Plain language summary
All carbohydrates are ranked based on their glycaemic impact, or the response they provoke in blood glucose after consumption. It has been proposed that diets with a low impact on blood glucose are associated with a reduction in disease risk, however the specific dietary factors and degree of influence of this association remains unclear. The aim of this meta-analysis was to assess which glycaemic impact factors are important for affecting the maintenance of health and management of disease. Data from 45 relevant publications were included to investigate various health risk markers of overweight and obesity, diabetes mellitus and coronary heart disease. This review found that diets with a reduced glycaemic impact and higher unavailable carbohydrate are associated with favourable changes for all examined health risk markers. The authors conclude that these interventions led to improved glycaemic control, therefore provide a compelling diet for managing chronic disease.
Abstract
BACKGROUND Reduction of dietary glycemic response has been proposed as a means of reducing the risk of diabetes and coronary heart disease. The impact of glycemic response on markers of health remains to be elucidated. OBJECTIVE We assessed the evidence relating the glycemic impact of foods to measures relevant for health maintenance and management of disease. DESIGN This was a systematic review and synthesis of interventional evidence from literature reported on glycemic index and markers of health through the use of meta-analyses and meta-regression models. RESULTS Data from 45 relevant publications were found to January 2005. Lower glycemic index (GI) diets reduced both fasting blood glucose and glycated proteins independently of variance in available and unavailable carbohydrate intakes. Elevated unavailable carbohydrate added to improvements in both blood glucose and glycated protein control. These effects were greater in persons with poor fasting blood glucose control. No effects were seen on fasting insulin<100 pmol/L; above this, study numbers were few but consistent with prevention of hyperinsulinemia in some but not all overweight persons. Insulin sensitivity according to a variety of measurement methods was improved by lower GI, higher unavailable carbohydrate interventions in persons with type 2 diabetes, in overweight and obese persons, and in all studies combined. Fasting triacylglycerol in addition to body weight reduction related more to glycemic load than to GI. Glycemic load reduction by >17 g glucose equivalents/d was associated with reduced body weight. CONCLUSIONS Consumption of reduced glycemic response diets are followed by favorable changes in the health markers examined. The case for the use of such diets looks compelling. Unavailable carbohydrate intake is equally important.
Methodological quality
Allocation concealment
:
Not applicable
