was conducted with 213 adolescents. Food intake was assessed using 24 h recalls. The association between dyslipidemia and dietary GI or GL was tested by using logistic regression models. Low HDL-c was the most prevalent risk factor (47.4%), followed by hypertriglyceridemia (25.4%). In this population, overall dietary GI was not associated with dyslipidemia. A high dietary GL was associated with 2.39 higher odds of low HDL-c (95% CI: 1.21-4.74) when compared to low GL. Female adolescents with high dietary GL had 3.20 higher odds of hypertriglyceridemia (95% CI: 1.03-9.88), whereas no association was found for males. No associations were observed between overall dietary GL and total cholesterol or LDL-c. In adolescents from urban and rural communities in Chiapas, a high dietary GL was associated with a detrimental effect on HDL-c. In female adolescents, high GL was associated with hypertriglyceridemia.
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Affiliation(s)
- Itandehui Castro-Quezada
- Health Department, El Colegio de la Frontera Sur, Villahermosa 86280, Mexico; (I.C.-Q.); (R.G.-M.); (C.A.I.-N.)
| | - Pilar Elena Núñez-Ortega
- Health Department, El Colegio de la Frontera Sur, San Cristóbal de las Casas 29290, Mexico; (P.E.N.-O.); (R.S.-H.); (C.M.-G.)
| | - Elena Flores-Guillén
- Faculty of Nutrition and Food Science, University of Science and Arts of Chiapas, Tuxtla Gutiérrez 29039, Mexico;
| | - Rosario García-Miranda
- Health Department, El Colegio de la Frontera Sur, Villahermosa 86280, Mexico; (I.C.-Q.); (R.G.-M.); (C.A.I.-N.)
| | - César Antonio Irecta-Nájera
- Health Department, El Colegio de la Frontera Sur, Villahermosa 86280, Mexico; (I.C.-Q.); (R.G.-M.); (C.A.I.-N.)
| | - Roberto Solís-Hernández
- Health Department, El Colegio de la Frontera Sur, San Cristóbal de las Casas 29290, Mexico; (P.E.N.-O.); (R.S.-H.); (C.M.-G.)
| | - Christian Medina-Gómez
- Health Department, El Colegio de la Frontera Sur, San Cristóbal de las Casas 29290, Mexico; (P.E.N.-O.); (R.S.-H.); (C.M.-G.)
| | - Héctor Ochoa-Díaz-López
- Health Department, El Colegio de la Frontera Sur, San Cristóbal de las Casas 29290, Mexico; (P.E.N.-O.); (R.S.-H.); (C.M.-G.)
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Lazarova SV, Sutherland JM, Jessri M. Adherence to emerging plant-based dietary patterns and its association with cardiovascular disease risk in a nationally representative sample of Canadian adults. Am J Clin Nutr 2022; 116:57-73. [PMID: 35265975 PMCID: PMC9257478 DOI: 10.1093/ajcn/nqac062] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/07/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Little is known about the role of emerging plant-based dietary patterns in cardiovascular disease (CVD) risk at the national population level. OBJECTIVES The objectives of this research were to assess the validity and reliability of newly established plant-based dietary indices, and to evaluate their associations with CVD risk among Canadian adults. METHODS Data were obtained from repeated 24-h dietary recalls of adult participants in the cross-sectional, nationally representative Canadian Community Health Survey cycle 2004 linked to health administrative databases (n = 12,323) and cycle 2015 (n = 14,026). Plant-based diet quality was assessed with a revised Plant-based Dietary Index (PDI), EAT-Lancet Reference Diet (ERD) score, and the latest Dietary Guidelines for Americans Adherence Index (DGAI) 2020. Weighted multivariate analyses were used for testing associations between diet quality and lifestyle characteristics, and weighted multivariable-adjusted Cox proportional hazards models for associations with CVD risk. RESULTS Construct validity was confirmed for the revised PDI and DGAI 2020 (but not the ERD) because participants in the highest (healthiest) quartile, compared to those in the lowest (least healthy), were more likely to be female (mean ± SE: 52.63% ± 1.27% compared with 44.80% ± 1.65% for revised PDI; 59.37% ± 2.01% compared with 40.84% ± 1.71% for DGAI 2020), older (mean ± SE: 50.55 ± 0.39 y compared with 45.56 ± 0.43 y for revised PDI; 51.57 ± 0.39 y compared with 46.35 ± 0.54 y for DGAI 2020), to have postsecondary education (mean ± SE: 32.36% ± 1.55% compared with 21.12% ± 1.31% for revised PDI; 34.17% ± 2.69% compared with 17.87% ± 0.98% for DGAI 2020), and less likely to be daily smokers (mean ± SE: 8.21% ± 1.0% compared with 17.06% ± 1.45% for revised PDI; 7.36% ± 1.71% compared with 21.53% ± 1.58% for DGAI 2020) (P-trend < 0.0001). No significant associations were observed between dietary index scores and CVD risk. CONCLUSIONS The revised PDI and DGAI 2020 provided valid and meaningful measures of plant-based eating among Canadians, whereas the validity of the ERD was not directly confirmed. Adherence to the plant-based dietary patterns was not associated with CVD risk. Future large-scale studies are necessary to further evaluate the role of plant-based eating in CVD prevention.
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Affiliation(s)
- Svilena V Lazarova
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jason M Sutherland
- Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mahsa Jessri
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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Lazarova SV, Jessri M. Associations between dietary patterns and cardiovascular disease risk in Canadian adults: a comparison of partial least squares, reduced rank regression, and the simplified dietary pattern technique. Am J Clin Nutr 2022; 116:362-377. [PMID: 35511218 PMCID: PMC9348992 DOI: 10.1093/ajcn/nqac117] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/26/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Hybrid methodologies have gained continuing interest as unique data reduction techniques for establishing a direct link between dietary exposures and clinical outcomes. OBJECTIVES We aimed to compare partial least squares (PLS) and reduced rank regression (RRR) in identifying a dietary pattern associated with a high cardiovascular disease (CVD) risk in Canadian adults, construct PLS- and RRR-based simplified dietary patterns, and assess associations between the 4 dietary pattern scores and CVD risk. METHODS Data were collected from 24-h dietary recalls of adult respondents in the 2 cycles of the nationally representative Canadian Community Health Survey (CCHS)-Nutrition: CCHS 2004 linked to health administrative databases (n = 12,313) and CCHS 2015 (n = 14,020). Using 39 food groups, PLS and RRR were applied for identification of an energy-dense (ED), high-saturated-fat (HSF), and low-fiber-density (LFD) dietary pattern. Associations of the derived dietary pattern scores with lifestyle characteristics and CVD risk were examined using weighted multivariate regression and weighted multivariable-adjusted Cox proportional hazard models, respectively. RESULTS PLS and RRR identified highly similar ED, HSF, and LFD dietary patterns with common high positive loadings for fast food, carbonated drinks, salty snacks, and solid fats, and high negative loadings for fruit, dark green vegetables, red and orange vegetables, other vegetables, whole grains, and legumes and soy (≥|0.17|). Food groups with the highest loadings were summed to form simplified pattern scores. Although the dietary patterns were not significantly associated with CVD risk, they were positively associated with 402-kcal/d higher energy intake (P-trends < 0.05) and higher obesity risk (PLS: OR: 2.09; 95% CI: 1.62, 2.70; RRR: OR: 1.76; 95% CI: 1.44, 2.17) (P-trends < 0.0001) in the fourth quartiles. CONCLUSIONS PLS and RRR were shown to be equally effective for the derivation of a high-CVD-risk dietary pattern among Canadian adults. Further research is warranted on the role of major dietary components in cardiovascular health.
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Affiliation(s)
- Svilena V Lazarova
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia, Canada
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He F, Chen C, Li F, Qi Y, Lin X, Liang P, Ren M, Yan L. An optimal glycemic load range is better for reducing obesity and diabetes risk among middle-aged and elderly adults. Nutr Metab (Lond) 2021; 18:31. [PMID: 33752703 PMCID: PMC7983372 DOI: 10.1186/s12986-020-00504-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 09/16/2020] [Indexed: 01/19/2023] Open
Abstract
Background Due to the lack of evidence, advice pertaining to glycemic load (GL) can be misleading. Does the excessive restriction of GL, mostly through an extreme reduction in carbohydrate intake, result in a relatively high intake of fat and protein and result in overweight and obesity? This study was performed to initially explore the optimal GL range. Methods A cross-sectional study involving 2029 participants aged 40 years or older in Guangzhou, China was conducted. Participants were divided into four groups according to cluster analysis. Dietary data were assessed using a previously validated 3-day food record. Results Instead of participants with the highest [cluster 1, median (interquartile ranges) GL was 112(107–119)/1000 kcal] and the lowest GL intake [cluster 4, 90(82–96)/1000 kcal], those with moderate GL intakes [clusters 2 and 3, 93(85–102) and 93(85–99)/1000 kcal, respectively] had a lower prevalence of overweight, obesity and diabetes. In addition, clusters 2 and 3 were more consistent with the macronutrient intake reference with adequate micronutrient intake. Therefore, the optimal GL range was determined to be (85–100)/1000 kcal, rather than “lower is better”. Conclusions Reducing the GL intake to prevent diabetes deserves more attention in the context of a balanced diet. An appropriate GL may be better than excessive restriction.
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Affiliation(s)
- Fengyi He
- Department of Clinical Nutrition, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Chaogang Chen
- Department of Clinical Nutrition, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Feng Li
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Yiqin Qi
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Xiuhong Lin
- Department of Clinical Nutrition, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Ping Liang
- Department of Clinical Nutrition, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Meng Ren
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China
| | - Li Yan
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China.
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Dietary Glycemic Index and Glycemic Load Are Not Associated with the Metabolic Syndrome in Lebanese Healthy Adults: A Cross-Sectional Study. Nutrients 2020; 12:nu12051394. [PMID: 32414004 PMCID: PMC7284586 DOI: 10.3390/nu12051394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/23/2020] [Accepted: 04/26/2020] [Indexed: 11/26/2022] Open
Abstract
High dietary glycemic index (GI) and glycemic load (GL) were suggested to increase the risk of metabolic syndrome (MetS). This study aims to estimate dietary GI and GL in a sample of healthy Lebanese adults and examine their association with MetS and its individual abnormalities. The study uses data from a community-based survey of 501 Lebanese urban adults. Dietary intake was assessed using a food frequency questionnaire. Biochemical, anthropometric, and blood pressure measurements were obtained. Subjects with previous diagnosis of chronic disease, metabolic abnormalities, or with incomplete data or implausible energy intakes were excluded, yielding a sample of 283. Participants were grouped into quartiles of GI and GL. Multivariate logistic regression analyses were performed. Average dietary GI and GL were estimated at 59.9 ± 8 and 209.7 ± 100.3. Participants belonging to the highest GI quartile were at increased risk of having MetS (odds ratio (OR) = 2.251, 95% CI:1.120–4.525) but this association lost significance with further adjustments. Those belonging to the second quartile of GI had significantly lower odds of having hyperglycemia (OR: 0.380, 95% CI:0.174–0.833). No associations were detected between GL and MetS. The study contributes to the body of evidence discussing the relationship between GI, GL, and MetS, in a nutrition transition context.
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The Role of Glycemic Index and Glycemic Load in the Development of Real-Time Postprandial Glycemic Response Prediction Models for Patients With Gestational Diabetes. Nutrients 2020; 12:nu12020302. [PMID: 31979294 PMCID: PMC7071209 DOI: 10.3390/nu12020302] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/18/2020] [Accepted: 01/20/2020] [Indexed: 12/21/2022] Open
Abstract
The incorporation of glycemic index (GI) and glycemic load (GL) is a promising way to improve the accuracy of postprandial glycemic response (PPGR) prediction for personalized treatment of gestational diabetes (GDM). Our aim was to assess the prediction accuracy for PPGR prediction models with and without GI data in women with GDM and healthy pregnant women. The GI values were sourced from University of Sydney’s database and assigned to a food database used in the mobile app DiaCompanion. Weekly continuous glucose monitoring (CGM) data for 124 pregnant women (90 GDM and 34 control) were analyzed together with records of 1489 food intakes. Pearson correlation (R) was used to quantify the accuracy of predicted PPGRs from the model relative to those obtained from CGM. The final model for incremental area under glucose curve (iAUC120) prediction chosen by stepwise multiple linear regression had an R of 0.705 when GI/GL was included among input variables and an R of 0.700 when GI/GL was not included. In linear regression with coefficients acquired using regularization methods, which was tested on the data of new patients, R was 0.584 for both models (with and without inclusion of GI/GL). In conclusion, the incorporation of GI and GL only slightly improved the accuracy of PPGR prediction models when used in remote monitoring.
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Castro-Quezada I, Flores-Guillén E, Núñez-Ortega PE, Irecta-Nájera CA, Sánchez-Chino XM, Mendez-Flores OG, Olivo-Vidal ZE, García-Miranda R, Solís-Hernández R, Ochoa-Díaz-López H. Dietary Carbohydrates and Insulin Resistance in Adolescents from Marginalized Areas of Chiapas, México. Nutrients 2019; 11:E3066. [PMID: 31888175 PMCID: PMC6950049 DOI: 10.3390/nu11123066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/05/2019] [Accepted: 12/12/2019] [Indexed: 12/28/2022] Open
Abstract
Evidence of the role that dietary carbohydrates (total carbohydrates, dietary fiber, total sugars, dietary glycemic index (GI) and glycemic load (GL)) exerts on insulin levels in adolescents is controversial. Thus, the aim of this study was to assess the association between dietary carbohydrates and insulin resistance in adolescents from Chiapas, México. A cross-sectional study was conducted in 217 adolescents. Sociodemographic, anthropometric, dietary and biochemical data were obtained. Total carbohydrates, dietary fiber, total sugars, dietary GI and GL were calculated from 24 h recalls. Two validated cut-off points for the homeostasis model assessment of insulin resistance (HOMA-IR) were used as surrogates of insulin resistance. Fasting insulin levels ≥ 14.38 μU/mL were considered as abnormal. Multivariate logistic regression models were fitted to assess the association between tertiles of dietary carbohydrates and insulin resistance or hyperinsulinemia. In our study, adolescents with the highest dietary fiber intake had lower odds of HOMA-IR > 2.97 (OR = 0.34; 95% CI: 0.13-0.93) when adjusted for sex, age, body fat percentage and saturated fatty acids intake. No significant associations were found for the rest of the carbohydrate variables. In summary, high-fiber diets reduce the probability of insulin resistance in adolescents from marginalized areas of Chiapas, México.
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Affiliation(s)
- Itandehui Castro-Quezada
- Health Department, El Colegio de la Frontera Sur, Carr. Panamericana y Periférico Sur s/n, Barrio de María Auxiliadora, San Cristóbal de las Casas, Chiapas 29290, Mexico
| | - Elena Flores-Guillén
- Health Department, El Colegio de la Frontera Sur, Carr. Panamericana y Periférico Sur s/n, Barrio de María Auxiliadora, San Cristóbal de las Casas, Chiapas 29290, Mexico
- Faculty of Nutrition and Food Science, University of Science and Arts of Chiapas, Libramiento Norte-Poniente 1150, Col. Lajas Maciel, Tuxtla Gutiérrez, Chiapas 29039, Mexico
| | - Pilar E. Núñez-Ortega
- Health Department, El Colegio de la Frontera Sur, Carr. Panamericana y Periférico Sur s/n, Barrio de María Auxiliadora, San Cristóbal de las Casas, Chiapas 29290, Mexico
| | - César A. Irecta-Nájera
- Health Department, El Colegio de la Frontera Sur, Carr. A Reforma Km. 15.5 s/n, RA. Guineo 2da. Sección, Villahermosa, Tabasco 86280, Mexico
| | - Xariss M. Sánchez-Chino
- Cátedra-CONACyT, Health Department, El Colegio de la Frontera Sur, Unidad Villahermosa, Carretera a Reforma Km. 15.5 s/n, RA. Guineo 2da. Sección, Villahermosa, Tabasco 86280, Mexico
| | - Orquidia G. Mendez-Flores
- Cátedra-CONACyT, Health Department, El Colegio de la Frontera Sur, Carr. Panamericana y Periférico Sur s/n, Barrio de María Auxiliadora, San Cristóbal de las Casas, Chiapas 29290, Mexico
| | - Zendy E. Olivo-Vidal
- Health Department, El Colegio de la Frontera Sur, Carr. A Reforma Km. 15.5 s/n, RA. Guineo 2da. Sección, Villahermosa, Tabasco 86280, Mexico
| | - Rosario García-Miranda
- Health Department, El Colegio de la Frontera Sur, Carr. Panamericana y Periférico Sur s/n, Barrio de María Auxiliadora, San Cristóbal de las Casas, Chiapas 29290, Mexico
| | - Roberto Solís-Hernández
- Health Department, El Colegio de la Frontera Sur, Carr. Panamericana y Periférico Sur s/n, Barrio de María Auxiliadora, San Cristóbal de las Casas, Chiapas 29290, Mexico
| | - Héctor Ochoa-Díaz-López
- Health Department, El Colegio de la Frontera Sur, Carr. Panamericana y Periférico Sur s/n, Barrio de María Auxiliadora, San Cristóbal de las Casas, Chiapas 29290, Mexico
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Suissa K, Benedetti A, Henderson M, Gray-Donald K, Paradis G. Effects of dietary glycemic index and load on children's cardiovascular risk factors. Ann Epidemiol 2019; 40:1-7.e3. [PMID: 31780200 DOI: 10.1016/j.annepidem.2019.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 10/12/2019] [Accepted: 10/17/2019] [Indexed: 02/08/2023]
Abstract
PURPOSE Consumption of foods high in glycemic index (GI) and glycemic load (GL) is associated with cardiovascular (CV) diseases in adulthood. We examined whether GI and GL predict CV risk factors in children after 2 years of follow-up. METHODS Three 24-hour recalls were administered at baseline, and individual average daily GI and GL scores were calculated in a cohort of 8-10 year-old children. CV risk factors included body mass index z-score (BMIz), percent fat mass, triglycerides (TGs), low-density lipoprotein and high-density lipoprotein (HDL) cholesterol, and systolic and diastolic blood pressure. Main analyses consisted of multiple linear regression adjusted for anthropometric, socioeconomic, and dietary factors. RESULTS After 2 years, the highest dietary GL tertile compared with the lowest was associated with increased BMIz (mean difference [MD], 1.1; 95% CI, 0.88-1.31), fat mass (MD, 10.8%; 95% CI, 8.62-13.0), TGs (MD, 0.17 mmol/L; 95% CI, 0.07-0.28), and decreased HDL (MD, -0.13 mmol/L; 95% CI, -0.19 to -0.07). The GL-TG and the GL-HDL associations were mediated by BMIz. CONCLUSIONS GL predicts increased BMIz, percent fat mass, and TGs and decreased HDL in young children after 2 years. Recommendations to decrease CV risk in children should include lowering foods high in GL.
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Affiliation(s)
- Karine Suissa
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Mélanie Henderson
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada; Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Katherine Gray-Donald
- School of Human Nutrition, Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.
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Moran LJ, McNaughton SA, Sui Z, Cramp C, Deussen AR, Grivell RM, Dodd JM. The characterisation of overweight and obese women who are under reporting energy intake during pregnancy. BMC Pregnancy Childbirth 2018; 18:204. [PMID: 29859056 PMCID: PMC5984749 DOI: 10.1186/s12884-018-1826-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 05/15/2018] [Indexed: 11/16/2022] Open
Abstract
Background Misreporting of energy intake is common and can contribute to biased estimates of the relationship between diet and disease. Energy intake misreporting is poorly understood in pregnancy and there is limited research assessing characteristics of women who misreport energy intake or changes in misreporting of energy intake across pregnancy. Methods An observational study in n = 945 overweight or obese pregnant women receiving standard antenatal care who participated in the LIMIT randomised trial. Diet, physical activity, psychological factors, body image satisfaction and dieting behaviour were assessed at trial entry (10–20 weeks gestation) and 36 weeks gestation. Energy misreporting status was assessed through the ratio of daily energy intake over basal metabolic rate. Logistic regression analyses were conducted with the dependent variable of under reporting of energy intake at study entry or 36 weeks in separate analysis. Results At study entry and 36 weeks, women were classified as under reporters (38 vs 49.4%), adequate reporters (59.7 vs 49.8%) or over reporters of energy intake (2.3 vs 0.8%) respectively. The prevalence of under reporting energy intake at 36 weeks was higher than at study entry (early pregnancy). Body mass index (BMI) at study entry and 36 weeks and socioeconomic status, dieting behaviour and risk of depression at 36 weeks were independent predictors of under reporting of energy intake. Conclusions Under reporting of energy intake was present in over a third of overweight and obese pregnant women and was higher in late compared to early pregnancy. Characteristics such as BMI, socioeconomic status, past dieting behaviour and risk of depression may aid in identifying women who either require support in accurate recording of food intake or attention for improving diet quality. Results were unable to distinguish whether under reporting reflects misreporting or a true restriction of dietary intake. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12607000161426, registered 9/3/2007. Electronic supplementary material The online version of this article (10.1186/s12884-018-1826-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L J Moran
- The Robinson Research Institute, Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, VIC, 3168, Australia. .,Monash Centre for Health Research Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia.
| | - S A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
| | - Z Sui
- The Robinson Research Institute, Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, VIC, 3168, Australia
| | - C Cramp
- The Robinson Research Institute, Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, VIC, 3168, Australia
| | - A R Deussen
- The Robinson Research Institute, Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, VIC, 3168, Australia
| | - R M Grivell
- The Robinson Research Institute, Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, VIC, 3168, Australia.,Department of Perinatal Medicine, Women's & Babies Division, Women's and Children's Hospital, North Adelaide, Adelaide, Australia
| | - J M Dodd
- The Robinson Research Institute, Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, VIC, 3168, Australia.,Department of Perinatal Medicine, Women's & Babies Division, Women's and Children's Hospital, North Adelaide, Adelaide, Australia
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Nishi SK, Jessri M, L'Abbé M. Assessing the Dietary Habits of Canadians by Eating Location and Occasion: Findings from the Canadian Community Health Survey, Cycle 2.2. Nutrients 2018; 10:nu10060682. [PMID: 29861491 PMCID: PMC6024605 DOI: 10.3390/nu10060682] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 12/04/2022] Open
Abstract
Occasion and location of food environment has an influence on dietary habits, nutritional quality and overall health and nutrition-related chronic disease risk. Eating occasion and location was assessed in 20,402 Canadians aged ≥ 2 years, with a focus on energy, saturated fat, added sugars, and sodium intake by age group. Data showed >80% of children, compared to ~60% of adolescents and adults, consumed three meals (breakfast, lunch, dinner) plus snacks in a day. Dinner contributed the most calories [ranging from 395 ± 11 kcal (2–3 year olds) to 952 ± 27 kcal (men 19–30 years)], saturated fat [7.4 ± 0.2% energy (2–3 year olds) to 9.1 ± 0.3% energy (women 31–50 years)], and sodium [851 ± 24 mg (2–3 year olds) to 1299 ± 69 mg (men 19–30 years)], while snacks contributed the most added sugars [22 ± 1 kcal (men >70 years) to 45 ± 1 kcal (2–3 year olds)]. By eating location, most Canadians (>90%) reported consuming food from home. Subsequently, home was associated with the majority of energy [1383 ± 23 kcal (women >70 years) to 2090 ± 35 kcal (boys 9–13 years)], saturated fat [20.4 ± 0.4%E (men 51–70 years) to 24.2 ± 0.4%E (2–3 year olds)], added sugars [77 ± 3 kcal (men 19–30 years) to 117 ± 2 kcal (2–3 year olds)], and sodium [2137 ± 59 mg (women 19–30 years) to 2638 ± 45 mg (men 51–70 years)] intakes. Reported eating behaviours suggest action is needed at individual and population levels to alter food purchasing and consumption habits, specifically with regards to snacking habits and foods prepared at home.
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Affiliation(s)
- Stephanie K Nishi
- Clinical Nutrition & Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5S 3E2, Canada.
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College Street., Toronto, ON M5S 3E2, Canada.
| | - Mahsa Jessri
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College Street., Toronto, ON M5S 3E2, Canada.
| | - Mary L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College Street., Toronto, ON M5S 3E2, Canada.
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He FY, Chen CG, Lin DZ, Lin XH, Qi YQ, Yan L. A greater glycemic load reduction was associated with a lower diabetes risk in pre-diabetic patients who consume a high glycemic load diet. Nutr Res 2018; 53:77-84. [PMID: 29685626 DOI: 10.1016/j.nutres.2018.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 01/17/2018] [Accepted: 03/19/2018] [Indexed: 12/14/2022]
Abstract
Few prospective studies evaluating the association between dietary glycemic load (GL) and diabetes have accounted for changes in GL. However, the diet of patients could be modified in response to an awareness of pre-diabetes. The aim of this study was to examine the longitudinal associations between changes in GL and the incidence of diabetes among pre-diabetic patients. We hypothesized that subjects with low and high baseline GL would show different correlations with diabetes. A total of 493 pre-diabetic patients (142 men and 351 women) between 40 and 79 years of age were included in this study. Dietary records and oral glucose tolerance tests were conducted every year. The participants were divided into low- and high-GL groups based on baseline GL. During a median 4 years of follow-up, 108 incident cases of diabetes were identified. Among participants with a high baseline GL, the incidence of diabetes increased with decreasing GL reduction, and the multivariate-adjusted HR (95% CI) was 2.34 (1.27-4.29) when comparing the lowest to the highest tertiles; however, among those with a low baseline GL, no significant association was observed. Regardless of baseline GL status, the incidence of diabetes was higher in individuals with a high follow-up GL than in those with a low follow-up GL, and the multivariate-adjusted HR (95% CI) was 1.64 (1.09-2.45). In conclusion, a greater GL reduction was associated with a lower diabetes risk in pre-diabetic patients with a high dietary GL. In patients with pre-diabetes and a low dietary GL, further reductions in GL did not show any additional effects.
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Affiliation(s)
- Feng-Yi He
- Department of Clinical Nutrition, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
| | - Chao-Gang Chen
- Department of Clinical Nutrition, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
| | - Diao-Zhu Lin
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
| | - Xiu-Hong Lin
- Department of Clinical Nutrition, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
| | - Yi-Qin Qi
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
| | - Li Yan
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
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12
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He F. Diets with a low glycaemic load have favourable effects on prediabetes progression and regression: a prospective cohort study. J Hum Nutr Diet 2018; 31:292-300. [DOI: 10.1111/jhn.12539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- F. He
- Department of Clinical Nutrition; Sun Yat-Sen Memorial Hospital; Sun Yat-Sen University; Guangzhou Guangdong China
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13
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Castro-Quezada I, Angulo-Estrada S, Sánchez-Villegas A, Ruiz-López MD, Artacho R, Serra-Majem L, Shamah-Levy T. Glycemic index, glycemic load, and metabolic syndrome in Mexican adolescents: a cross-sectional study from the NHNS-2012. BMC Nutr 2017; 3:44. [PMID: 32153824 PMCID: PMC7050917 DOI: 10.1186/s40795-017-0162-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 05/12/2017] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The role of dietary glycemic index (GI) and dietary glycemic load (GL) on metabolic syndrome (MetS) in youth populations remains unclear. The aim of the present study was to evaluate the association among dietary GI, dietary GL, and MetS and its components in Mexican adolescents. METHODS This study was conducted within the framework of the National Health and Nutrition Survey 2012, a cross-sectional, probabilistic, population-based survey with a multistage stratified cluster sampling design. We analyzed a sample of 1346 subjects aged 12-19 years, representing 13,164,077 adolescents. Dietary habits were assessed through a validated semiquantitative food-frequency questionnaire. We assigned GI values using the International Tables of GI values. We defined MetS according to the International Diabetes Federation criteria developed for adolescents. Multiple logistic regression models were used to estimate odds ratios (ORs) and their 95% confidence intervals (CIs) to evaluate the association between categories of dietary GI and GL and the prevalence of MetS and its components. RESULTS We observed no associations between dietary GI or GL and MetS prevalence. Female adolescents in the highest category of dietary GI had higher odds of abnormal blood pressure (OR = 3.66; 95% CI, 1.46-9.22; P for trend = 0.012). A high dietary GL was also associated with higher odds of abnormal blood pressure in female adolescents (OR = 5.67; 95% CI, 1.84-17.46; P for trend = 0.003). CONCLUSIONS We found higher odds of abnormal blood pressure for female adolescents with a high dietary GI and dietary GL.
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Affiliation(s)
- Itandehui Castro-Quezada
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Luis Pasteur s/n, 35016 Las Palmas de Gran Canaria, Spain
- Department of Nutrition and Food Science, School of Pharmacy, University of Granada, Campus Universitario de la Cartuja, 18071 Granada, Spain
| | - Salomón Angulo-Estrada
- Center for Nutrition and Health Research, National Institute of Public Health of Mexico, Universidad No. 655, Colonia Santa María Ahuacatitlán, 62100 Cuernavaca, Morelos Mexico
| | - Almudena Sánchez-Villegas
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Luis Pasteur s/n, 35016 Las Palmas de Gran Canaria, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
| | - María Dolores Ruiz-López
- Department of Nutrition and Food Science, School of Pharmacy, University of Granada, Campus Universitario de la Cartuja, 18071 Granada, Spain
- Institute of Nutrition and Food Technologies, University of Granada, Avda. del Conocimiento, Armilla, 18100 Granada, Spain
| | - Reyes Artacho
- Department of Nutrition and Food Science, School of Pharmacy, University of Granada, Campus Universitario de la Cartuja, 18071 Granada, Spain
| | - Lluís Serra-Majem
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Luis Pasteur s/n, 35016 Las Palmas de Gran Canaria, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
| | - Teresa Shamah-Levy
- Center for Nutrition and Health Research, National Institute of Public Health of Mexico, Universidad No. 655, Colonia Santa María Ahuacatitlán, 62100 Cuernavaca, Morelos Mexico
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Jessri M, Wolfinger RD, Lou WY, L'Abbé MR. Identification of dietary patterns associated with obesity in a nationally representative survey of Canadian adults: application of a priori, hybrid, and simplified dietary pattern techniques. Am J Clin Nutr 2017; 105:669-684. [PMID: 28148504 DOI: 10.3945/ajcn.116.134684] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 12/21/2016] [Indexed: 11/14/2022] Open
Abstract
Background: Analyzing the effects of dietary patterns is an important approach for examining the complex role of nutrition in the etiology of obesity and chronic diseases.Objectives: The objectives of this study were to characterize the dietary patterns of Canadians with the use of a priori, hybrid, and simplified dietary pattern techniques, and to compare the associations of these patterns with obesity risk in individuals with and without chronic diseases (unhealthy and healthy obesity).Design: Dietary recalls from 11,748 participants (≥18 y of age) in the cross-sectional, nationally representative Canadian Community Health Survey 2.2 were used. A priori dietary pattern was characterized with the use of the previously validated 2015 Dietary Guidelines for Americans Adherence Index (DGAI). Weighted partial least squares (hybrid method) was used to derive an energy-dense (ED), high-fat (HF), low-fiber density (LFD) dietary pattern with the use of 38 food groups. The associations of derived dietary patterns with disease outcomes were then tested with the use of multinomial logistic regression.Results: An ED, HF, and LFD dietary pattern had high positive loadings for fast foods, carbonated drinks, and refined grains, and high negative loadings for whole fruits and vegetables (≥|0.17|). Food groups with a high loading were summed to form a simplified dietary pattern score. Moving from the first (healthiest) to the fourth (least healthy) quartiles of the ED, HF, and LFD pattern and the simplified dietary pattern scores was associated with increasingly elevated ORs for unhealthy obesity, with individuals in quartile 4 having an OR of 2.57 (95% CI: 1.75, 3.76) and 2.73 (95% CI: 1.88, 3.98), respectively (P-trend < 0.0001). Individuals who adhered the most to the 2015 DGAI recommendations (quartile 4) had a 53% lower OR of unhealthy obesity (P-trend < 0.0001). The associations of dietary patterns with healthy obesity and unhealthy nonobesity were weaker, albeit significant.Conclusions: Consuming an ED, HF, and LFD dietary pattern and lack of adherence to the recommendations of the 2015 DGAI were associated with a significantly higher risk of obesity with and without accompanying chronic diseases.
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Affiliation(s)
- Mahsa Jessri
- Department of Nutritional Sciences, Faculty of Medicine, and
| | - Russell D Wolfinger
- Department of Statistics, North Carolina State University, Raleigh, NC; and.,Scientific Discovery and Genomics, SAS Institute, Cary, NC
| | - Wendy Y Lou
- Biostatistics Division, Canada Research Chair in Statistical Methods for Health Care, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, and
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15
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Glycemic index, glycemic load and invasive breast cancer incidence in postmenopausal women: The PREDIMED study. Eur J Cancer Prev 2016; 25:524-32. [PMID: 26633163 DOI: 10.1097/cej.0000000000000209] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Jessri M, Nishi SK, L'Abbe MR. Assessing the nutritional quality of diets of Canadian children and adolescents using the 2014 Health Canada Surveillance Tool Tier System. BMC Public Health 2016; 16:381. [PMID: 27165415 PMCID: PMC4862040 DOI: 10.1186/s12889-016-3038-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 02/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health Canada's Surveillance Tool (HCST) Tier System was developed in 2014 with the aim of assessing the adherence of dietary intakes with Eating Well with Canada's Food Guide (EWCFG). HCST uses a Tier system to categorize all foods into one of four Tiers based on thresholds for total fat, saturated fat, sodium, and sugar, with Tier 4 reflecting the unhealthiest and Tier 1 the healthiest foods. This study presents the first application of the HCST to examine (i) the dietary patterns of Canadian children, and (ii) the applicability and relevance of HCST as a measure of diet quality. METHODS Data were from the nationally-representative, cross-sectional Canadian Community Health Survey 2.2. A total of 13,749 participants aged 2-18 years who had complete lifestyle and 24-hour dietary recall data were examined. RESULTS Dietary patterns of Canadian children and adolescents demonstrated a high prevalence of Tier 4 foods within the sub-groups of processed meats and potatoes. On average, 23-31 % of daily calories were derived from "other" foods and beverages not recommended in EWCFG. However, the majority of food choices fell within the Tier 2 and 3 classifications due to lenient criteria used by the HCST for classifying foods. Adherence to the recommendations presented in the HCST was associated with closer compliance to meeting nutrient Dietary Reference Intake recommendations, however it did not relate to reduced obesity as assessed by body mass index (p > 0.05). CONCLUSIONS EWCFG recommendations are currently not being met by most children and adolescents. Future nutrient profiling systems need to incorporate both positive and negative nutrients and an overall score. In addition, a wider range of nutrient thresholds should be considered for HCST to better capture product differences, prevent categorization of most foods as Tiers 2-3 and provide incentives for product reformulation.
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Affiliation(s)
- Mahsa Jessri
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Toronto, ON, M5S 3E2, Canada
| | - Stephanie K Nishi
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Toronto, ON, M5S 3E2, Canada.,Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital Toronto, Toronto, Canada
| | - Mary R L'Abbe
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Toronto, ON, M5S 3E2, Canada.
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Assessing the Nutritional Quality of Diets of Canadian Adults Using the 2014 Health Canada Surveillance Tool Tier System. Nutrients 2015; 7:10447-68. [PMID: 26703721 PMCID: PMC4690095 DOI: 10.3390/nu7125543] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 11/10/2015] [Accepted: 11/27/2015] [Indexed: 12/03/2022] Open
Abstract
The 2014 Health Canada Surveillance Tool (HCST) was developed to assess adherence of dietary intakes with Canada’s Food Guide. HCST classifies foods into one of four Tiers based on thresholds for sodium, total fat, saturated fat and sugar, with Tier 1 representing the healthiest and Tier 4 foods being the unhealthiest. This study presents the first application of HCST to assess (a) dietary patterns of Canadians; and (b) applicability of this tool as a measure of diet quality among 19,912 adult participants of Canadian Community Health Survey 2.2. Findings indicated that even though most of processed meats and potatoes were Tier 4, the majority of reported foods in general were categorized as Tiers 2 and 3 due to the adjustable lenient criteria used in HCST. Moving from the 1st to the 4th quartile of Tier 4 and “other” foods/beverages, there was a significant trend towards increased calories (1876 kcal vs. 2290 kcal) and “harmful” nutrients (e.g., sodium) as well as decreased “beneficial” nutrients. Compliance with the HCST was not associated with lower body mass index. Future nutrient profiling systems need to incorporate both “positive” and “negative” nutrients, an overall score and a wider range of nutrient thresholds to better capture food product differences.
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Louie JCY, Flood VM, Atkinson FS, Barclay AW, Brand-Miller JC. Methodology for assigning appropriate glycaemic index values to an Australian food composition database. J Food Compost Anal 2015. [DOI: 10.1016/j.jfca.2014.06.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Castro-Quezada I, Sánchez-Villegas A, Estruch R, Salas-Salvadó J, Corella D, Schröder H, Álvarez-Pérez J, Ruiz-López MD, Artacho R, Ros E, Bulló M, Covas MI, Ruiz-Gutiérrez V, Ruiz-Canela M, Buil-Cosiales P, Gómez-Gracia E, Lapetra J, Pintó X, Arós F, Fiol M, Lamuela-Raventós RM, Martínez-González MÁ, Serra-Majem L. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk. PLoS One 2014; 9:e107968. [PMID: 25250626 PMCID: PMC4176720 DOI: 10.1371/journal.pone.0107968] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 08/21/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04); P for trend = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.
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Affiliation(s)
- Itandehui Castro-Quezada
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Almudena Sánchez-Villegas
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
| | - Ramón Estruch
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Internal Medicine, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Jordi Salas-Salvadó
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Human Nutrition Department, School of Medicine, University Rovira i Virgili, Reus, Tarragona, Spain
| | - Dolores Corella
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group, Institut Municipal d'Investigació Medica (IMIM)-Institut de Recerca del Hospital del Mar, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
| | - Jacqueline Álvarez-Pérez
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
| | - María Dolores Ruiz-López
- Department of Nutrition and Food Science, School of Pharmacy, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technologies, University of Granada. Armilla, Granada, Spain
| | - Reyes Artacho
- Department of Nutrition and Food Science, School of Pharmacy, University of Granada, Granada, Spain
| | - Emilio Ros
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clinic, l'Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Mónica Bulló
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Human Nutrition Department, School of Medicine, University Rovira i Virgili, Reus, Tarragona, Spain
| | - María-Isabel Covas
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group, Institut Municipal d'Investigació Medica (IMIM)-Institut de Recerca del Hospital del Mar, Barcelona, Spain
| | - Valentina Ruiz-Gutiérrez
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Group of Nutrition and Lipid Metabolism, Instituto de la Grasa (CSIC), Seville, Spain
| | - Miguel Ruiz-Canela
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine – Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarra, Spain
| | - Pilar Buil-Cosiales
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine – Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarra, Spain
| | - Enrique Gómez-Gracia
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine, School of Medicine, University of Malaga, Malaga, Spain
| | - José Lapetra
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain
| | - Xavier Pintó
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Internal Medicine Service, Hospital of Bellvitge, Barcelona, Spain
| | - Fernando Arós
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Cardiology, Hospital Txagorritxu, Vitoria, Alava, Spain
| | - Miquel Fiol
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- University Institute for Health Sciences Investigation, University of Balearic Islands, Palma de Mallorca, Spain
- Department of Cardiology, Hospital Son Espases, Palma de Mallorca, Spain
| | - Rosa María Lamuela-Raventós
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Nutrition and Bromatology, School of Pharmacy, University of Barcelona, Barcelona, Spain
| | - Miguel Ángel Martínez-González
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine – Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarra, Spain
| | - Lluís Serra-Majem
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
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Effect of a Mediterranean Diet Intervention on Dietary Glycemic Load and Dietary Glycemic Index: The PREDIMED Study. J Nutr Metab 2014; 2014:985373. [PMID: 25295183 PMCID: PMC4180650 DOI: 10.1155/2014/985373] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 08/04/2014] [Indexed: 11/18/2022] Open
Abstract
Objective. To compare the one year effect of two dietary interventions with MeDiet on GL and GI in the PREDIMED trial. Methods. Participants were older subjects at high risk for cardiovascular disease. This analysis included 2866 nondiabetic subjects. Diet was assessed with a validated 137-item food frequency questionnaire (FFQ). The GI of each FFQ item was assigned by a 5-step methodology using the International Tables of GI and GL Values. Generalized linear models were fitted to assess the relationship between the intervention group and dietary GL and GI at one year of follow-up, using control group as reference. Results. Multivariate-adjusted models showed an inverse association between GL and MeDiet + extra virgin olive oil (EVOO) group: β = −8.52 (95% CI: −10.83 to −6.20) and MeDiet + Nuts group: β = −10.34 (95% CI: −12.69 to −8.00), when comparing with control group. Regarding GI, β = −0.93 (95% CI: −1.38 to −0.49) for MeDiet + EVOO, β = −1.06 (95% CI: −1.51 to −0.62) for MeDiet + Nuts when comparing with control group. Conclusion. Dietary intervention with MeDiet supplemented with EVOO or nuts lowers dietary GL and GI.
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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 2014; 54:523-34. [DOI: 10.1007/s00394-014-0733-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 06/30/2014] [Indexed: 10/25/2022]
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Hao L, Chen Q, Lu J, Li Z, Guo C, Qian P, Yu J, Xing X. A novel hypotonic sports drink containing a high molecular weight polysaccharide. Food Funct 2014; 5:961-5. [PMID: 24599404 DOI: 10.1039/c3fo60692a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Carbohydrate consumption during exercise can improve performance and delay the onset of fatigue. The purpose of this study was to develop a novel sports drink powder, Jxdrink, containing the high molecular weight polysaccharide Jxsac. Animal experiments including digestion and exhaustive swimming experiments were conducted to observe the physiological effects of this beverage. Human experiments involved the participation of 10 healthy male athletes completing a 180 km road cycling test. The osmolality of Jxdrink was 170-175 mosmol kg(-1), lower than that of human blood. Jxdrink was found to prolong the exhaustive swimming time in test animals. Moreover, Jxdrink had a relatively high glycemic index that maintained blood glucose levels during human cycling experiments. Thus, Jxdrink was found to effectively delay the onset of fatigue in both human and animal experiments.
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Affiliation(s)
- Limin Hao
- The Quartermaster Equipment Institute of General Logistics Department of People's Liberation Army, Beijing 100010, China.
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Kien CL, Bunn JY, Stevens R, Bain J, Ikayeva O, Crain K, Koves TR, Muoio DM. Dietary intake of palmitate and oleate has broad impact on systemic and tissue lipid profiles in humans. Am J Clin Nutr 2014; 99:436-45. [PMID: 24429541 PMCID: PMC3927687 DOI: 10.3945/ajcn.113.070557] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Epidemiologic evidence has suggested that diets with a high ratio of palmitic acid (PA) to oleic acid (OA) increase risk of cardiovascular disease (CVD). OBJECTIVE To gain additional insights into the relative effect of dietary fatty acids and their metabolism on CVD risk, we sought to identify a metabolomic signature that tracks with diet-induced changes in blood lipid concentrations and whole-body fat oxidation. DESIGN We applied comprehensive metabolomic profiling tools to biological specimens collected from 18 healthy adults enrolled in a crossover trial that compared a 3-wk high-palmitic acid (HPA) with a low-palmitic acid and high-oleic acid (HOA) diet. RESULTS A principal components analysis of the data set including 329 variables measured in 15 subjects in the fasted state identified one factor, the principal components analysis factor in the fasted state (PCF1-Fasted), which was heavily weighted by the PA:OA ratio of serum and muscle lipids, that was affected by diet (P < 0.0001; HPA greater than HOA). One other factor, the additional principal components analysis factor in the fasted state (PCF2-Fasted), reflected a wide range of acylcarnitines and was affected by diet in women only (P = 0.0198; HPA greater than HOA). HOA lowered the ratio of serum low-density lipoprotein to high-density lipoprotein (LDL:HDL) in men and women, and adjustment for the PCF1-Fasted abolished the effect. In women only, adjustment for the PCF2-Fasted eliminated the HOA-diet effect on serum total- and LDL-cholesterol concentrations. The respiratory exchange ratio in the fasted state was lower with the HPA diet (P = 0.04), and the diet effect was eliminated after adjustment for the PCF1-Fasted. The messenger RNA expression of the cholesterol regulatory gene insulin-induced gene-1 was higher with the HOA diet (P = 0.008). CONCLUSIONS These results suggest that replacing dietary PA with OA reduces the blood LDL concentration and whole-body fat oxidation by modifying the saturation index of circulating and tissue lipids. In women, these effects are also associated with a higher production and accumulation of acylcarnitines, possibly reflecting a shift in fat catabolism.
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Affiliation(s)
- C Lawrence Kien
- Departments of Pediatrics (CLK), Medicine (CLK and KC), and Medical Biostatistics (JYB), University of Vermont, Burlington, VT, and the Stedman Nutrition and Metabolism Center (RS, JB, OI, TRK, and DMM) and Departments of Medicine (TRK and DMM) and Pharmacology and Cancer Biology (DMM), Duke University, Durham, NC
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Gopinath B, Louie JCY, Flood VM, Rochtchina E, Baur LA, Mitchell P. Parental history of hypertension and dietary intakes in early adolescent offspring: a population-based study. J Hum Hypertens 2014; 28:721-5. [PMID: 24573132 DOI: 10.1038/jhh.2014.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/16/2013] [Accepted: 01/13/2014] [Indexed: 11/09/2022]
Abstract
We investigated the cross-sectional association between parental history of hypertension and dietary intakes among early adolescent schoolchildren. A total of 1845 participants aged 12 years had complete data on diet and parental medical history, and thus they were included in the final analyses. Dietary data were assessed from validated semi-quantitative food-frequency questionnaires. Parents completed questionnaires about their medical conditions. Cases where the biological mother and/or father had hypertension were classified as positive parental history of hypertension. After multivariable adjustment, participants with positive versus negative parental history of hypertension had 33% greater likelihood of consuming soft drinks ⩾1 per week. Boys with a parental history versus boys without a parental history of hypertension consumed more energy-dense, nutrient-poor foods: 379.4 g per day and 318.0 g per day, respectively, P=0.02. Girls with a positive versus a negative parental history consumed more vegetables: 164.1 versus 142.6 g per day, P=0.01. Significant associations were not observed between those with and those without a positive parental history in mean dietary intakes of carbohydrates, fats, sugars and sodium. Children with a positive parental history of hypertension were 67% more likely to simultaneously engage in three unhealthy lifestyle behaviors (excessive recreational screen viewing, high consumption of snacks and and high consumption of soft drinks). Parental hypertension was associated with unhealthy dietary behaviors among offspring, including higher consumption of soft drinks and energy-dense, nutrient-poor foods.
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Affiliation(s)
- B Gopinath
- Centre for Vision Research, Westmead Millennium Institute, Department of Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
| | - J C Y Louie
- Faculty of Health and Behavioural Sciences, University of Wollongong, Sydney, New South Wales, Australia
| | - V M Flood
- Faculty of Health and Behavioural Sciences, University of Wollongong, Sydney, New South Wales, Australia
| | - E Rochtchina
- Centre for Vision Research, Westmead Millennium Institute, Department of Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
| | - L A Baur
- 1] University of Sydney Clinical School, The Children's Hospital at Westmead, Sydney, New South Wales, Australia [2] School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - P Mitchell
- Centre for Vision Research, Westmead Millennium Institute, Department of Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
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Joslowski G, Halim J, Goletzke J, Gow M, Ho M, Louie JCY, Buyken AE, Cowell CT, Garnett SP. Dietary glycemic load, insulin load, and weight loss in obese, insulin resistant adolescents: RESIST study. Clin Nutr 2014; 34:89-94. [PMID: 24534012 DOI: 10.1016/j.clnu.2014.01.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 01/10/2014] [Accepted: 01/20/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS The optimal dietary approach for weight loss and improving insulin sensitivity in adolescents is unknown. This study aimed to explore the association between the estimated insulin demand of the diet, as measured by glycemic and insulin load, weight loss, percentage body fat and insulin sensitivity index (ISI) in obese adolescents with clinical features of insulin resistance and/or prediabetes after a 3 month lifestyle and metformin intervention. METHODS Secondary data analysis of 91 adolescents (median age 12.7 years (range 10.1-17.4) participating in a randomized controlled trial, known as RESIST; ACTRN12608000416392. Weight change between baseline and 3 months was measured by BMI expressed as percentage of the 95th centile (BMI %95). Body composition was measured by dual energy X-ray absorptiometry and ISI was determined by an oral glucose tolerance test. RESULTS Higher dietary glycemic load and insulin load were associated with less weight loss (BMI %95), adjusted for sex and pubertal stage, β = 0.0466, P = 0.007 and β = 0.0124, P = 0.040, respectively. Inclusion of total energy intake in the model explained observed associations between dietary glycemic load and insulin load and change in BMI %95. Neither dietary glycemic load nor insulin load were associated with changes in percentage body fat or ISI. Dietary glycemic index and macronutrient content (% of total energy) were not associated to changes in BMI %95, percentage body fat or ISI. CONCLUSION Reduced energy diet contributes to weight loss in obese, insulin resistant adolescents. Diets with a lower insulin demand were associated with a lower energy intake and may hence assist with weight loss.
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Affiliation(s)
- Gesa Joslowski
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Germany.
| | - Jocelyn Halim
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Janina Goletzke
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Germany
| | - Megan Gow
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia
| | - Mandy Ho
- The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia
| | - Jimmy C-Y Louie
- Faculty of Science, Medicine and Health, The University of Wollongong, Australia
| | - Anette E Buyken
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Germany
| | - Chris T Cowell
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia; Kids Research Institute at the Children's Hospital at Westmead, Sydney, Australia
| | - Sarah P Garnett
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia; Kids Research Institute at the Children's Hospital at Westmead, Sydney, Australia
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Associations of dietary glycaemic index and glycaemic load with food and nutrient intake and general and central obesity in British adults. Br J Nutr 2013; 110:2047-57. [PMID: 23656860 DOI: 10.1017/s0007114513001414] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Inconsistent associations between dietary glycaemic index (GI) and glycaemic load (GL) and body fatness may be partly due to differences in the underlying dietary patterns or energy under-reporting. In the present study, we examined the cross-sectional associations of dietary GI and GL with food and nutrient intake and general and central obesity, accounting for energy under-reporting. The subjects were 1487 British adults aged 19-64 years. Dietary intake was assessed using a 7 d weighed dietary record. Breads and potatoes were the positive predictive foods for dietary GI, while fruit, other cereals and dairy products were the negative predictors. These foods were similarly identified in the analysis of only acceptable reporters (AR; ratio of reported energy intake:estimated energy requirement within 0·665-1·335) and under-reporters (UR; ratio < 0·665). Dietary GL was closely correlated with carbohydrate intake. Multiple linear regression analyses showed that dietary GI was independently associated with a higher risk of general obesity (BMI ≥ 30 kg/m²) and central obesity (waist circumference ≥ 102 cm in men and ≥ 88 cm in women). Dietary GL was also associated with general (only women) and central obesity. Similarly, in the analysis of AR, the GI showed positive associations with general and central obesity, and, only in women, the GL showed positive associations with general and central obesity. Conversely, in the analysis of UR, the associations were generally weaker and many of them failed to reach statistical significance. In conclusion, we found independent positive associations of dietary GI and GL with general and central obesity in British adults.
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Murakami K, McCaffrey TA, Gallagher AM, Neville CE, Boreham CA, Livingstone MBE. Dietary glycemic index and glycemic load in relation to changes in body composition measures during adolescence: Northern Ireland Young Hearts Study. Int J Obes (Lond) 2013; 38:252-8. [PMID: 23732655 DOI: 10.1038/ijo.2013.63] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/11/2013] [Accepted: 04/25/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Epidemiologic evidence on the influence of dietary glycemic index (GI) and glycemic load (GL) on the development of obesity is limited. OBJECTIVE This prospective study examined the associations between dietary GI and GL and changes in body composition measures during adolescence. DESIGN In a representative sample of Northern Irish adolescents aged 12 years at baseline and 15 years at follow-up (n=426), dietary intake was assessed by a diet history interview. Body composition measures included body mass index (BMI; kg m(-2)), BMI z-score, sum of four skinfold thicknesses, percentage body fat, fat mass index (FMI; kg m(-2)) and fat-free mass index (kg m(-2)). RESULTS After adjustment for potential confounding factors, baseline GI was associated with increased change in FMI. Mean (95% confidence interval) values of changes in FMI according to tertiles of baseline GI were 0.41 (0.25, 0.57), 0.42 (0.26, 0.58) and 0.67 (0.51, 0.83) kg m(-2), respectively (P for trend=0.03). There was no significant association of baseline GI with changes in other body composition measures (P for trend≥0.054). Conversely, baseline GL showed no association with changes in any of the measures (P for trend≥0.41). Furthermore, changes in GI or GL were not associated with changes in any of the measures (P for trend≥0.16). CONCLUSION Dietary GI at age 12 years was independently associated with increased change in FMI between ages 12 and 15 years in a representative sample from Northern Ireland, whereas dietary GL showed no association with changes in any of the body composition measures examined.
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Affiliation(s)
- K Murakami
- 1] Northern Ireland Centre for Food and Health (NICHE), University of Ulster, Coleraine, UK [2] Japan Society for the Promotion of Science, Tokyo, Japan
| | - T A McCaffrey
- Northern Ireland Centre for Food and Health (NICHE), University of Ulster, Coleraine, UK
| | - A M Gallagher
- Northern Ireland Centre for Food and Health (NICHE), University of Ulster, Coleraine, UK
| | - C E Neville
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - C A Boreham
- Institute for Sport and Health, University College Dublin, Dublin, Ireland
| | - M B E Livingstone
- Northern Ireland Centre for Food and Health (NICHE), University of Ulster, Coleraine, UK
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Louie JCY, Markovic TP, Ross GP, Foote D, Brand-Miller JC. Higher glycemic load diet is associated with poorer nutrient intake in women with gestational diabetes mellitus. Nutr Res 2013; 33:259-65. [DOI: 10.1016/j.nutres.2013.02.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 02/11/2013] [Accepted: 02/19/2013] [Indexed: 01/17/2023]
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Kien CL, Bunn JY, Tompkins CL, Dumas JA, Crain KI, Ebenstein DB, Koves TR, Muoio DM. Substituting dietary monounsaturated fat for saturated fat is associated with increased daily physical activity and resting energy expenditure and with changes in mood. Am J Clin Nutr 2013; 97:689-97. [PMID: 23446891 PMCID: PMC3607650 DOI: 10.3945/ajcn.112.051730] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The Western diet increases risk of metabolic disease. OBJECTIVE We determined whether lowering the ratio of saturated fatty acids to monounsaturated fatty acids in the Western diet would affect physical activity and energy expenditure. DESIGN With the use of a balanced design, 2 cohorts of 18 and 14 young adults were enrolled in separate randomized, double-masked, crossover trials that compared a 3-wk high-palmitic acid diet (HPA; similar to the Western diet fat composition) to a low-palmitic acid and high-oleic acid diet (HOA; similar to the Mediterranean diet fat composition). All foods were provided by the investigators, and the palmitic acid (PA):oleic acid (OA) ratio was manipulated by adding different oil blends to the same foods. In both cohorts, we assessed physical activity (monitored continuously by using accelerometry) and resting energy expenditure (REE). To gain insight into a possible mood disturbance that might explain changes in physical activity, the Profile of Mood States (POMS) was administered in cohort 2. RESULTS Physical activity was higher during the HOA than during the HPA in 15 of 17 subjects in cohort 1 (P = 0.008) (mean: 12% higher; P = 0.003) and in 12 of 12 subjects in the second, confirmatory cohort (P = 0.005) (mean: 15% higher; P = 0.003). When the HOA was compared with the HPA, REE measured during the fed state was 3% higher for cohort 1 (P < 0.01), and REE was 4.5% higher in the fasted state for cohort 2 (P = 0.04). POMS testing showed that the anger-hostility score was significantly higher during the HPA (P = 0.007). CONCLUSIONS The replacement of dietary PA with OA was associated with increased physical activity and REE and less anger. Besides presumed effects on mitochondrial function (increased REE), the dietary PA:OA ratio appears to affect behavior. The second cohort was derived from a study that was registered at clinicaltrials.gov as R01DK082803.
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Affiliation(s)
- C Lawrence Kien
- Departments of Pediatrics, University of Vermont, Burlington, VT, USA.
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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 2013; 110:1512-23. [DOI: 10.1017/s000711451300072x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The diversity of the associations of dietary glycaemic index (GI) and glycaemic load (GL) with dietary intake and body fatness observed in epidemiological studies may be partly due to the differences in underlying dietary intake patterns. We examined the cross-sectional associations of dietary GI and GL with food and nutrient intakes and indices of body fatness in 818 children aged 4–10 years and 818 adolescents aged 11–18 years in Britain, based on the data from the National Diet and Nutrition Survey. Dietary intake was assessed using a 7 d weighed dietary record. Overweight was defined as BMI ≥ 85th percentile of the age- and sex-specific British growth reference data. Central obesity was defined as waist:height ratio (WHtR) ≥ 0·5 (adolescents only). Breads, breakfast cereals and potatoes were the positive predictive food groups for dietary GI, while dairy products, fruit juice, other cereals and fruit were the negative predictors. Dietary GL was closely correlated with carbohydrate intake. Dietary GI showed no associations with overweight or central obesity. Conversely, dietary GL showed an independent association with a higher risk of overweight in children and a higher risk of central obesity (but not overweight) in adolescents. However, dietary GI and GL were not associated with BMI z-score in children and adolescents or WHtR in adolescents. In conclusion, the present study showed that dietary GL was independently associated with overweight in children and with central obesity in adolescents. Nevertheless, given no associations when body fatness measures were treated as continuous variables, the results must be interpreted cautiously.
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Abstract
Recent criticisms of the glycaemic index (GI) focus on its validity with assertions that GI methodology is not valid, GI values are inaccurate and imprecise, GI does not predict what foods are healthy and that whole grain and fibre are better markers of carbohydrate quality than GI. None of the critics provide sound reasons for rejecting GI because some of their arguments are based on flagrant errors in understanding and interpretation while others are not supported by current data or are inconsistent with other nutritional recommendations. This paper addresses current criticisms of GI and outlines reasons why GI is valid: (1) GI methodology is accurate and precise enough for practical use; (2) GI is a property of foods; and (3) GI is biologically meaningful and relevant to virtually everyone. Current dietary guidelines recommend increased consumption of whole grains and dietary fibre but do not mention GI. However, this is illogical because the evidence that GI affects health outcomes is at least as good or better than that for whole grains and fibre. GI is a novel concept from a regulatory point of view and a number of problems need to be addressed to successfully translate GI knowledge into practice. The problems are not insurmountable but no progress can be made until bias and misunderstanding about GI can be overcome and there is better agreement about what is the actual state of knowledge on GI so that the real issues can be identified and addressed.
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Affiliation(s)
- T M S Wolever
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Lin CS, Kimokoti RW, Brown LS, Kaye EA, Nunn ME, Millen BE. Methodology for adding glycemic index to the National Health and Nutrition Examination Survey nutrient database. J Acad Nutr Diet 2013; 112:1843-51. [PMID: 23102184 DOI: 10.1016/j.jand.2012.07.035] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 07/30/2012] [Indexed: 11/17/2022]
Abstract
Generating valid estimates of dietary glycemic index (GI) and glycemic load (GL) has been a challenge in nutritional epidemiology. The methodologic issues may have contributed to the wide variation of GI/GL associations with health outcomes observed in existing literature. We describe a standardized methodology for assigning GI values to items in the National Health and Nutrition Examination Survey (NHANES) nutrient database using the new International Tables to develop research-driven, systematic procedures and strategies to estimate dietary GI/GL exposures of a nationally representative population sample. Nutrient databases for NHANES 2003-2006 contain information on 3,155 unique foods derived from the US Department of Agriculture National Nutrient Database for Standard Reference versions 18 and 20. Assignment of GI values were made to a subset of 2,078 carbohydrate-containing foods using systematic food item matching procedures applied to 2008 international GI tables and online data sources. Matching protocols indicated that 45.4% of foods had identical matches with existing data sources, 31.9% had similar matches, 2.5% derived GI values calculated with the formula for combination foods, 13.6% were assigned a default GI value based on low carbohydrate content, and 6.7% of GI values were based on data extrapolation. Most GI values were derived from international sources; 36.1% were from North American product information. To confirm data assignments, dietary GI and GL intakes of the NHANES 2003-2006 adult participants were estimated from two 24-hour recalls and compared with published studies. Among the 3,689 men and 4,112 women studied, mean dietary GI was 56.2 (men 56.9, women 55.5), mean dietary GL was 138.1 (men 162.1, women 116.4); the distribution of dietary GI was approximately normal. Estimates of population GI and GL compare favorably with other published literature. This methodology of adding GI values to an existing population nutrient database utilized systematic matching protocols and the latest comprehensive data sources on food composition. The database can be applied in clinical and survey research settings where there is interest in estimating individual and population dietary exposures and relating them to health outcomes.
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Affiliation(s)
- Chii-Shy Lin
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
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Louie JCY, Gwynn J, Turner N, Cochrane J, Wiggers J, Flood V. Dietary glycemic index and glycemic load among Indigenous and non-Indigenous children aged 10–12 years. Nutrition 2012; 28:e14-22. [DOI: 10.1016/j.nut.2011.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 12/13/2011] [Accepted: 12/15/2011] [Indexed: 11/16/2022]
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Gopinath B, Flood VM, Wang JJ, Smith W, Rochtchina E, Louie JCY, Wong TY, Brand-Miller J, Mitchell P. Carbohydrate nutrition is associated with changes in the retinal vascular structure and branching pattern in children. Am J Clin Nutr 2012; 95:1215-22. [PMID: 22456656 DOI: 10.3945/ajcn.111.031641] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Higher intake of carbohydrates and high-glycemic index (high-GI) diets could lead to small vessel dysfunction. OBJECTIVES We aimed to assess the associations between intakes of high-GI and high-glycemic load (high-GL) diets, carbohydrate, and the main carbohydrate-containing food groups and retinal microvascular changes in preadolescents. DESIGN Students aged 12 y (n = 2353) from a random cluster sample of 21 schools underwent detailed eye examinations. Retinal vessel caliber and fractal dimension were measured from digital retinal images. A validated semiquantitative food-frequency questionnaire was administered. RESULTS After multivariable adjustment, children who consumed soft drinks once or more per day had significantly narrower mean retinal arterioles (∼1.9 μm) than did those who never or rarely consumed soft drinks (P-trend = 0.03). When the highest to lowest tertiles of carbohydrate consumption were compared, girls had significantly narrower retinal arterioles (∼1.4 μm; P-trend = 0.03) and boys had wider venules (∼2.3 μm; P-trend = 0.02). In girls only, a higher-GI diet was associated with narrower retinal arterioles (0.98-μm narrowing of retinal arteriolar caliber per SD increase in GI, P = 0.01). Carbohydrate intake and a high-GL diet were associated with greater retinal fractal dimension in girls (highest compared with lowest tertiles: P-trend = 0.003 and 0.01, respectively). CONCLUSIONS Greater consumption of carbohydrates and soft drinks was associated with retinal arteriolar narrowing and venular widening. Because these microvascular signs have been shown to be markers of future cardiovascular disease risk, the presence of this risk factor in children could support the need for healthy dietary patterns that include lower consumption of high-GI foods and soft drinks.
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Affiliation(s)
- Bamini Gopinath
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
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Gopinath B, Flood VM, Rochtchina E, Baur LA, Smith W, Mitchell P. Influence of high glycemic index and glycemic load diets on blood pressure during adolescence. Hypertension 2012; 59:1272-7. [PMID: 22493075 DOI: 10.1161/hypertensionaha.112.190991] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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-SD = 7.10 g/d) increase in baseline dietary intake of total fiber was associated with a 0.96-, 0.62-, and 0.75-mmHg decrease in mean systolic (P = 0.02), diastolic (P = 0.01), and arterial blood pressures (P = 0.002), respectively, 5 years later. In girls, each 1-SD increase in dietary glycemic index, glycemic load, carbohydrate, and fructose was concurrently related to increases of 1.81 (P = 0.001), 4.02 (P = 0.01), 4.74 (P = 0.01), and 1.80 mm Hg (P = 0.03) in systolic blood pressure, respectively, >5 years. Significant associations between carbohydrate nutrition variables and blood pressure were not observed among boys. Excessive dietary intake of carbohydrates, specifically from high glycemic index/glycemic load foods, could adversely influence blood pressure, particularly in girls, whereas fiber-rich diets may be protective against elevated blood pressure during adolescence.
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Affiliation(s)
- Bamini Gopinath
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
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Louie JCY, Buyken AE, Brand-Miller JC, Flood VM. The link between dietary glycemic index and nutrient adequacy. Am J Clin Nutr 2012; 95:694-702. [PMID: 22258270 DOI: 10.3945/ajcn.111.015271] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Low-glycemic index (low-GI) diets may be less nutritious because of limited food choices. Alternately, high-GI diets could be less healthful because of a higher intake of refined carbohydrate. OBJECTIVE The objective was to investigate the association between dietary GI, intakes of carbohydrates from high-GI (CHO(high GI)) and low-GI (CHO(low GI)) sources, and the risk of nutrient inadequacy in children and adolescents. DESIGN Children, aged 2-16 y, who provided 2 plausible 24-h recalls in a national survey were included (n = 4140). The ORs of not meeting the Australian Nutrient Reference Values (NRVs) were calculated by logistic regression. RESULTS Subjects with higher intakes of CHO(high GI) were found to be at risk of not meeting the NRVs for a wide range of nutrients, including calcium and iodine (both P-trend < 0.001). In comparison with subjects in the lowest quartile of CHO(high GI), those in the highest quartile had 3 times (adjusted OR: 3.13; 95% CI: 2.47, 3.97; P-trend < 0.001) the risk of not meeting the Estimated Average Requirement for calcium. For iodine, the risk increased >5-fold (adjusted OR: 5.45; 95% CI: 3.97, 7.48; P-trend < 0.001). On the other hand, subjects with higher intakes of CHO(low GI) were less likely to meet Adequate Intakes of unsaturated fatty acids (all P-trend < 0.001), despite having lower risks of not meeting the NRVs for most nutrients. CONCLUSION Children and adolescents who consume more CHO(low GI) are more likely to meet most nutrient recommendations than those consuming higher GI diets.
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Affiliation(s)
- Jimmy Chun Yu Louie
- Cluster for Public Health Nutrition, Boden Institute of Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia
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Louie JCY, Markovic TP, Perera N, Foote D, Petocz P, Ross GP, Brand-Miller JC. A randomized controlled trial investigating the effects of a low-glycemic index diet on pregnancy outcomes in gestational diabetes mellitus. Diabetes Care 2011; 34:2341-6. [PMID: 21900148 PMCID: PMC3198285 DOI: 10.2337/dc11-0985] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The prevalence of gestational diabetes mellitus (GDM) is rising. There is little evidence to demonstrate the effectiveness of one dietary therapy over another. We aimed to investigate the effect of a low-glycemic index (LGI) versus a conventional high-fiber diet on pregnancy outcomes, neonatal anthropometry, and maternal metabolic profile in GDM. RESEARCH DESIGN AND METHODS Ninety-nine women (age 26-42 years; mean ± SD prepregnancy BMI 24 ± 5 kg/m²) diagnosed with GDM at 20-32 weeks' gestation were randomized to follow either an LGI (n = 50; target glycemic index [GI] ~50) or a high-fiber moderate-GI diet (HF) (n = 49; target GI ~60). Dietary intake was assessed by 3-day food records. Pregnancy outcomes were collected from medical records. RESULTS The LGI group achieved a modestly lower GI than the HF group (mean ± SEM 47 ± 1 vs. 53 ± 1; P < 0.001). At birth, there was no significant difference in birth weight (LGI 3.3 ± 0.1 kg vs. HF 3.3 ± 0.1 kg; P = 0.619), birth weight centile (LGI 52.5 ± 4.3 vs. HF 52.2 ± 4.0; P = 0.969), prevalence of macrosomia (LGI 2.1% vs. HF 6.7%; P = 0.157), insulin treatment (LGI 53% vs. HF 65%; P = 0.251), or adverse pregnancy outcomes. CONCLUSIONS In intensively monitored women with GDM, an LGI diet and a conventional HF diet produce similar pregnancy outcomes.
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Affiliation(s)
- Jimmy Chun Yu Louie
- School of Molecular Bioscience and Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia
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Abstract
There are no published data regarding the overall dietary glycaemic index (GI) and glycaemic load (GL) of Australian children and adolescents. We therefore aim to describe the dietary GI and GL of participants of the 2007 Australian National Children's Nutrition and Physical Activity Survey (2007ANCNPAS), and to identify the main foods contributing to their GL. Children, aged 2–16 years, who provided two 24 h recalls in the 2007ANCNPAS were included. A final dataset of 4184 participants was analysed. GI of each food item was assigned using a previously published method. GL was calculated, and food groups contributing to the GL were described by age group and sex. The weighted mean dietary GI and GL of the participants were 54 (sd 5) and 136 (sd 44), respectively. Among the nutrients examined, Ca had the highest inverse relationship with GI (P < 0·001), while percentage energy from starch was most positively associated with GI. The association between fibre density and GI was modest, and percentage energy from sugar had an inverse relationship with GI. Daily dietary GL contributed by energy-dense and/or nutrient-poor (EDNP) items in subjects aged 14–16 years was more than doubled that of subjects aged 2–3 years. To conclude, Australian children and adolescents were having a high-GI dietary pattern characterised by high-starchy food intake and low Ca intake. A significant proportion of their dietary GL was from EDNP foods. Efforts to reduce dietary GI and GL in children and adolescents should focus on energy-dense starchy foods.
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