Glycemic Index and Diabetes

For speed readers : Don't eat rice
I knew that already :)
Gys

Arch Intern Med. 2007;167(21):2304-2309.
Glycemic Index, Glycemic Load, and Cereal Fiber Intake and Risk of Type 2
Diabetes in US Black Women
Background
Previous studies of carbohydrate quality and risk of type 2 diabetes
mellitus have yielded inconsistent findings. Because diet is in part
culturally determined, a study of dietary factors in US black women is of
interest.
Methods
We used data from the Black Women's Health Study, a prospective cohort study
of 59 000 US black women, to examine the association of glycemic load,
glycemic index, and cereal fiber with risk of type 2 diabetes. Diet was
assessed at baseline in 1995 with a modified version of the National Cancer
Institute-Block food frequency questionnaire.
Results
During 8 years of follow-up, there were 1938 incident cases of diabetes. Cox
proportional hazards models were used to estimate incidence rate ratios
(IRRs) for quintiles of dietary factors, while controlling for lifestyle and
dietary factors. Glycemic index was positively associated with the risk of
diabetes: the IRR for the highest quintile relative to the lowest was 1.23
(95% confidence interval [CI], 1.05-1.44). Cereal fiber intake was inversely
associated with risk of diabetes, with an IRR of 0.82 (95% CI, 0.70-0.96)
for the highest vs lowest quintiles of intake. Stronger associations were
seen among women with a body mass index (calculated as weight in kilograms
divided by height in meters squared) lower than 25: IRRs for the highest vs
lowest quintile were 1.91 (95% CI, 1.16-3.16) for glycemic index (P value
for interaction, .12) and 0.41 (95% CI, 0.24-0.72) for cereal fiber intake
(P value for interaction, .05).
Conclusion
Increasing cereal fiber in the diet may be an effective means of reducing
the risk of type 2 diabetes, a disease that has reached epidemic proportions
in black women.

Arch Intern Med. 2007;167(21):2310-2316.
Prospective Study of Dietary Carbohydrates, Glycemic Index, Glycemic Load,
and Incidence of Type 2 Diabetes Mellitus in Middle-aged Chinese Women
Background
Much uncertainty exists about the role of dietary glycemic index and
glycemic load in the development of type 2 diabetes mellitus, especially in
populations that traditionally subsist on a diet high in carbohydrates.
Methods
We observed a cohort of 64 227 Chinese women with no history of diabetes or
other chronic disease at baseline for 4.6 years. In-person interviews were
conducted to collect data on dietary habits, physical activity, and other
relevant information using a validated questionnaire. Incident diabetes
cases were identified via in-person follow-up. Associations between dietary
carbohydrate intake, glycemic index, and glycemic load and diabetes
incidence were evaluated using multivariable Cox proportional hazards
models.
Results
We identified 1608 incident cases of type 2 diabetes mellitus in 297 755
person-years of follow-up. Dietary carbohydrate intake and consumption of
rice were positively associated with risk of developing type 2 diabetes
mellitus. The multivariable-adjusted estimates of relative risk comparing
the highest vs the lowest quintiles of intake were 1.28 (95% confidence
interval, 1.09-1.50) for carbohydrates and 1.78 (95% confidence interval,
1.48-2.15) for rice. The relative risk for increasing quintiles of intake
was 1.00, 1.04, 1.02, 1.09, and 1.21 (95% confidence interval, 1.03-1.43)
for dietary glycemic index and 1.00, 1.06, 0.97, 1.23, and 1.34 (95%
confidence interval, 1.13-1.58) for dietary glycemic load.
Conclusion
High intake of foods with a high glycemic index and glycemic load,
especially rice, the main carbohydrate-contributing food in this population,
may increase the risk of type 2 diabetes mellitus in Chinese women.

hth
Gys


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