Carbohydrate quantity and quality and cardio-metabolic risk

This review highlights the recent research on the effects of dietary carbohydrate (CHO) content and quality in body weight control, glucose homeostasis and cardiovascular risk.

There is some evidence for a role of CHO content and glycemic index in long-term weight control. Prospective cohort studies show that a high glycemic index and a high glycemic load diet increase the risk for diabetes. A controlled short-term feeding study indicates that the glycemic index is less important in insulin sensitivity and cardio-metabolic risk in the context of an overall healthy diet in high-risk individuals. In one of the few dietary intervention studies, taken cardiovascular disease as outcome, it has been shown that a Mediterranean diet reduced the incidence of cardiovascular events in individuals at increased risk.

Overall, energy restriction is the primary factor producing weight loss, and it is increasingly understood that distinct macronutrients may vary in energy yield and effects on satiety, also based on individuals' phenotype and genotype. Although an overall healthy diet, either Mediterranean or a low-fat, high-complex CHO diet may be effective in diabetes and cardiovascular prevention, insight is increasing that dietary prevention or treatment may require more personalized approaches to become most effective.