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Association between carbohydrate quality and inflammatory markers: systematic review of observational and interventional studies.
Buyken, AE, Goletzke, J, Joslowski, G, Felbick, A, Cheng, G, Herder, C, Brand-Miller, JC
The American journal of clinical nutrition. 2014;(4):813-33
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Abstract
BACKGROUND Chronic low-grade inflammation is a likely intermediary between quality of carbohydrate and chronic disease risk. OBJECTIVE We conducted a systematic literature search to evaluate the relevance of carbohydrate quality on inflammatory markers in observational and intervention studies. DESIGN MEDLINE, EMBASE, and the Cochrane Library were searched for studies on associations between glycemic index (GI), glycemic load (GL), dietary fiber or fiber supplements or whole grain intake, and high-sensitivity C-reactive protein (hsCRP) or interleukin 6 (IL-6). Included studies had to be conducted on adults (healthy, overweight, with type 2 diabetes or metabolic syndrome features, but without inflammatory disease) with ≥20 participants and a 3-wk duration. RESULTS In total, 22 of the 60 studies that met our inclusion criteria examined GI/GL: 5 of 9 observational studies reported lower concentrations of hsCRP or IL-6 among persons with a lower dietary GI/GL; 3 of 13 intervention studies showed significant antiinflammatory effects of a low-GI/GL diet, and 4 further studies suggested beneficial effects (trends or effects in a subgroup). For fiber intake, 13 of 16 observational studies reported an inverse relation with hsCRP or IL-6, but only 1 of 11 intervention studies showed a significant antiinflammatory effect of fiber intake, and a further trial reported a beneficial trend. For whole-grain intake, 6 of 7 observational studies observed an inverse association with inflammatory markers, but only 1 of 7 intervention studies reported significant antiinflammatory effects, 1 further study was suggestive (in a subgroup) of such, and another study found an adverse effect (trend only). CONCLUSIONS Evidence from intervention studies for antiinflammatory benefits is less consistent for higher-fiber or whole-grain diets than for low-GI/GL diets. Benefits of higher fiber and whole-grain intakes suggested by observational studies may reflect confounding.
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Glycemic load and chronic disease.
Brand-Miller, JC
Nutrition reviews. 2003;(5 Pt 2):S49-55
Abstract
The glycemic index (GI) has proven to be a useful nutritional concept, providing new insights into the relationship between foods and chronic disease. Observational studies suggest that diets with a high glycemic load (GI x carbohydrate content) are independently associated with increased risk of type 2 diabetes and cardiovascular disease. Postprandial hyperglycemia plays a direct pathogenic role in the disease process. Lower glucose and insulin levels are associated with improved risk profile, including high-density lipoprotein cholesterol, glycosylated proteins, oxidative status, hemostatic variables, and endothelial function. Limited evidence suggests that a low-GI diet may also protect against obesity, colon cancer, and breast cancer. Diets with a high glycemic load may affect health differently in insulin-resistant and insulin-sensitive individuals. Improvements in postprandial hyperglycemia can be brought about by manipulating either the type (i.e., GI) or amount of dietary carbohydrate, or both; at present, the GI appears to be more effective.