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Glycemic index and glycemic load are associated with some cardiovascular risk factors among the PREMIER study
Pao-Hwa Lin1, Chuhe Chen, Deborah R Young
1Department of Medicine, Nephrology Division, Duke University Medical Center, Durham, NC, USA.
Insights
Glycemic index (GI) and glycemic load (GL) show associations with total cholesterol and LDL-C, particularly in older adults. These findings highlight the clinical impact of dietary carbohydrate quality on cardiovascular disease risk factors.
Area of Science:
- Nutrition Science
- Cardiovascular Health
- Dietary Interventions
Background:
- The clinical significance of glycemic index (GI) and glycemic load (GL) in relation to cardiovascular disease (CVD) risk factors remains inconclusive.
- Dietary Approaches to Stop Hypertension (DASH) intervention aims to reduce blood pressure (BP) through lifestyle modifications.
Purpose of the Study:
- To examine the association between GI and GL with clinical CVD risk factors over time.
- To assess changes in body weight, BP, serum lipids, fasting glucose, insulin, and homocysteine in relation to GI and GL.
Main Methods:
- An 18-month randomized lifestyle intervention trial (PREMIER) involving 756 participants.
- GI and GL were estimated from 24-hour dietary recalls at baseline, 6, and 18 months.
- Mixed-effects models analyzed the association of changes in GI/GL with changes in CVD risk factors, considering age interactions.
Main Results:
- Neither GI nor GL changes were associated with risk factors at 6 months.
- At 18 months, GI changes positively correlated with total cholesterol (TC) changes (p<0.05).
- GL changes positively correlated with TC and negatively with LDL-C, with significant age interactions for both.
Conclusions:
- GI and GL are associated with TC and LDL-C, independent of energy, fat, and fiber intake.
- These associations are modified by age, suggesting a greater impact in older individuals.
- Further research is warranted due to the potential clinical implications for cardiovascular health.
Background:
The clinical significance of glycemic index (GI) and glycemic load (GL) is inconclusive.
Objective:
This study was conducted to examine the association of GI and GL with clinical cardiovascular disease (CVD) risk factors including body weight, blood pressure (BP), serum lipids, fasting glucose, insulin and homocysteine over time among the PREMIER participants.
Design:
PREMIER was an 18-month randomized lifestyle intervention trial, conducted from 2000 to 2002, designed to help participants reduce BP by following the Dietary Approaches to Stop Hypertension (DASH) dietary pattern, losing weight, reducing sodium and increasing physical activity. GI and GL were estimated from 24 h diet recall data at baseline, 6 and 18 months after intervention. PROC MIXED model was used to examine the association of changes in GI or GL with changes in CVD risk factors.
Results:
A total of 756 randomized participants, 62% females and 34% African Americans and who averaged 50.0±0.3 years old and 95.3±0.7 kg, were included in this report. Neither GI nor GL changes was associated with changes in any risk factors at 6 months. At 18 months, however, the GI change was significantly and positively associated with total cholesterol (TC) change only (p<0.05, β=23.80±12.11 mg/dL or 0.62±0.31 mmol/L) with a significant age interaction. The GL change was significantly associated with TC (p=0.02, β=0.28±0.15 mg/dL or 0.01±0.00 mmol/L) positively and with low density lipoprotein cholesterol (LDL-C) changes negatively (p=0.03, β=-0.01±0.00 mg/dL or -0.00±0.00 mmol/L), and significant age interactions were observed for both.
Conclusions:
GI and GL was associated with TC and LDL-C after controlling for energy, fat and fiber intake and other potential confounders and the associations were modified by age. Further investigation into this relationship is important because of its potential clinical impact.
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