Skip to main content
×
×
Home

Meta-analysis of the health effects of using the glycaemic index in meal-planning

  • A. Maretha Opperman (a1), Christina S. Venter (a1), Welma Oosthuizen (a1), Rachel L. Thompson (a2) and Hester H. Vorster (a1)...
Abstract

Diabetes mellitus and CVD are some of the leading causes of mortality and morbidity. Accumulating data indicate that a diet characterised by low-glycaemic index (GI) foods may improve the management of diabetes or lipid profiles. The objective of the present meta-analysis was to critically analyse the scientific evidence that low-GI diets have beneficial effects on carbohydrate and lipid metabolism compared with high-GI diets. We searched for randomised controlled trials with a crossover or parallel design published in English between 1981 and 2003, investigating the effect of low-GI v. high-GI diets on markers for carbohydrate and lipid metabolism. Unstandardised differences in mean values were examined using the random effects model. The main outcomes were fructosamine, glycated Hb (HbA1c), HDL-cholesterol, LDL-cholesterol, total cholesterol and triacylglycerol. Literature searches identified sixteen studies that met the strict inclusion criteria. Low-GI diets significantly reduced fructosamine by –0·1 (95 % CI –0·20, 0·00) mmol/l (P=0·05), HbA1c by 0·27 (95 % CI –0·5, –0·03) % (P=0·03), total cholesterol by –0·33 (95 % CI –0·47, –0·18) mmol/l (P>0·0001) and tended to reduce LDL-cholesterol in type 2 diabetic subjects by –0·15 (95 % CI –0·31, –0·00) mmol/l (P=0·06) compared with high-GI diets. No changes were observed in HDL-cholesterol and triacylglycerol concentrations. No substantial heterogeneity was detected, suggesting that the effects of low-GI diets in these studies were uniform. Results of the present meta-analysis support the use of the GI as a scientifically based tool to enable selection of carbohydrate-containing foods to reduce total cholesterol and to improve overall metabolic control of diabetes.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Meta-analysis of the health effects of using the glycaemic index in meal-planning
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Meta-analysis of the health effects of using the glycaemic index in meal-planning
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Meta-analysis of the health effects of using the glycaemic index in meal-planning
      Available formats
      ×
Copyright
Corresponding author
*Corresponding author: fax + 27 18 299 2464, Email vgeamo@puknet.puk.ac.za
References
Hide All
Adult Treatment Panel III Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults. J Am Med Assoc (2001) 285, 24862498.
American Diabetes Association Nutrition recommendations and principles for people with diabetes mellitus. Diabetes Care (2001) 24, S44S47.
American Dietetic Association Medical nutrition therapy and pharmacotherapy – position of the ADA. J Am Diet Assoc (1999) 99, 227230.
Augustin, LS, Franceschi, S, Jenkins, DJAKendall, CWC, La Vecchia, CGlycemic index and chronic disease: a review. Eur J Clin Nutr (2002) 56, 10491071.
Balkau, B, Shipley, M, Jarret, RJPyorala, K, Forhan, A, Eschwege, EHigh blood glucose concentration is a risk factor for mortality in middle-aged nondiabetic men. 20-year follow-up in the Whitehall Study, the Paris Prospective Study, and the Helsinki Policemen Study. Diabetes Care (1998) 21, 360367.
Barakat, HA, Vadlamudi, S, Maclean, PMacdonald, K, Pories, WJLipoprotein metabolism in non-insulin dependent diabetes mellitus. J Nutr Biochem (1996) 7, 586598.
Bouche, C, Rizkalla, SW, Luo, JVidal, H, Veronese, A, Pacher, N, Fouquet, C, Lang, V, Slama, GFive week, low-glycemic index diets decreases total fat mass and improves plasma lipid profile in moderately overweight nondiabetic men. Diabetes Care (2002) 25, 822822.
Brand, JC, Colagiuri, S, Crossman, SAllen, A, Roberts, DCK, Truswell, ASLow-glycemic index foods improve long-term glycemic control in NIDDM. Diabetes Care (1991) 14, 95101.
Brand-Miller, J, Hayne, S, Petocz, PColagiuri, SLow-glycemic index diets in the management of diabetes. A meta-analysis of randomized controlled trials. Diabetes Care (2003) 26, 22612267.
Brand-Miller, J, Nantel, G, Slama, G, Lang, VGlycemic index and health:the quality of the evidence ParisJohn Libbey Eurotext (2001)
Brand-Miller, JC, Holt, SHA, Pawlak, DBMcMillan, JGlycaemic index and obesity. Am J Clin Nutr (2002) 76, 281S285SSuppl.
Brand-Miller, JCImportance of glycemic index in diabetes. Am J Clin Nutr (1994) 59, 747S752SSuppl.
Brussaard, JH, Katan, MB, Groot, PHEHavekes, LM, Hautvast, JGAJSerum lipoproteins of healthy persons fed a low-fat diet or a polyunsaturated fat diet for three months. Atherosclerosis (1982) 42, 205219.
Brynes, AE, Edwards, CM, Ghatei, MADornhorst, A, Morgan, LM, Bloom, SR & Frost, GRA randomised four-intervention crossover study investigating the effect of carbohydrates on daytime profiles of insulin, glucose, non-esterified fatty acids and triacylglycerols in middle-aged men. Br J Nutr (2003) 89, 207218.
Buyken, AE, Toeller, M, Heitkamp, GKaramaros, B, Rottiers, R, Muggeo, M & Fuller, JGlycemic index in the diet of European outpatients with type 1 diabetes: relations to glycated hemoglobin and serum lipids. Am J Clin Nutr (2001) 73, 574581.
Calle-Pascual, A, Gomez, V, Leon, EBordiu, EFoods with a low glycemic index do not improve glycemic control of both type 1 and type 2 diabetic patients after one month of therapy. Diabete Metab (1988) 14, 629633
Canadian Diabetes Association Guidelines for the nutritional management of diabetes mellitus in the new millennium. A position statement by the Canadian Diabetes Association. Can J Diabetes Care (2000) 23, 5669.
Castro Cabezas, M, Halkes, CJM, Meijssen, SVan Oostrom, AJHHM, Erkelens, DWDiurnal triglyceride profiles: a novel approach to study triglyceride changes. Atherosclerosis (2001) 155, 219228.
Clarke, M & Oxman, AD (2001) Analysing and presenting the results. In. Cochrane Reviewers Handbook 4.1.4 (updated October 2001), section 8, pp. 5978. The Cochrane Library, Oxford: Update Software.
Collier, G, Giudici, S, Kalmusky, JWolever, T, Helman, G, Wesson, V, Ehrlich, R, Jenkins, DLow glycaemic index starchy foods improve glucose control and lower serum cholesterol in diabetic children. Diabetes Nutr Metab (1988) 1, 1119.
Coulston, AM & Reaven, GMMuch ado about (almost) nothing. Diabetes Care (1997) 20, 241243.
Coutinho, M, Gerstein, HC, Wang, YYusuf, SFoods with a low glycemic index do not improve glycemic control of both type 1 and type 2 diabetic patients after one month of therapy. Diabete Metab (1999) 22, 233240
Defronzo, RA, Bonadonna, RC, Ferrannini, ELow-glycemic index diets in the management of diabetes. A meta-analysis of randomized controlled trials. Diabetes Care (1992) 13, 610630.
Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD) Recommendations for the nutritional management of patients with diabetes mellitus. Eur J Clin Nutr (2000) 54, 353355.
Diabetes, UK (2003) Diabetes in Practice. New Nutritional Guidelines http://www.diabetes.org.uk
Dietitians Association of Australia Glycaemic index in diabetes management. Aust J Nutr Diet (1997) 54, 5763.
Follmann, D, Elliott, P, Suh, ICutler, JVariance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol (1992) 45, 769773
Fontvielle, A, Acosta, M, Rizkalla, SBornet, F, David, P, Letanoux, M, Tchobroutsky, G, Slama, GA moderate switch from high to low glycaemic-index foods for 3 weeks improves the metabolic control of type I (IDDM) diabetic subjects. Diabetes Nutr Metab (1988) 1, 139143.
Fontvielle, A, Rizkalla, S, Penfornis, AAcosta, M, Bornet, F, Slama, GThe use of low glycaemic index foods improves metabolic control of diabetic patients over five weeks. Diabetic Med (1992) 9, 444450.
Food and Agricultural Organization/World Health Organization (1997) Carbohydrates in Human Nutrition – A Summary of the Joint FAO/WHO Expert Consultation. http://www.fao.org/docrep/w8079e/w8079e00.htm
Ford, ES & Liu, SGlycemic index and serum high-density lipoprotein cholesterol concentration among US adults. Arch Intern Med (2001) 161, 572576.
Frost, G, Keogh, B, Smith, BSmith, D, Akinsanya, K, Leeds, AGlycemic index in the diet of European outpatients with type 1 diabetes: relations to glycated hemoglobin and serum lipids. Am J Clin Nutr (1996) 46, 669672.
Frost, G, Leeds, A, Trew, GMargara, R, Dornhorst, AInsulin sensitivity in women at risk of coronary heart disease and the effect of a low glycemic diet. Metabolism (1998) 47, 12451251.
Frost, G, Leeds, AA, Dore, CJMadeiros, S, Brading, S, Dornhorst, AGlycaemic index as determinant of serum HDL-cholesterol concentration. Lancet (1999) 353, 10291030.
Frost, G, Wilding, J, Beecham, JDietary advice based on the glycaemic index improves dietary profile and metabolic control in type 2 diabetic patients. Diabet Med (1994) 11, 397401.
Garg, AInsulin resistance in the pathogenesis of dyslipidemia. Diabetes Care (1996) 19, 387389.
Gilbertson, H, Brand-Miller, J, Thorburn, AEvans, S, Chondros, P, Werhter, GThe effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes. Diabetes Care (2001) 24, 11371143.
Gilbertson, H, Thorburn, A, Brand-Miller, JChandros, P, Werhter, GEffect of low-glycemic-index dietary advice on dietary quality and food choice in children with type 1 diabetes. Am J Clin Nutr (2003) 77, 8390.
Granberry, MC & Fonseca, VAInsulin resistance syndrome: options for treatment. South Med J (1999) 92, 214.
Heilbronn, L, Noakes, M, Clifton, PThe effect of high- and low-glycemic index energy restricted diets on plasma lipid and glucose profiles in type 2 diabetic subjects with varying glycemic control. J Am Coll Nutr (2002) 21, 120127.
Higgins, PT, Thompson, SG, Deeks, JJAltman, DGMeasuring inconsistency in meta-analyses. Br Med J (2003) 327, 557560
Holt, SH, Brand-Miller, JC, Petocz, PAn insulin index of common foods: the insulin demand generated by 1000 kJ portions of common foods. Am J Clin Nutr (1997) 66, 12641276.
Jarvi, A, Karlstrom, B, Granfelt, YBjork, I, Asp, N, Vessby, BImproved glycaemic control and lipid profile and normalized fibrinolytic activity on a low-glycaemic index diet in type 2 diabetic patients. Diabetes Care (1999) 22, 1018.
Jenkins, D, Wolever, T, Buckley, GLow-glycemic-index starchy foods in the diabetic diet. Am J Clin Nutr (1988) 48, 248254.
Jenkins, DWolever, T, Collier, G, Ocana, A, Venketeshwer, A, Buckley, G, Lam, Y, Mayer, A, Thompson, LMetabolic effects of a low-glycemic-index diet. Am J Clin Nutr (1987 a) 46, 968975.
Jenkins, D, Wolever, T, Kalmusky, HLow glycemic index carbohydrate foods in the management of hyperlipidemia. Am J Clin Nutr (1985) 42, 604617.
Jenkins, D, Wolever, T, Kalmusky, HLow-glycemic index diet in hyperlipidemia: use of traditional starchy foods. Am J Clin Nutr (1987 b) 46, 6671.
Jenkins, DJWolever, TM, Taylor, RH, Barker, H, Fielden, H, Baldwin, JM, Bowling, AC, Newman, HC, Jenkins, AL, Goff, DVGlycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr (1981) 34, 362366.
Jenkins, DJA, Wolever, TMS, Jenkins, ALJosse, RG, Wong, GSThe glycaemic response to carbohydrate foods. Lancet (1984) 2, 388391.
Jones, IROwens, DR, Williams, S, Ryder, RE, Birtwell, AJ, Jones, MK, Gicheru, K, Hayes, TMGlycosylated serum albumin: an intermediate index of diabetic control. Diabetes Care (1983) 6, 501503.
Kabir, MOppert, J-M, Vidal, H, Bruzzo, F, Fiquet, C, Wursch, P, Slama, G, Rizkalla, SFour-week low-glycemic index breakfast with a modest amount of soluble fibres in type 2 diabetic men. Metabolism (2002) 51, 81826.
Kahn, CRInsulin action, diabetogenes, and the cause of type II diabetes. Diabetes (1994) 43, 10661084.
King, H, Aubert, RE, Herman, WHGlobal burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care (1998) 21, 14141431.
Kratz, A & Lewandrowski, KBNormal reference laboratory values. Case records of the Massachusetts General Hospital. N Engl J Med (1998) 339, 10631072.
Krauss, RM, Eckel, RH, Howard, BAHA dietary guidelines: revision: a statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation (2000) 102, 22842299.
Kumar, P, Clark, MClinical Medicine LondonW.B.Saunders (1998)
Lafrance, L, Rahasa-Lohret, R, Poisson, DDucros, F, Chiasson, J-LEffects of different glycaemic index foods and dietary fibre intake on glycaemic control in type 1 diabetic patients on intensive insulin therapy. Diabet Med (1998) 15, 972978.
Lindsey, CC, Carter, AW, Mangum, SGreene, D, Richardson, A, Brown, SA prospective, randomized, multi-centered controlled trial to compare the annual outcomes of patients with diabetes mellitus monitored with weekly fructosamine testing versus usual care: a 3-month interim analysis. Diabetes Technol Ther (2002) 4, 637642.
Liu, SIntake of refined carbohydrates and whole grain foods in relation to risk of type 2 diabetes mellitus and coronary heart disease. J Am Coll Nutr (2002) 21, 298306.
Ludwig, DSThe glycemic index. Physiological mechanisms relating to obesity, diabetes and cardiovascular disease. J Am Med Assoc (2002) 287, 24142423.
Ludwig, DS, Eckel, RH, Howard, BThe glycemic index at 20 y. Am J Clin Nutr (2002) 76, 264S265S.
Luscombe, N, Noakes, M, Clifton, PDiets high and low in glycemic index versus high monounsaturated fat diets: effects on glucose and lipid metabolism in NIDDM. Eur J Clin Nutr (1999) 53, 473478.
Nazir, DJ, Roberts, RS, Hill, SAMcQueen, MJMonthly intra-individual variation in lipids over a 1-year period in 22 normal subjects. Clin Biochem (1999) 5, 381389
Rizkalla, SW, Bellisle, F, Slama, GHealth benefits of low glycaemic index foods, such as pulses, in diabetic patients and healthy individuals. Br J Nutr (2002) 88, S255S262.
Salmeron, JManson, J, Stampfer, M, Colditz, G, Wing, A, Willet, WDietary fibre, glycemic load and risk of non-insulin-dependent diabetes mellitus in women. J Am Med Assoc (1997 a) 277, 472477.
Salmeron, JManson, JE, Stampfer, MJ, Colditz, GA, Wing, AL, Willet, WCDietary fibre, glycemic load and risk of NIDDM in men. Diabetes Care (1997 b) 20, 545550.
Seidell, JCObesity, insulin resistance and diabetes – a worldwide epidemic. Br J Nutr (2000) 83, 58.
Singer, DE, Nathan, DM, Anderson, KMWilson, PW, Evans, JCAssociation of HbA 1c with prevalent cardiovascular disease in the original cohort of the Framingham Heart Study. Diabetes (1992) 41, 202208.
Stratton, IMAdler, AI, Andrew, H, Neil, W, Matthews, DR, Manley, SE, Cull, CA, Hadden, D, Turner, RC, Holman, RRAssociation of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. Br Med J (2000) 321, 405412.
Timar, O, Sestier, F, Levy, EMetabolic syndrome X: a review. Can J Cardiol (2000) 16, 779789.
Tsihlias, EB, Gibbs, AL, McBurney, IWolever, TComparison of high- and low-glycemic-index breakfast cereals with monounsaturated fat in the long-term dietary management of type 2 diabetes. Am J Clin Nutr (2000) 72, 439449
UK Prospective Diabetes Study Group Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet (1998) 352, 837853.
Van Dam, RM, Visscher, AWJ, Feskens, EJMVerhoef, P, Kromhout, DDietary glycemic index in relation to metabolic risk factors and incidence of coronary heart disease: the Zutphen Elderly Study. Eur J Clin Nutr (2000) 54, 729731.
Van Horn, L, Ernst, N, Buckley, GA summary of the science supporting the new National Cholesterol Education Program dietary recommendations: what dietitians should know. J Am Diet Assoc (2001) 10, 11481154.
Vorster, HH, Oosthuizen, W, Jerling, JC, Veldman, FJ, Burger, HMThe Nutritional Status of South Africans. A Review of the Literature from 1975–1996 DurbanHealth Systems Trust (1997)
Vorster, HH, Venter, CS, Thompson, RLMargetts, BMEvidence-based nutrition – using a meta-analysis to review the literature. S Afr J Clin Nutr (2003) 16, 4348
Willet, W, Manson, J, Liu, SGlycemic index, glycemic load, and risk of type 2 diabetes. Am J Clin Nutr (2002) 76, 274S280SSuppl.
Wolever, TJenkins, D, Vuksan, V, Jenkins, A, Buckley, G, Wong, G, Josse, RBeneficial effect of a low glycemic index diet in type 2 diabetes. Diabet Med (1992 a) 9, 451458.
Wolever, TJenkins, D, Vuksan, V, Jenkins, A, Wong, G, Josse, RBeneficial effect of low-glycemic index diet in overweight NIDDM subjects. Diabetes Care (1992 b) 15, 562564.
Wolever, T & Mehling, CLong-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance. Am J Clin Nutr (2003) 77, 612621.
Wolever, TMSDietary carbohydrates and insulin action in humans. Br J Nutr (2000) 83, S97S102.
Wolever, TMSCarbohydrate and the regulation of blood glucose and metabolism. Nutr Rev (2003) 61, S40S48.
Wolever, TMS, Jenkins, DJA, Jenkins, ALJosse, RGThe glycemic index: methodology and clinical implications. Am J Clin Nutr (1991) 54, 846854
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 350 *
Loading metrics...

Abstract views

Total abstract views: 863 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 19th August 2018. This data will be updated every 24 hours.