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Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies.
Livesey, G, Taylor, R, Livesey, HF, Buyken, AE, Jenkins, DJA, Augustin, LSA, Sievenpiper, JL, Barclay, AW, Liu, S, Wolever, TMS, et al
Nutrients. 2019;(6)
Abstract
Published meta-analyses indicate significant but inconsistent incident type-2 diabetes(T2D)-dietary glycemic index (GI) and glycemic load (GL) risk ratios or risk relations (RR). It is nowover a decade ago that a published meta-analysis used a predefined standard to identify validstudies. Considering valid studies only, and using random effects dose-response meta-analysis(DRM) while withdrawing spurious results (p < 0.05), we ascertained whether these relationswould support nutrition guidance, specifically for an RR > 1.20 with a lower 95% confidence limit>1.10 across typical intakes (approximately 10th to 90th percentiles of population intakes). Thecombined T2D-GI RR was 1.27 (1.15-1.40) (p < 0.001, n = 10 studies) per 10 units GI, while that forthe T2D-GL RR was 1.26 (1.15-1.37) (p < 0.001, n = 15) per 80 g/d GL in a 2000 kcal (8400 kJ) diet.The corresponding global DRM using restricted cubic splines were 1.87 (1.56-2.25) (p < 0.001, n =10) and 1.89 (1.66-2.16) (p < 0.001, n = 15) from 47.6 to 76.1 units GI and 73 to 257 g/d GL in a 2000kcal diet, respectively. In conclusion, among adults initially in good health, diets higher in GI or GLwere robustly associated with incident T2D. Together with mechanistic and other data, thissupports that consideration should be given to these dietary risk factors in nutrition advice.Concerning the public health relevance at the global level, our evidence indicates that GI and GLare substantial food markers predicting the development of T2D worldwide, for persons ofEuropean ancestry and of East Asian ancestry.
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Weighing the Evidence of Common Beliefs in Obesity Research.
Casazza, K, Brown, A, Astrup, A, Bertz, F, Baum, C, Brown, MB, Dawson, J, Durant, N, Dutton, G, Fields, DA, et al
Critical reviews in food science and nutrition. 2015;(14):2014-53
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Abstract
Obesity is a topic on which many views are strongly held in the absence of scientific evidence to support those views, and some views are strongly held despite evidence to contradict those views. We refer to the former as "presumptions" and the latter as "myths." Here, we present nine myths and 10 presumptions surrounding the effects of rapid weight loss; setting realistic goals in weight loss therapy; stage of change or readiness to lose weight; physical education classes; breastfeeding; daily self-weighing; genetic contribution to obesity; the "Freshman 15"; food deserts; regularly eating (versus skipping) breakfast; eating close to bedtime; eating more fruits and vegetables; weight cycling (i.e., yo-yo dieting); snacking; built environment; reducing screen time in childhood obesity; portion size; participation in family mealtime; and drinking water as a means of weight loss. For each of these, we describe the belief and present evidence that the belief is widely held or stated, reasons to support the conjecture that the belief might be true, evidence to directly support or refute the belief, and findings from randomized controlled trials, if available. We conclude with a discussion of the implications of these determinations, conjecture on why so many myths and presumptions exist, and suggestions for limiting the spread of these and other unsubstantiated beliefs about the obesity domain.
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Nutrition transition and its relationship to the development of obesity and related chronic diseases.
Astrup, A, Dyerberg, J, Selleck, M, Stender, S
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2008;:48-52
Abstract
The prevalence of overweight and obesity has also increased substantially in the nutritional transition countries, and the health burden of obesity-related complications is growing. The introduction of fast-food chains and Westernized dietary habits providing meals with fast-food characteristics seems to be a marker of the increasing prevalence of obesity. The mechanisms involved are probably that the supply of foods is characterized by large portion sizes with a high energy density, and sugar-rich soft drinks. The high energy density of foods is partly brought about by a high dietary fat content, and it has been shown that even in a Chinese population the increase from about 15% to 20% in the proportion of calories from fat is sufficient to explain some weight gain in the population. In addition, fast food from major chains in most countries still contains unacceptably high levels of industrially produced trans fatty acids that have powerful biological effects, and contribute to type 2 diabetes and coronary artery disease. New evidence also suggests that a high intake of trans fat may produce abdominal obesity, an important factor in the metabolic syndrome, type 2 diabetes and cardiovascular disease. The optimal diet for the prevention of weight gain, obesity, metabolic syndrome and type 2 diabetes is fat-reduced, without any industrially produced trans fatty acids, fibre-rich, high in low energy density carbohydrates (fruit, vegetables and whole grain products) and with a restricted intake of energy-containing drinks.
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How to maintain a healthy body weight.
Astrup, A
International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition. 2006;(4):208-15
Abstract
The epidemic of both obesity and type 2 diabetes is due to environmental factors, but the individuals developing the conditions possess a strong genetic predisposition. Observational surveys and intervention studies have shown that excess body fatness is the major environmental cause of type 2 diabetes, and that even a minor weight loss can prevent its development in high-risk subjects. Maintenance of a healthy body weight in susceptible individuals requires 45-60 minutes physical activity daily, a fat-reduced diet with plenty of fruit, vegetables, whole grain, and lean meat and dairy products, and moderate consumption of calorie containing beverages. The use of table values to predict the glycemic index of meals is of little--if any--value, and the role of a low-glycemic index diet for body weight control is controversial. The replacement of starchy carbohydrates with protein from lean meat and lean dairy products enhances satiety, and facilitate weight control. It is possible that dairy calcium also promotes weight loss, although the mechanism of action remains unclear. A weight loss of 5-10% can be induced in almost all obese patients providing treatment is offered by a professional team consisting of a physician and dietitians or nurses trained to focus on weight loss and maintenance. Whereas increasing daily physical activity and regular exercise does not significantly effect the rate of weight loss in the induction phase, it plays an important role in the weight maintenance phase due to an impact on daily energy expenditure and also to a direct enhancement of insulin sensitivity.