Associations between dietary glycemic and insulinemic patterns and eating behavior in adults: a cluster-based
Elif Ulug1,2, Nesli Ersoy1, Aylin Acikgoz Pinar3
1Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Türkiye.
Background:
Although eating behavior may be influenced by the type and amount of carbohydrates and insulin-stimulating nutrients consumed, studies specifically addressing these dietary characteristics in relation to eating behavior are extremely limited. Therefore, the purpose of this study was to investigate the connections between different aspects of adult eating behavior and dietary glycemic and insulinemic indices.
Methods:
A total of 561 healthy adults aged 19-64 years were assessed in this study. Dietary intake was evaluated with a semiquantitative food frequency questionnaire, and glycemic index (GI), glycemic load (GL), insulin index (II), and insulin load (IL) were calculated. Participants were categorized into three clusters based on their dietary glycemic parameters (GI, GL, and carbohydrate intake) and separately into three clusters based on insulinemic parameters (II, IL, and energy intake) using k-means clustering. The body weight, height, waist and hip circumference were measured. Eating behavior was evaluated using the Three-Factor Eating Questionnaire-Revised 18 (TFEQ-R18) and the Food Cravings Questionnaire-Trait (FCQ-T).
Results:
The mean BMI was significantly lower in Cluster I, whereas waist and hip circumference did not differ across glycemic clusters. For insulinemic clusters, Cluster III had the highest BMI, waist and hip circumference (p < 0.05). Participants in the high-GL cluster exhibited significantly higher emotional and uncontrolled eating scores, along with greater susceptibility to food-related cues, negative emotions, and guilt (p < 0.05). Similarly, individuals in the high-IL cluster reported elevated scores in emotional and uncontrolled eating and food craving subscales related to positive and negative reinforcement, emotional triggers, and loss of control (p < 0.05). In contrast, both in low GI/GL and in low-II/IL clusters displayed more favorable eating behavioral patterns. These associations remained significant after adjusting for confounders (age, gender, BMI, and waist circumference).
Conclusion:
Increased food cravings and maladaptive eating patterns are associated with diets that have higher glycemic or insulin loads. Beyond merely controlling energy intake, dietary interventions that are self-regarding glycemic and insulinemic properties may improve behavioral regulation of eating.
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