Dietary glycemic index and glycemic load are associated with high-density-lipoprotein cholesterol at baseline but not with increased risk of diabetes in the Whitehall II study2

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Abstract

Background: Findings of the effect of dietary glycemic index (GI) and glycemic load (GL) on the risk of incident diabetes are inconsistent.

Objective: We examined the associations of dietary GI and GL with clinical variables at baseline and the incidence of diabetes.

Design: The 7321 white Whitehall II participants (71% men) attending screening in 1991–1993, free of diabetes at baseline, and with food-frequency questionnaire data were followed for 13 y.

Results: At baseline, dietary GI and GL were associated inversely with HDL cholesterol, and GI was associated directly with triacylglycerols. Dietary GI and GL were related inversely to fasting glucose and directly to 2-h postload glucose, but only the association between GI and 2-h postload glucose was robust to statistical adjustments for employment grade, physical activity, smoking status, and intakes of alcohol, fiber, and carbohydrates. High-dietary GI was not associated with increased risk of incident diabetes. Hazard ratios (HRs) across sex-specific tertiles of dietary GI were 1.00, 0.95 (95% CI: 0.73, 1.24), and 0.94 (95% CI: 0.72, 1.22) (adjusted for sex, age, and energy misreporting; P for trend = 0.64). Corresponding HRs across tertiles of dietary GL were 1.00, 0.92 (95% CI: 0.71, 1.19), and 0.70 (95% CI: 0.54, 0.92) (P for trend = 0.01). The protective effect on diabetes risk remained significant after adjustment for employment grade, smoking, and alcohol intake but not after further adjustment for carbohydrate and fiber intakes.

Conclusion: The proposed protective effect of low-dietary GI and GL diets on diabetes risk could not be confirmed in this study.

Keywords:

Glycemic index
carbohydrate
diabetes
glycemia
lipids

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2

Supported by grants from the Medical Research Council; Economic and Social Research Council; British Heart Foundation; Health and Safety Executive; Department of Health; National Institutes of Health, National Heart, Lung, and Blood Institute (HL36310): National Institute on Aging (AG13196); NIH Agency for Health Care Policy Research (HS06516); and the John D and Catherine T MacArthur Foundation Research Networks on Successful Midlife Development and Socioeconomic Status and Health. MM is supported by a Medical Research Council (MRC) Research Professorship.