Influence of high glycemic index and glycemic load diets on blood pressure during adolescence

Relationship between TyG-BMI index and glycemic index with diet quality, anthropometric indices, and blood pressure in patients with metabolic syndrome

A recently introduced metric for assessing metabolic syndrome (MetS) is the triglyceride glucose-body mass index (TyG-BMI). Additionally, the glycemic index (GI) is recognized as a significant measure for evaluating conditions associated with blood glucose. In this context, our research explores the correlation between TyG-BMI and GI in relation to diet quality, anthropometric measurements, and blood pressure among individuals diagnosed with MetS. A cross-sectional descriptive-analytical study was conducted on 431 employees with MetS at Shiraz University of Medical Sciences (SUMS). Anthropometric measurements of height, weight, waist circumference (WC), and hip circumference (HC) were taken according to Persian cohort protocols. BMI, C-index, visceral adiposity index (VAI), body adiposity index (BAI), body shape index (ABSI), abdominal volume index (AVI), potential renal acid load (PRAL), TyG-BMI and GI were calculated. A physician measured blood pressure, while the dietary inflammatory index was determined using guidelines. Biochemical parameters were analyzed using standard laboratory techniques. Data analysis was conducted using SPSS software version 21, with a significance threshold set at <.05. A significant correlation was identified between the TyG-BMI index and the PRAL index (β = 0.094, P-value = .026), WC (β = 0.627, P-value < .001), BAI (β = 0.396, P-value < .001), and blood pressure (β = 0.063, P-value = .002). Furthermore, the findings indicated a notable association between the GI and blood pressure (β = 0.610, P-value < .001). The results of this study suggest that managing the PRAL index, body weight, and blood pressure may be associated with an enhanced status of TyG-BMI. Additionally, appropriate GI may be linked to regulated blood pressure. These findings can inform health-related policy decisions for these patients.

Dietary and activity habits associated with hypertension in Kunming school-aged children and adolescents: A multilevel analysis of the study of hypertension risks in children and adolescents

Objective

Hypertension has become a public health challenge for Yunnan children and adolescents. The study aims is to assess the dietary and activity habits associated with hypertension in Kunming children and adolescents and to develop effective strategies for preventing and controlling, Southwest China.

Methods

Conducted in 2019, the cross-sectional study involved 3,150 students, aged 13.25 ± 2.77 years, multistage, stratified, randomly sampled from Chenggong and Fumin areas, Southwest China.

Results

Among 3,150 participants, 6.19 % never drank milk, 3.46 % never consumed fresh fruit. 2.67 % never consumed fresh vegetables, 2.48 % never ate breakfast and 10.06 % frequently drank sugary beverages (soft drinking). Additionally, 21.56 % engaged in moderate-intensity exercise less than one Day a week, and 31.97 % performed high-intensity exercise less than one Day a week. The intraclass correlation coefficient indicated that 49.40 % of the total variance was attributed to the dietary level and 42.10 % was attributed to the activity level. Eating fresh vegetables and fruit, taking physical education classes they attended per week and the frequency of moderate-intensity and high-intensity exercise per week were independent protective factors for hypertension (P < 0.01); drinking sugary beverages (soft drinking) was a independent risk factor against hypertension (P < 0.05); breakfast skipping was a possible risk factor for hypertension (P < 0.15). No significant associations were found with fried food or sweet food weekly consumption (P < 0.15).

Conclusions

The hypertension of children and adolescents cannot be ignored in Kunming, Southwest china. Dietary and activity factors are modifiable. We should make comprehensive child-friendly health education materials as soon as possible.

Assessing the Hypertension Risk: A Deep Dive into Cereal Consumption and Cooking Methods-Insights from China

BACKGROUND

Cereal grains are rich in carbohydrates and could trigger a hyperglycemic response which is closely linked to blood pressure status. We aim to examine the associations between the consumption of cereals with different cooking methods and hypertension risk.

METHODS

We conducted a prospective analysis utilizing the nationwide data of 11,080 adult participants who were free of hypertension at baseline. Cereal intake was assessed using 3-day 24 h dietary recalls with a weighing technique. Hypertension incidence was identified in adherence with the Seventh Joint National Commission guidelines during the follow-up. Cox proportional hazards regression models were used to extrapolate hazard ratios associated with hypertension risk.

RESULTS

Over an average follow-up span of 7 years (77,560 person-years), we identified 3643 new hypertension cases. The intake of total, fried, and baked cereals was associated with 15%, 20%, and 20% higher risk of hypertension, respectively. Whole grain consumers had an 8% lower risk of hypertension compared with non-consumers, while total refined grain consumers showed no significant association. Replacing one daily serving of fried or baked cereals with an equivalent serving of boiled cereals was related to a 28% or 14% lower risk, respectively.

CONCLUSIONS

Total, fried, and baked cereal consumption was positively associated with hypertension risk, while consuming whole grains was related to a lower risk. Modifying cooking methods from frying or baking to boiling for cereals may be beneficial to lower risk. The current study underscores the significance of considering both the degree of processing and cooking methods applied to cereals in addressing hypertension prevention and management.

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

BACKGROUND

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

OBJECTIVE

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

SUBJECTS AND METHODS

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

RESULTS

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

CONCLUSIONS

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

CLINICAL TRIAL REGISTRY NUMBER

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

Health relevance of lowering postprandial glycaemia in the paediatric population through diet': results from a multistakeholder workshop

To summarize current knowledge and gaps regarding the role of postprandial glycaemic response in the paediatric population, a workshop was organized in June 2021 by the European branch of the International Life Science Institute (ILSI). This virtual event comprised of talks given by experts followed by in-depth discussions in breakout sessions with workshop participants. The main pre-specified topics addressed by the workshop organizing committee to the invited speakers and the workshop participants were: (1) the role of glycaemic responses for paediatric health, based on mechanistic insights from animal and human data, and long-term evidence from observational and intervention studies in paediatric populations, and (2) changes in metabolism and changes in dietary needs from infancy to adolescence. Each talk as well as the discussions were summarised, including the main identified research gaps. The workshop led to the consensus on the crucial role on health of postprandial glycaemic response in paediatric population. However, a lack of scientific data has been identified regarding detailed glucose and insulin profiles in response to foods commonly consumed by paediatric populations, as well as a lack of long-term evidence including the need for suitable predictors during childhood and adolescence to anticipate health effects during adulthood.

The association of Carbohydrate Quality Index with cardiovascular disease risk factors among women with overweight and obesity: A cross-sectional study

Purpose

Diet is one of the most important factors influencing cardiovascular disease (CVD). The negative relationship between carbohydrate intake with lipid profiles and body weight has been previously investigated. However, this is the first study seeking to assess the association of carbohydrate quality index (CQI) with CVD risk factors.

Methods

This cross-sectional study was conducted on 291 Iranian overweight and obese women, with a body mass index (BMI) ranging between 25 and 40 kg/m², and aged 18–48 years. CQI scores were calculated by using a validated 168-item semi-quantitative food frequency questionnaire (FFQ). Biochemical and anthropometric measures were assessed using standard methods, and bioelectrical impedance was used to measure body composition.

Results

We observed that fruits (P < 0.001), vegetables (P < 0.001), and protein (P = 0.002) intake were higher in participants with a higher score of the CQI. When we adjusted for potential confounders, we observed that the CQI was negatively related to systolic blood pressure (SBP) (β = −6.10; 95% CI = −10.11, −2.10; P = 0.003) and DBP (β = −3.11; 95% CI = −6.15, −0.08; P = 0.04). Also, greater adherence to a high CQI dietary pattern, compared to the reference group, was negatively related to HOMA-IR (β = −0.53; 95% CI = −0.94, −0.12) (P for trend = 0.01), WC (β = −3.18; 95% CI = −6.26, −0.10) (P for trend = 0.04), BMI (β = −1.21; 95% CI = −2.50, 0.07) (P for trend = 0.06), and BF (β = −2.06; 95% CI = −3.82, −0.30) (P for trend = 0.02).

Conclusion

In line with previous studies, the CQI was inversely associated with blood pressure, WC, BMI, and BF. Further prospective and clinical trial studies are suggested to confirm these data.

EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA), Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch‐Ernst KI, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Naska A, Peláez C, Pentieva K, Siani A, Thies F, Tsabouri S, Adan R, Emmett P, Galli C, Kersting M, Moynihan P, Tappy L, Ciccolallo L, de Sesmaisons‐Lecarré A, Fabiani L, Horvath Z, Martino L, Muñoz Guajardo I, Valtueña Martínez S, Vinceti M. Tolerable upper intake level for dietary sugars

Following a request from five European Nordic countries, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was tasked to provide scientific advice on a tolerable upper intake level (UL) or a safe level of intake for dietary (total/added/free) sugars based on available data on chronic metabolic diseases, pregnancy-related endpoints and dental caries. Specific sugar types (fructose) and sources of sugars were also addressed. The intake of dietary sugars is a well-established hazard in relation to dental caries in humans. Based on a systematic review of the literature, prospective cohort studies do not support a positive relationship between the intake of dietary sugars, in isocaloric exchange with other macronutrients, and any of the chronic metabolic diseases or pregnancy-related endpoints assessed. Based on randomised control trials on surrogate disease endpoints, there is evidence for a positive and causal relationship between the intake of added/free sugars and risk of some chronic metabolic diseases: The level of certainty is moderate for obesity and dyslipidaemia (> 50-75% probability), low for non-alcoholic fatty liver disease and type 2 diabetes (> 15-50% probability) and very low for hypertension (0-15% probability). Health effects of added vs. free sugars could not be compared. A level of sugars intake at which the risk of dental caries/chronic metabolic diseases is not increased could not be identified over the range of observed intakes, and thus, a UL or a safe level of intake could not be set. Based on available data and related uncertainties, the intake of added and free sugars should be as low as possible in the context of a nutritionally adequate diet. Decreasing the intake of added and free sugars would decrease the intake of total sugars to a similar extent. This opinion can assist EU Member States in setting national goals/recommendations.

Diet quality in relation to the risk of hypertension among Iranian adults: cross-sectional analysis of Fasa PERSIAN cohort study

BACKGROUND

Hypertension is a common chronic disease with various complications and is a main contributing factor to cardiovascular disease (CVD). This study aimed to assess the association of diet quality, assessed by dietary diversity score (DDS), Mediterranean dietary score (MDS), diet quality index-international (DQI-I), and healthy eating index-2015 (HEI-2015) with the risk of hypertension.

METHODS

This study recruited a total of 10,111 individuals (45.14% male) with mean age of 48.63 ± 9.57 years from the Fasa Cohort Study, Iran. Indices of diet quality, including MDS, HEI-2015, DQI-I, and DDS were computed by a 125-item Food Frequency Questionnaire. Participants were diagnosed as hypertensive if they had a diastolic blood pressure (DBP) ≥90 mmHg, systolic blood pressure (SBP) ≥140 mmHg,, or used antihypertensive drugs.

RESULTS

Hypertension was prevalent in 28.3% of the population (21.59% in males and 33.74% in females). In the whole population, after adjustment for potential covariates, including daily energy intake, age, gender, physical activity, smoking, family history of hypertension, body mass index, and the level of education, higher adherence to the MDS (OR: 0.86, 95%CI = 0.75-0.99) and HEI-2015 (OR: 0.79, 95%CI = 0.68-0.90) was significantly associated with decreased risk of hypertension. The protective effect of HEI-2015 against hypertension remained significant for both males (OR: 0.80, 95%CI = 0.64-0.99) and females (OR: 0.78, 95%CI = 0.66-0.94), while, for MDS, this relationship disappeared in the subgroup analysis by gender. DQI-I and DDS were not related to the odds of hypertension.

CONCLUSIONS

Adhering to MDS and HEI-2015 diets could contribute to the prevention of hypertension.

Fibre Intake Is Associated with Cardiovascular Health in European Children

BACKGROUND

We aimed at analysing the association between dietary fibre intake during childhood and cardiovascular health markers.

METHODS

We used observational longitudinal analysis and recorded diet using 3-day diaries at the ages of 3, 4, 5, 6, and 8 years in children from the EU Childhood Obesity Project Trial. At the age of 8, waist circumference, systolic and diastolic blood pressure (SBP and DBP) and biochemical analyses (lipoproteins, triglycerides and homeostasis model for insulin resistance (HOMA-IR)) were evaluated. Those parameters were combined into a cardiometabolic risk score through the sum of their internal z-scores.

RESULTS

Four-hundred children (51.8% girls) attended to the 8-year visit with a 3-day diary. Adjusted linear regression models showed that children who repeatedly stayed in the lowest tertile of fibre intake during childhood had higher HOMA-IR (p = 0.004), higher cardiometabolic risk score (p = 0.02) and a nonsignificant trend toward a higher SBP at 8 years. The higher the dietary intake of soluble fibre (from fruits and vegetables) at 8 years, the lower the HOMA-IR and the cardiometabolic risk score (p = 0.002; p = 0.004). SBP was directly associated with fibre from potatoes and inversely with fibre from nuts and pulses.

CONCLUSION

A diet rich in dietary fibre from fruits, vegetables, pulses and nuts from early childhood was associated to a healthier cardiovascular profile, regardless of children's weight.

Disparities in Sources of Added Sugars and High Glycemic Index Foods in Diets of US Children, 2011-2016

INTRODUCTION

Added sugars and high glycemic index (GI) foods might play a role in cardiometabolic pathogenesis. Our study aimed to describe the top sources of added sugars and types of high GI foods in diets of children by race/ethnicity.

METHODS

We examined data for 3,112 children, aged 6 to 11 years from the National Health and Nutrition Examination Survey (NHANES), 2011 to 2016. Mean intake was estimated and linear regression models tested for differences by race/ethnicity. Population proportions for food sources were created and ranked, accounting for survey weighting when appropriate.

RESULTS

Asian American and Mexican American children had the lowest reported added sugar intake. Cereals were observed to contribute highly to added sugar intake. Soft drinks did not contribute as much added sugar intake for Asian American children as it did for children of other races/ethnicities. Asian American children consumed significantly more high GI foods than other groups. Types of high GI foods differed meaningfully across racial/ethnic groups (ie, Mexican American: burritos/tacos; other Hispanic, White, and Black: pizza; Asian American: rice). Rice accounted for 37% of total high GI foods consumed by Asian American children.

CONCLUSIONS

Sources of added sugars and types of high GI foods in children's diets vary across racial/ethnic groups. Targeting foods identified as top sources of added sugars for all race/ethnicities and focusing on substitution of whole grains may reduce obesity, diabetes, and related cardiometabolic risk more equitably.

The association of glycemic index and glycemic load with elevated blood pressure in Iranian women

Introduction: Dietary intake is a risk factor related to elevated blood pressure (EBP). Few studies have investigated an association of dietary glycemic index (GI) and glycemic load (GL) with the EBP. The aim of the current study was to examine the association of dietary GI and GL with the EBP among a group of healthy women. Methods: This population-based cross-sectional study was conducted on 306 healthy women. Dietary GI and GL were measured using a validated semi-quantitative food frequency questionnaire (FFQ). Blood pressure (BP) was measured twice by a mercury sphygmomanometer from the right arm. Anthropometric measurements were also assessed according to the standard protocols. Results: Before controlling for potential confounders, no significant association was seen between dietary GI/GL and SBP/DBP. Also after controlling for potential confounders, the associations did not change between dietary GI and SBP (odds ratio [OR]: 0.96; 95% CI: 0.42-2.17, P = 0.87), between GI and DBP (OR: 0.72; 95% CI: 0.35-1.45, P = 0.37), as well as between GL and SBP (OR: 1.04; 95% CI: 0.43-2.49, P = 1.00) and between GL and DBP (OR: 1.20; 95% CI: 0.56-2.00, P = 0.61). In a stratified analysis by obesity and overweight, differences between tertiles of GI were not significant (OR: 0.75; 95% CI: 0.42-1.31, P = 0.31), even after adjustment for the potential confounders (OR: 1.54; 95% CI: 0.70-3.40, P = 0.26). Conclusion: This study did not show a significant association between dietary GI/GL and the risk of high SBP/DBP. In addition, no significant association was found between dietary GI/GL and odds of overweight or obesity in adult women.

A comparison of the sensitivity and specificity of anthropometric measurements to predict unhealthy metabolic phenotype in overweight and obese women

AIM

Metabolically Healthy Obese (MHO) is called to obese people that their insulin sensitivity, lipid profiles and inflammatory profiles are favorable, and there are no signs of hypertension and cardio-metabolic diseases. The metabolically unhealthy obese (MUHO) is the opposite. A Body Shape Index (ABSI) is a marker to identifying abdominal obesity that is derived from weight, height and waist circumference (WC). Several studies have reported ABSI is associated with diabetes, metabolic syndrome, hypertension and higher mortality rate.

MATERIALS AND METHODS

A total of 305 overweight and obese women were included in the current comparative cross-sectional study. Body composition was measured using body composition analyzer. Blood samples were obtained. The usual food intake of evaluated through the use of a semi-quantitative food frequency questionnaire.

RESULTS

The results of this study revealed that there is a significant relationship between ABSI and MHO and MUHO (p = 0.04) and area under the ROC curve was 0.60. Also there is a significant relationship between BMI, fat mass index (FMI), free fat mass index (FFMI), neck circumference (NC), WC, fat mass (FM) and metabolic healthy status (MHS). The largest area under the ROC curve belonged to NC, WC, FM and BMI (0.66).

CONCLUSION

The findings of this study suggest that there is a significant relationship between ABSI, BMI, FMI, FFMI, NC, WC, FM and MHS. The largest area under the ROC curve was related to the NC, WC, FM and BMI not ABSI, that means NC, WC, FM and BMI have maximum sensitivity and specificity.

The Decreasing Trend in Dietary Glycaemic Index and Glycaemic Load in Australian Children and Adolescents between 1995 and 2012

This study aims to examine whether there were changes between 1995⁻2012 in the dietary glycaemic index (dGI) and glycaemic load (dGL) in Australian children (<16 years) according to three national surveys in 1995 (1995NS), 2007 (2007NS), and 2011⁻2012 (2012NS). Glycaemic index (GI) values of foods were assigned using published methodology. Plausible 24-h recall data from the 1995NS, 2007NS and 2012NS (weighted n = 2475, 4373 and 1691 respectively) were compared for differences in dGI and dGL, and the contribution to dGL from different foods using one-way ANOVA with Bonferroni post hoc comparisons and linear regression. Decreasing trends across surveys were found in dGI and dGL (p < 0.001). Between 1995 and 2012, dGI and dGL per Megajoule (MJ) dropped by 2% and 6% respectively. The per capita dGL contribution from breads and bread rolls, fruit and vegetable juices, sweetened beverages and potatoes showed strong decreasing trends (R² > 0.7). Our findings suggest that dGI and dGL of Australian youths declined between 1995 to 2012, which may be due to increased awareness of the GI concept and healthy diet, widened food choices and immigrants with diverse dietary habits. This may lower the future risks of chronic degenerative diseases in Australian youths.

Dietary Fibre as a Unifying Remedy for the Whole Spectrum of Obesity-Associated Cardiovascular Risk

Obesity is a pandemic carrying the heavy burden of multiple and serious co-morbidities including metabolic syndrome, type 2 diabetes and cardiovascular diseases. The pathophysiological processes leading to the accumulation of body fat slowly evolve to fat accumulation in other body compartments than subcutaneous tissue. This abnormal fat deposition determines insulin resistance which in turn causes blood glucose and lipid metabolism derangement, non-alcoholic fatty liver disease, hypertension, and metabolic syndrome. All these conditions contribute to increase the cardiovascular risk of obese people. Several randomized clinical trials demonstrated that moderate weight loss (5⁻10%) in obese patients improves obesity-related metabolic risk factors and coexisting disorders. Therefore, nutritional strategies able to facilitate weight management, and in the meantime positively influence obesity-associated cardiovascular risk factors, should be implemented. To this aim, a suitable option could be dietary fibres that may also act independently of weight loss. The present narrative review summarizes the current evidence about the effects of dietary fibres on weight management in obese people. Moreover, all of the different cardiovascular risk factors are individually considered and evidence on cardiovascular outcomes is summarized. We also describe the plausible mechanisms by which different dietary fibres could modulate cardio-metabolic risk factors. Overall, despite both epidemiological and intervention studies on weight loss that show statistically significant but negligible clinical effects, dietary fibres seem to have a beneficial impact on main pathophysiological pathways involved in cardiovascular risk (i.e., insulin resistance, renin-angiotensin, and sympathetic nervous systems). Although the evidence is not conclusive, this suggests that fibre would be a suitable option to counteract obesity-related cardio-metabolic diseases also independently of weight loss. However, evidence is not consistent for the different risk factors, with clear beneficial effects shown on blood glucose metabolism and Low Density Lipoprotein (LDL) cholesterol while there is fewer, and less consistent data shown on plasma triglyceride and blood pressure. Ascribing the beneficial effect of some foods (i.e., fruits and vegetables) solely to their fibre content requires more investigation on the pathophysiological role of other dietary components, such as polyphenols.

Glycemic index, glycemic load, and metabolic syndrome in Mexican adolescents: a cross-sectional study from the NHNS-2012

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.

Dietary glycaemic index and glycaemic load among Australian children and adolescents: results from the 2011–2012 Australian Health Survey

This study aimed to examine the dietary glycaemic index (GI) and glycaemic load (GL) of Australian children and adolescents, as well as the major food groups contributing to GL, in the recent 2011–2012 Australian Health Survey. Plausible food intake data from 1876 children and adolescents (51 % boys), collected using a multiple-pass 24-h recall, were analysed. The GI of foods was assigned based on a step-wise published method using values from common GI databases. Descriptive statistics were calculated for dietary GI, GL and contribution to GL by food groups, stratified by age group and sex. Linear regression was used to test for trends across age groups for BMI, dietary GI and GL, and intakes of energy, nutrients and food groups. Pearson’s χ2 test was used to test for differences between age groups for categorical subject characteristic variables. Mean dietary GI and GL of participants were 55·5 (sd 5·3) and 137·4 (sd 50·8), respectively. The main contributors to dietary GL were starchy foods: breads, cereal-based dishes, breakfast cereals, flours, grains and potatoes accounted for 41 % of total GL. Sweetened beverages, fruit and vegetable juices/drinks, cake-type desserts and sweet biscuits contributed 15 %. No significant difference (at P<0·001) was observed between sexes. In conclusion, Australian children and adolescents appear to consume diets with a lower GI than European children. Exchanging high-GI foods for low-GI alternatives within core and non-core foods may improve diet quality of Australian children and adolescents.

Dietary glycemic index and glycemic load and their relationship to cardiovascular risk factors in Chinese children

The purpose of this study was to examine the cross-sectional associations between dietary glycemic index (GI) and glycemic load (GL) and cardiovascular disease (CVD) risk factors in Chinese children. A total of 234 Chinese schoolchildren aged 8-11 years in Guangdong participated in the study. Dietary intake was assessed via a 3-day dietary record. Seven established cardiovascular indicators were analyzed in this study: fasting plasma glucose (FPG), fasting triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure, and diastolic blood pressure. Higher dietary GI was significantly associated with higher TG levels (P = 0.037) and lower HDL-C levels (P = 0.005) after adjusting for age, sex, nutritional intake, physical activity, and body mass index z score. LDL-C was found to differ across tertiles of dietary GL. The middle tertile tended to show the highest level of LDL-C. TC, FPG, and blood pressure were independent of both dietary GI and GL. Our findings suggest that higher dietary GI is differentially associated with some CVD risk factors, including lower HDL-C and higher TG, in school-aged children from south China.

Position of the Academy of Nutrition and Dietetics: Health Implications of Dietary Fiber

It is the position of the Academy of Nutrition and Dietetics that the public should consume adequate amounts of dietary fiber from a variety of plant foods. Dietary fiber is defined by the Institute of Medicine Food Nutrition Board as "nondigestible carbohydrates and lignin that are intrinsic and intact in plants." Populations that consume more dietary fiber have less chronic disease. Higher intakes of dietary fiber reduce the risk of developing several chronic diseases, including cardiovascular disease, type 2 diabetes, and some cancers, and have been associated with lower body weights. The Adequate Intake for fiber is 14 g total fiber per 1,000 kcal, or 25 g for adult women and 38 g for adult men, based on research demonstrating protection against coronary heart disease. Properties of dietary fiber, such as fermentability and viscosity, are thought to be important parameters influencing the risk of disease. Plant components associated with dietary fiber may also contribute to reduced disease risk. The mean intake of dietary fiber in the United States is 17 g/day with only 5% of the population meeting the Adequate Intake. Healthy adults and children can achieve adequate dietary fiber intakes by increasing their intake of plant foods while concurrently decreasing energy from foods high in added sugar and fat, and low in fiber. Dietary messages to increase consumption of whole grains, legumes, vegetables, fruits, and nuts should be broadly supported by food and nutrition practitioners.

Retinal vascular imaging in early life: insights into processes and risk of cardiovascular disease

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. In recent years, studies have shown that the origins of CVD may be traced to vascular and metabolic processes in early life. Retinal vascular imaging is a new technology that allows detailed non-invasive in vivo assessment and monitoring of the microvasculature. In this systematic review, we described the application of retinal vascular imaging in children and adolescents, and we examined the use of retinal vascular imaging in understanding CVD risk in early life. We reviewed all publications with quantitative retinal vascular assessment in two databases: PubMed and Scopus. Early life CVD risk factors were classified into four groups: birth risk factors, environmental risk factors, systemic risk factors and conditions linked to future CVD development. Retinal vascular changes were associated with lower birth weight, shorter gestational age, low-fibre and high-sugar diet, lesser physical activity, parental hypertension history, childhood hypertension, childhood overweight/obesity, childhood depression/anxiety and childhood type 1 diabetes mellitus. In summary, there is increasing evidence supporting the view that structural changes in the retinal microvasculature are associated with CVD risk factors in early life. Thus, the retina is a useful site for pre-clinical assessment of microvascular processes that may underlie the future development of CVD in adulthood.

Low-Glycemic-Index Foods Can Decrease Systolic and Diastolic Blood Pressure in the Short Term

Background. We aimed to compare the effects of low- and high-GI foods on 24-hour ambulatory blood pressure. Methods. This longitudinal study was performed on 30 women, aged 18 to 40 years, during 24 hours. In the first leg of study all recruited subjects were assigned to LGI period for 24 hours and, after a 2-week washout period, all subjects were assigned to HGI period. BP was measured every hour during the 24-hour monitoring. Results. After the intervention, there were significant decreases in SBP and DBP in the LGI period (102.26 ± 14.18 mmHg versus 112.86 ± 9.33 mmHg for SBP and 66.96 ± 10.39 mmHg versus 74.46 ± 7.61 mmHg for DBP) (P = 0.00 and P = 0.002, resp.). However, in the HGI period, there was no significant change in SBP or DBP (110.66 ± 9.85 versus 111.80 ± 9.57 for SBP and 71.16 ± 9.16 versus 74.26 ± 10.09 for DBP) (P = 0.6 and P = 0.06, resp.). Conclusion. The results suggest that LGI foods may be beneficial in reducing 24-hour BP.

Glycemic index, glycemic load and glycemic response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC)

BACKGROUND AND AIMS

The positive and negative health effects of dietary carbohydrates are of interest to both researchers and consumers.

METHODS

International experts on carbohydrate research held a scientific summit in Stresa, Italy, in June 2013 to discuss controversies surrounding the utility of the glycemic index (GI), glycemic load (GL) and glycemic response (GR).

RESULTS

The outcome was a scientific consensus statement which recognized the importance of postprandial glycemia in overall health, and the GI as a valid and reproducible method of classifying carbohydrate foods for this purpose. There was consensus that diets low in GI and GL were relevant to the prevention and management of diabetes and coronary heart disease, and probably obesity. Moderate to weak associations were observed for selected cancers. The group affirmed that diets low in GI and GL should always be considered in the context of diets otherwise understood as healthy, complementing additional ways of characterizing carbohydrate foods, such as fiber and whole grain content. Diets of low GI and GL were considered particularly important in individuals with insulin resistance.

CONCLUSIONS

Given the high prevalence of diabetes and pre-diabetes worldwide and the consistency of the scientific evidence reviewed, the expert panel confirmed an urgent need to communicate information on GI and GL to the general public and health professionals, through channels such as national dietary guidelines, food composition tables and food labels.

Dietary fibre and health in children and adolescents

The role of dietary fibre in promoting sustained health has been studied for several decades and in adults there is good evidence that diets rich in high-fibre foods reduce the risk of chronic diseases, including CVD and cancer. Research in this area, however, has been hampered by uncertainties about the definition of dietary fibre which has resulted in many studies measuring fibre in different ways. There is also a wide range of properties and actions of different fibres in the human body, depending on their solubility, viscosity and fermentability by the colonic microbiota. This review considers the epidemiological evidence for dietary fibre and health in children and the current dietary recommendations and measured intakes in several countries using national surveys. In children and adolescents, there is a particular lack of relevant research on which to formulate appropriate dietary fibre recommendations and these are often based on extrapolation from adult data. However, children are not little adults and have differing physiology and nutritional needs as they grow. The dietary recommendations in different countries are based on varying premises and daily amounts. Intakes vary from country to country and on the whole do not meet recommendations. Much more research is needed in children to fully understand the impact of dietary fibre on growth and health in the young to allow more appropriate recommendations to be made.

Dairy food consumption, blood pressure and retinal microcirculation in adolescents

BACKGROUND AND AIMS

The relationship between dairy food consumption and dietary calcium intake, and vascular risk factors during adolescence remains unclear. We aimed to prospectively assess whether dairy food consumption (milk, cheese, yoghurt) is associated with blood pressure (BP) and retinal microvascular signs among adolescents.

METHODS AND RESULTS

As many as 2353 and 1216 participants aged 12 and 17, respectively, were examined. Longitudinal analyses involved 888 subjects with complete baseline and follow-up data. Dairy consumption was assessed from validated semi-quantitative food frequency questionnaires. BP information was collected and retinal vessel caliber was quantified from digital photographs using computer software. In girls, after multivariable adjustment, each serve/day increase in total dairy intake was concurrently associated with 1.04 (p = 0.03) and 1.10 mm Hg (p = 0.02) decreases in mean diastolic and arterial BP, respectively. Also in girls, each serve/day increase in cheese intake over 5 years was concurrently related to 7.18 (p = 0.001), 5.28 (p = 0.002) and 5.79 mm Hg (p = 0.001) decrease in mean systolic, diastolic and arterial BP, respectively. Among girls, each 100 mg/day increase in dietary calcium intake was associated with a concurrent 0.5 (p = 0.01) and 0.3 mm Hg (p = 0.02) decrease in mean systolic and arterial BP, respectively. Cross-sectionally, adolescents in the highest versus lowest tertile of yoghurt intake had ∼ 1.3 μm wider retinal arterioles (p = 0.05) and ∼ 2.0 μm narrower venules (p = 0.04).

CONCLUSIONS

Consumption of dairy products, particularly cheese, could have a beneficial effect on BP, particularly among girls.

Glycemic index: is it a predictor of metabolic and vascular disorders?

PURPOSE OF REVIEW

The role of glycemic index on metabolic and cardiovascular risk factors received considerable attention in light of the current increase in cardiometabolic disorders. We aimed to deal and identify the recently published prospective epidemiological studies as well as randomized controlled studies investigating the associations of metabolic and cardiovascular risk markers with dietary intake of carbohydrates and with measures of the induced glycemic index. The main prospective studies and meta-analysis grouping the recent prospective and clinical interventions are discussed.

RECENT FINDINGS

Recently, during the last few years, evidence exists that high glycemic index/glycemic load diets contribute to risk of type 2 diabetes and cardiovascular disease. Additionally, low glycemic index/glycemic load diets were found to be effective in the treatment of cardiometabolic disorders.

SUMMARY

The use of the low glycemic index notion in the dietary recommendations for children, adolescents and adults might play a role in the prevention, and or treatment, of metabolic diseases and their cardiovascular complications.