Carbohydrate quality, glycemic index, glycemic load and cardiometabolic risks in the US, Europe and Asia: A dose-response meta-analysis.
Nutr Metab Cardiovasc Dis
; 30(6): 853-871, 2020 06 09.
Article
en En
| MEDLINE
| ID: mdl-32278608
BACKGROUND AND AIMS: Despite the proven evidence of high glycemic index (GI) and glycemic load (GL) diets to increase cardiometabolic risks, knowledge about the meta-evidence for carbohydrate quality within world geographic regions is limited. We conducted a meta-analysis to synthesize the evidence of GI/GL studies and carbohydrate quality, gathering additional exposures for carbohydrate, high glycemic carbohydrate, total dietary fiber, and cereal fiber and risks for type 2 diabetes (T2DM), coronary heart disease (CHD), stroke, and mortality, grouped into the US, Europe, and Asia. Secondary aims examined cardiometabolic risks in overweight/obese individuals, by sex, and dose-response dietary variable trends. METHODS AND RESULTS: 40-prospective observational studies from 4-Medline bibliographical databases (Ovid, PubMed, EBSCOhost, CINAHL) were search up to November 2019. Random-effects hazard ratios (HR) and 95% confidence intervals (CI) for highest vs. lowest categories and continuous form combined were reported. Heterogeneity (I2>50%) was frequent in US GI/GL studies due to differing study characteristics. Increased risks ((HRGI,T2DM,US=1.14;CI:1.06,1.21), HRGL,T2DM,US=1.02 (1.01, 1.03)), HRGI,T2DM,Asia=1.25;1.02,1.53), and HRGL,T2DM,Asia=1.37 (1.17, 1.60)) were associated with cardiometabolic diseases. GI/GL in overweight/obese females had the strongest magnitude of risks in US-and Asian studies. Total dietary fiber (HRT2DM,US = 0.92;0.88,0.96) and cereal fiber (HRT2DM,US = 0.83;0.77,0.90) decreased risk of developing T2DM. Among females, we found protective dose-response risks for total dietary fiber (HR5g-total-dietary-fiber,T2DM,US = 0.94;0.92,0.97), but cereal fiber showed better ability to lower T2DM risk (HR5g-cereal-fiber,T2DM,US = 0.67;0.60,0.74). Total dietary-and cereal fibers' dose-response effects were nullified by GL, but not so for cereal fiber with GI. CONCLUSIONS: Overweight/obese females could shift their carbohydrate intake for higher cereal fiber to decrease T2DM risk, but higher GL may cancel-out this effect.
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Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Glucemia
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Carbohidratos de la Dieta
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Enfermedad Coronaria
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Accidente Cerebrovascular
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Índice Glucémico
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Diabetes Mellitus Tipo 2
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Carga Glucémica
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
/
Systematic_reviews
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
America do norte
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Asia
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Europa
Idioma:
En
Revista:
Nutr Metab Cardiovasc Dis
Asunto de la revista:
ANGIOLOGIA
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CARDIOLOGIA
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CIENCIAS DA NUTRICAO
/
METABOLISMO
Año:
2020
Tipo del documento:
Article
Pais de publicación:
Países Bajos