Effects of low- and high-glycemic index/glycemic load diets on coronary heart disease risk factors in overweight/obese men. Dietary fiber, glycemic index, glycemic load and renal cell carcinoma risk. Association between dietary glycemic index, glycemic load, and high-sensitivity C-reactive protein. Glycemic Index and Glycemic Load and Their Association with C-Reactive Protein and Incident Type 2 Diabetes Relation of dietary glycemic index, glycemic load, added sugar intake, or fiber intake to the development of body composition between ages 2 and 7 y. Dietary fiber, whole grains, carbohydrate, glycemic index, and glycemic load in relation to risk of prostate cancer Glycemic index, glycemic load and invasive breast cancer incidence in postmenopausal women: The PREDIMED study Continuous glucose monitoring to assess the ecologic validity of dietary glycemic index and glycemic load. 
The effect of consumption of low-glycemic-index and low-glycemic-load desserts on anthropometric parameters and inflammatory markers in patients with type 2 diabetes mellitus Glycemic index and glycemic load are associated with some cardiovascular risk factors among the PREMIER study participants A low-glycemic index diet in the treatment of pediatric obesity. Dietary glycemic index, glycemic load, and cancer risk: results from the EPIC-Italy study Dietary micronutrient intake during pregnancy is a function of carbohydrate quality. Glycemic load, glycemic index, and pancreatic cancer risk in the Netherlands Cohort Study. Dietary fiber and the glycemic index: a background paper for the Nordic Nutrition Recommendations 2012 Low Glycemic Load Experimental Diet More Satiating Than High Glycemic Load Diet Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Glycemic Index, Glycemic Load and Mammographic Breast Density: The EPIC Florence Longitudinal Study A randomized controlled trial to investigate the impact of a low glycemic index (GI) diet on body mass index in obese adolescents Glycemic index, glycemic load, and pancreatic cancer risk (Canada) A reduced-glycemic load diet in the treatment of adolescent obesity. Dietary Determinants of Changes in Waist Circumference Adjusted for Body Mass Index – a Proxy Measure of Visceral Adiposity Effects of hypocaloric diets with different glycemic indexes on endothelial function and glycemic variability in overweight and in obese adult patients at increased cardiovascular risk.
Chronic insulin resistance contributes to sub clinical inflammation , thrombosis/impaired fibrinolysis , and dyslipidemia . The effect of dietary carbohydrate , specifically of glycemic index ( GI ) and glycemic load ( GL ) , on established and emerging coronary heart disease risk factors has not been eluci date d fully . We conducted a r and omized crossover feeding study of matched diets differing only in GI and GL in 24 overweight or obese but otherwise healthy men to investigate the effects on insulin sensitivity , inflammation , thrombosis/fibrinolysis , lipoproteins/lipids , and body composition .  All meals for the high- and low-GI/GL diets were prepared in a metabolic kitchen . Each participant consumed both diets in r and om order for 4 weeks each , with a 4-week washout period in between . Each participant underwent a frequently sample d intravenous glucose tolerance test for assessment of insulin sensitivity ; blood sampling for the measurement of inflammatory markers , coagulation factors , and lipoproteins/lipids ; and dual-energy x-ray absorptiometry for assessment of body composition at the beginning and end of each dietary period . There were no statistically significant differences in glucose metabolism factors , inflammatory markers , or coagulation factors after 4 weeks on the high- and low-GI/GL diets . The high-GI/GL diet result ed in a slightly greater reduction in fat mass and a slightly greater increase in lean mass compared with the low-GI/GL diet . The high-GI/GL diet result ed in significant , but unexpected , reductions in total and low-density lipoprotein cholesterol , whereas high-density lipoprotein cholesterol concentration was significantly reduced on the high-GI/GL diet compared with the low-GI/GL diet . Overall , high- and low-GI/GL diets of 4 weeks ' duration had no consistent effects on coronary heart disease risk factors in this group of overweight/obese men Several epidemiological studies have investigated the potential association between dietary fiber , glycemic index ( GI ) or glycemic load ( GL ) , and renal cell carcinoma ( RCC ) risk with inconsistent results . The aim of this study was to systematic ally evaluate this issue with a meta- analysis approach . A comprehensive literature search up to March 2018 was performed in PubMed and Web of Science data bases . Summary relative risks ( RRs ) and 95 % confidence intervals ( CIs ) were estimated with a r and om-effects model . Twelve studies were finally included in this study ( eight for fiber analysis , five for GI and five for GL ) . A significant positive association was observed between GI and the risk of RCC ( summary RR 1.16 , 95 % CI 1.02 - 1.32 ) , and no significant heterogeneity was detected among studies ( I2 = 22.8 % , P = 0.262 ) . A significant inverse association was found between fiber intake and the risk of RCC ( summary RR 0.82 , 95 % CI 0.72 - 0.92 ) , and no significant heterogeneity was observed across studies ( I2 = 27.6 % , P = 0.218 ) . GL was not significantly associated with RCC risk ( summary RR 1.14 , 95 % CI 0.81 - 1.60 ) , and significant heterogeneity was found across studies ( I2 = 78.6 % , P < 0.001 ) . In conclusion , this systematic review and meta- analysis suggests that dietary GI and fiber may be associated with the risk of RCC . Further large prospect i ve cohort studies are still warranted to confirm our preliminary findings OBJECTIVE This study examined the relation between quality of dietary carbohydrate intake , as measured by glycemic index ( GI ) and glycemic load ( GL ) , and serum high-sensitivity C-reactive protein ( hs-CRP ) levels . METHODS During a 1-y observational study , data were collected at baseline and at each quarter thereafter . GI and GL were calculated from multiple 24-h dietary recalls ( 24HRs ) , 3 r and omly selected 24HRs at every quarter , with up to 15 24HRs per participant . The  hs-CRP was measured in blood sample s collected at baseline and each of the four quarterly measurement points . Multivariable linear mixed models were used to examine the cross-sectional and longitudinal associations of GI , GL , and hs-CRP . RESULTS Among 582 adult men and women with at least two measurements of diet and hs-CRP , average daily GI score ( white bread = 100 ) was 85 and average GL was 198 , and average hs-CRP was 1.84 mg/L. Overall , there was no association between GI or GL and hs-CRP . Subgroup analyses revealed an inverse association between GL and hs-CRP  among obese individuals ( body mass index > or = 30 kg/m(2 ) ) . CONCLUSION Quality of dietary carbohydrates does not appear to be associated with serum hs-CRP levels .  Among obese individuals , higher dietary GL appears to be related to lower hs-CRP levels . Due to the limited number of studies on this topic and their conflicting results , further investigation is warranted Objective . To investigate whether the Glycemic Index ( GI ) or Glycemic Load ( GL ) of a diet is associated with C-reactive Protein ( CRP ) and risk of type 2 diabetes  in a prospect i ve study . Material s and Methods . Our analysis included 4,366 participants who did not have diabetes at baseline . During follow-up 456 diabetes cases were confirmed . Dietary GI and GL were derived from a food-frequency question naire and its association with CRP was examined cross-sectionally using linear regression models . The association of GI and GL with diabetes incidence was examined using Cox proportional hazard models . Results . GL , but not GI , was associated with lnCRP at baseline ( b GL = 0.11 per 50 units ; P = .01 ) . When comparing the highest to the lowest tertile of GI with respect to diabetes incidence , a Relative Risk ( RR ) of 0.95 [ 95%CI 0.75 , 1.21 ] was found after adjustment for lifestyle and nutritional factors . For GL the RR for diabetes incidence was 1.00 [ 95%CI 0.74 , 1.36 ] . Additional adjustment for CRP did not change RRs . Conclusion . Since GI was not associated with CRP and risk of type 2 diabetes , it is unlikely that a high GI diet induces the previously shown positive association between CRP and risk of type 2 diabetes by increasing CRP concentrations BACKGROUND Observational studies in adults suggest that a diet with a high glycemic index ( GI ) or glycemic load ( GL ) , a high intake of sugary foods , or a low fiber intake may increase the risk of overweight . OBJECTIVES We aim ed to examine prospect ively whether dietary GI , GL , added sugar intake , or fiber intake between age 2 and 7 y are associated with the development of body composition . If so , we aim ed to ascertain whether these associations are modified by meal frequency . DESIGN Linear mixed-effect regression analyses were performed in 380 participants of the DOrtmund Nutrition and Anthropometric Longitudinally Design ed ( DONALD ) Study for whom 4 - 6 weighed 3-d dietary records and anthropometric data were obtained between ages 2 and 7 y. RESULTS Changes in dietary GI , GL , or added sugar intake between ages 2 and 7 y were not associated with concurrent changes in percentage body fat ( % BF , as estimated from skinfold thicknesses ) or body mass index SD scores . An increase in fiber intake was related to a concurrent decrease in % BF between ages 2 and 7 y only in children who consumed < 6 meals/d as toddlers ( beta + /- SE from fully adjusted model : -0.26 + /- 0.09%BF per 1-SD increase in fiber intake , P = 0.005 ) , whereas children with a higher meal frequency had no concurrent change ( 0.07 + /- 0.07%BF per 1-SD increase in fiber intake , P = 0.3 ) . CONCLUSIONS Dietary GI , GL , or added sugar intake between ages 2 and 7 y does not appear to influence the development of body composition . Potential benefits associated with increasing fiber intake throughout childhood may be limited to toddlers with a lower meal frequency Background The relationships between dietary fiber , whole grains , carbohydrate , glycemic index ( GI ) , glycemic load ( GL ) , and prostate cancer risk are unclear . We conducted a systematic review and meta- analysis to investigate these associations . Methods Relevant studies were identified by a search of PubMed data base and EMBASE data base up to April 2015 . A r and om effects model was used to calculate the summary relative risks ( RRs ) and their corresponding 95 % confidence intervals ( CIs ) . Results Twenty-seven epidemiological studies ( 18 case – control studies and nine cohort studies ) were included in the final analysis .  The pooled RRs of prostate cancer were 0.94 ( 95 % CI 0.85–1.05 , P=0.285 ) , 1.13 ( 95 % CI 0.98–1.30 , P=0.095 ) , 0.96 ( 95 % CI 0.81–1.14 , P=0.672 ) , 1.06 ( 95 % CI 0.96–1.18 , P=0.254 ) , and 1.04 ( 95 % CI 0.91–1.18 , P=0.590 ) for dietary fiber , whole grains , carbohydrate , GI , and GL , respectively . There was no evidence of significant publication bias based on the Begg ’s test and Egger ’s test . Conclusion The findings of this meta- analysis indicate that , based on available information , dietary fiber , whole grains , carbohydrate , GI , and GL are not associated with the risk of prostate cancer The objective of this study was to evaluate the prospect i ve associations between dietary glycemic index ( GI ) and glycemic load ( GL ) and the risk for invasive breast cancer incidence  in postmenopausal women at high cardiovascular disease ( CVD ) risk . This study was conducted within the framework of the PREvención con DIeta MEDiterránea ( PREDIMED ) study , a nutritional intervention trial for primary cardiovascular prevention . We included 4010 women aged between 60 and 80 years who were initially free from breast cancer but at high risk for CVD disease .  Dietary information was collected using a vali date d 137-item food frequency question naire . We assigned GI values using the International Tables of GI and GL values . Cases were ascertained through yearly consultation of medical records and through consultation of the National Death Index . Only cases confirmed by results from cytology tests or histological evaluation were included . We estimated multivariable-adjusted hazard ratios for invasive breast cancer risk across tertiles of energy-adjusted dietary GI/GL using Cox regression models . We repeated our analyses using yearly repeated measures of GI/GL intakes . No associations were found between baseline dietary GI/GL and invasive breast cancer incidence . The multivariable hazard ratio and 95 % confidence interval ( CI ) for the top tertile of dietary GI was 1.02 ( 95 % CI : 0.42–2.46 ) and for dietary GL was 1.00 ( 95 % CI : 0.44–2.30 ) when compared with the bottom tertile . Repeated- measures analyses yielded similar results . In sensitivity analyses , no significant associations were observed for women with obesity or diabetes . Dietary GI and GL did not appear to be associated with an increased risk for invasive breast cancer in postmenopausal women at high CVD risk BACKGROUND The circumstances under which the glycemic index ( GI ) and glycemic load ( GL ) are derived do not reflect real-world eating behavior . Thus , the ecologic validity of these constructs is incompletely known . OBJECTIVE This study examined the relation of  dietary intake to glycemic response when foods are consumed under free-living conditions . DESIGN Participants were 26 overweight or obese adults with type 2 diabetes who participated in a r and omized trial of lifestyle modification . The current study includes baseline data , before initiation of the intervention . Participants wore a continuous glucose monitor and simultaneously kept a food diary for 3 d. The dietary  variables  included  GI , GL , and intakes of energy , fat , protein , carbohydrate , sugars , and fiber .  The glycemic response variables included AUC , mean and SD of continuous glucose monitoring ( CGM ) values , percentage of CGM values in euglycemic and hyperglycemic ranges , and mean amplitude of glycemic excursions . Relations between daily dietary intake and glycemic outcomes were examined . RESULTS Data were available from 41 d of monitoring . Partial correlations , controlled for energy intake , indicated that GI or GL was significantly associated with each glycemic response outcome . In multivariate analyses , dietary GI accounted for 10 % to 18 % of the variance in each glycemic variable , independent of energy and carbohydrate intakes ( P < 0.01 ) . CONCLUSIONS The data support the ecologic validity of the GI and GL constructs in free-living obese adults with type 2 diabetes . GI was the strongest and most consistent independent predictor of glycemic stability and variability Abstract Purpose The aim of the present study was to examine the effects of consumption of desserts with low glycemic index ( GI ) and low glycemic load ( GL ) , as part of a balanced hypo-caloric diet , on anthropometric and biochemical parameters in patients with type 2 diabetes mellitus ( T2DM ) . Methods A total of 61 subjects with T2DM were r and omly assigned to the intervention ( n = 30 ) or to the control group ( n = 31 ) . Both groups followed the same hypo-caloric ( −500 kcal ) diet for 12 weeks . Consumption of four portions of low-GI/low-GL desserts/week was included in the diet in the intervention group while one portion of a favorite usual sweet/week was allowed to be consumed in the control group . Results Thirty subjects in the control and 28 subjects in the intervention group completed the trial . Body weight , body mass index , and waist circumference were reduced significantly in both groups . Arterial blood pressure , fasting blood glucose , glycosylated hemoglobin , insulin , and γ-GT were reduced significantly only in the intervention group ; however , there were no significant differences between the two groups at endpoint . C-reactive protein was reduced in the intervention , and HDL cholesterol was also reduced in the control group ; the reductions were significantly different at the end of the trial . No significant changes were observed in the other plasma lipids , uric acid , leptin , adiponectin , and interleukin-6 in either study group . Conclusions Consumption of desserts with low GI/GL in a balanced hypo-caloric diet has a positive impact on anthropometric and metabolic parameters of patients with T2DM 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 r and omized lifestyle intervention trial , conducted from 2000 to 2002 , design ed 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 r and omized 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 CONTEXT Conventional dietary approaches for the treatment of obesity have generally yielded disappointing results . OBJECTIVE To examine the effects of a low-glycemic index ( GI ) diet compared with a st and ard reduced-fat diet in the management of pediatric obesity . DESIGN Retrospective cohort study of children attending an outpatient pediatric obesity program from September 1997 to December 1998 . SETTING Academic medical center . PARTICIPANTS One hundred seven obese but otherwise healthy children . MAIN OUTCOME MEASURES Changes in body mass index ( BMI [ calculated as weight in kilograms divided by the square of height in meters ] ) and body weight from first to last clinic visit . RESULTS A total of 64 patients received the low glycemic index diet and 43 received the reduced-fat diet for 4.3 vs 4.2 months ' mean duration of follow-up , with 3.3 vs 3.3 mean number of visits , respectively . Body mass index ( -1.53 kg/m(2 ) [ 95 % confidence interval , -1.94 to -1.12 ] vs -0.06 kg/m(2 ) [ -0.56 to + 0 . 44 ] , P<.001 ) and body weight ( -2.03 kg [ 95 % confidence interval -3 . 19 to -0.88 ] vs + 1.31 kg [ -0.11 to + 2.72 ] , P<.001 ) decreased more in the low-GI group compared with the reduced-fat group . In multivariate models , these differences remained significant ( P<.01 ) after adjustment for age , sex , ethnicity , BMI or baseline weight , participation in behavioral modification sessions , and treatment duration . Significantly more patients in the low-GI group experienced a decrease in BMI of at least 3 kg/m(2 ) ( 11 kg/m(2 ) [ 17 . 2 % ] vs. 1 kg/m(2 ) [ 2.3 % ] , P = .03 ) . CONCLUSIONS A low-GI diet seems to be a promising alternative to st and ard dietary treatment for obesity in children . Long-term r and omized controlled trials of a low-GI diet in the prevention and treatment of obesity are needed Factors linked to glucose metabolism are involved in the etiology of several cancers . High glycemic index ( GI ) or high glycemic load ( GL ) diets , which chronically raise postpr and ial blood glucose , may increase cancer risk by affecting insulin-like growth factor . We prospect ively investigated cancer risk and dietary GI/GL in the EPIC-Italy cohort . After a median 14.9 years , 5112 incident cancers and 2460 deaths were identified among 45,148 recruited adults . High GI was associated with increased risk of colon and bladder cancer . High GL was associated with : increased risk of colon cancer ; increased risk of diabetes-related cancers ; and decreased risk of rectal cancer . High intake of carbohydrate from high GI foods was significantly associated with increased risk of colon and diabetes-related cancers , but decreased risk of stomach cancer ; whereas high intake of carbohydrates from low GI foods was associated with reduced colon cancer risk . In a Mediterranean population with high and varied carbohydrate intake , carbohydrates that strongly raise postpr and ial blood glucose may increase colon and bladder cancer risk , while the quantity of carbohydrate consumed may be involved in diabetes-related cancers . Further studies are needed to confirm the opposing effects of high dietary GL on risks of colon and rectal cancers BACKGROUND Despite normal gestational weight gain , dietary studies in pregnant women show intakes below the recommendations for energy and micronutrients . OBJECTIVE This study compared changes in dietary intake from the second to third trimester with emphasis on energy intake and carbohydrate quality . DESIGN These post hoc analyses were based on 566 women participating in the Pregnancy and Glycemic Index Outcomes study , a r and omized controlled trial comparing the effect of low-glycemic index ( GI ) dietary advice with healthy eating advice on selected pregnancy outcomes . With the use of multilevel mixed-regression analysis , changes in total energy intake , starch , sugar , fiber intake , GI , and glycemic load ( GL ) were correlated with intake of different micronutrients . RESULTS Energy intake decreased in the third trimester , and most women did not meet the national recommended amounts for iron , folate , and dietary fiber from food sources alone . After adjustment for age , ethnicity , prepregnancy body mass index , and intervention group , change in energy intake was positively related to change in intake of all micronutrients ( P < 0.001 ) . GI , GL , and starch intake were inversely related to micronutrient intake ( P < 0.001 ) , whereas higher total sugars predicted higher intake ( P < 0.001 ) . Associations with dietary fiber were inconsistent . CONCLUSIONS Normal pregnancy can be associated with a decline in energy and micronutrient intake from diet . Low dietary GI and GL were the best predictors of a favorable micronutrient profile . This trial was registered at www.anzctr.org.au as ACTRN12610000174088 BACKGROUND Recent studies of pancreatic cancer suggest a role for hyperinsulinemia in carcinogenesis . Because insulin is secreted in response to elevated blood glucose concentrations , dietary factors that increase these concentrations may be important in pancreatic carcinogenesis . OBJECTIVE The objective was to examine prospect ively the relation between pancreatic cancer risk and dietary glycemic load ( GL ) , overall glycemic index ( GI ) , and intake of total carbohydrates and mono- and disaccharides . DESIGN The Netherl and s Cohort Study consisted of 120,852 men and women who completed a baseline question naire in 1986 . After 13.3 y of follow-up , 408 pancreatic cancer cases were detected , 66 % of which were microscopically confirmed . A vali date d 150-item food-frequency question naire , completed at baseline , was used to calculate carbohydrate and mono- and disaccharide intakes and the GL and GI of the diet . RESULTS Dietary GL , GI , or intake of carbohydrates and mono- and disaccharides were not associated with pancreatic cancer risk in this cohort . Also , the associations were not modified by sex . Our results did not change after the analysis was restricted to microscopically confirmed pancreatic cancer cases or after individuals who reported a history of diabetes at baseline were excluded from the analyses . CONCLUSIONS Overall , our findings do not support the hypothesis that GL , GI , or intake of carbohydrates and mono- and disaccharides are positively associated with pancreatic cancer risk . This is in agreement with previous prospect i ve studies that investigated the relation between GL and GI and pancreatic cancer risk The aim of this study is to review recent data on dietary fiber ( DF ) and the glycemic index ( GI ) , with special focus on studies from the Nordic countries regarding cardiometabolic risk factors , type 2 diabetes , cardiovascular disease , cancer , and total mortality . In this study , recent guidelines and scientific background papers or up date s on older reports on DF and GI published between 2000 and 2011 from the US , EU , WHO , and the World Cancer Research Fund were review ed , as well as prospect i ve cohort and intervention studies carried out in the Nordic countries . All of the reports support the role for fiber-rich foods and DF as an important part of a healthy diet . All of the five identified Nordic papers found protective associations between high intake of DF and health outcomes ; lower risk of cardiovascular disease , type 2 diabetes , colorectal and breast cancer . None of the reports and few of the Nordic papers found clear evidence for the GI in prevention of risk factors or diseases in healthy population s , although association was found in sub-groups , e.g. overweight and obese individuals and suggestive for prevention of type 2 diabetes . It was concluded that DF is associated with decreased risk of different chronic diseases and metabolic conditions . There is not enough evidence that choosing foods with low GI will decrease the risk of chronic diseases in the population overall . However , there is suggestive evidence that ranking food based on their GI might be of use for overweight and obese individuals . Issues regarding methodology , validity and practicality of the GI remain to be clarified Effective strategies for reducing food intake are needed to reduce risk of obesity-related cancers . We investigated the effect of low and high glycemic load ( GL ) diets on satiety and whether satiety varied by body mass index ( BMI ) , gender , and serum leptin . Eighty normal weight ( BMI = 18.5–24.9 kg/m2 ) and overweight/ obese ( BMI = 28.0–40.0 kg/m2 ) adults participated in a r and omized , crossover controlled feeding study testing low GL vs. high GL diets . The 28-day diets were isocaloric with identical macronutrient distributions , differing only in GL and fiber . Participants completed visual analog satiety surveys and fasting serum leptin after each 28-day period . T-tests compared mean within- and between-person satiety scores and leptin values . Participants reported 7 % greater satiation on the low GL vs. the high GL diet ( P = 0.03 ) and fewer food cravings on the low GL vs. the high GL diet ( P < 0.001 ) . Compared to males , females reported less hunger ( P = 0.05 ) and more satiety on the low GL vs. the high GL diet ( P < 0.01 ) . Participants with low body fat ( < 25.0 % for men ; < 32.0 % for women ) and BMI < 25.0 kg/m2 reported study food was tastier on the low GL vs. the high GL diet ( P = 0.04 and P = 0.05 , respectively ) . In summary , reducing GL , and /or increasing fiber , may be an effective way to lower calories consumed , improve energy balance , and ultimately reduce cancer risk BACKGROUND The glycemic potential of a diet is associated with chronically elevated insulin concentrations , which may augment breast cancer ( BC ) risk by stimulating insulin receptor or by affecting insulin-like growth factor I (IGF-I)-mediated mitogenesis . It is unclear whether this effect differs by BC phenotype . OBJECTIVE The objective was to investigate the relation between glycemic index ( GI ) , glycemic load ( GL ) , and total carbohydrate intake with BC by using data from the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) . DESIGN We identified 11,576 women with invasive BC among 334,849 EPIC women aged 34 - 66 y ( 5th to 95th percentiles ) at baseline over a median follow-up of 11.5 y.  Dietary GI and GL were calculated from country-specific dietary question naires . We used multivariable Cox proportional hazards models to quantify the association between GI , GL , and carbohydrate intake and BC risk . BC tumors were classified by receptor status . RESULTS Overall GI , GL , and carbohydrates were not related to BC . Among postmenopausal women , GL and carbohy date intake were significantly associated with an increased risk of estrogen receptor-negative ( ER(- ) ) BC when extreme quintiles ( Q ) were compared [ multivariable HR(Q5-Q1 ) ( 95 % CI ) = 1.36 ( 1.02 , 1.82 ; P-trend = 0.010 ) and HR(Q5-Q1 ) = 1.41 ( 1.05 , 1.89 ; P-trend = 0.009 ) , respectively ] . Further stratification by progesterone receptor ( PR ) status showed slightly stronger associations with ER(-)/PR(- ) BC [ HR(Q5-Q1 ) ( 95 % CI ) = 1.48 ( 1.07 , 2.05 ; P-trend = 0.010 ) for GL and HR(Q5-Q1 ) = 1.62 ( 1.15 , 2.30 ; P-trend = 0.005 ) for carbohydrates ] . No significant association with ER-positive BC was observed . CONCLUSION Our results indicate that a diet with a high GL and carbohydrate intake is positively associated with an increased risk of developing ER(- ) and ER(-)/PR(- ) BC among postmenopausal women A few studies have evaluated the association between diet and mammographic breast density ( MBD ) and results are inconsistent . MBD , a well-recognized risk factor for breast cancer , has been proposed as a marker of cumulative exposure to hormones and growth factors . Diets with a high glycemic index ( GI ) or glycemic load ( GL ) may increase breast cancer risk , via an effect on the insulin-like growth factor axis . We have investigated the association between carbohydrate intake , GI , GL and MBD in a prospect i ve study . We identified a large series of women , in the frame of the EPIC-Florence cohort , with a mammogram taken five years after enrolment , when detailed information on dietary and lifestyle habits and anthropometric measurements had been collected . Mammograms have been retrieved ( 1,668 , 83 % ) and MBD assessed according to Wolfe ’s classification . We compared women with high MBD ( P2+DY Wolfe ’s categories ) with those with low MBD ( N1+P1 ) through logistic models adjusted for age , education , body mass index , menopause , number of children , breast feeding , physical activity , non-alcohol energy , fibers , saturated fat and alcohol . A direct association between GL and high MBD emerged in the highest quintile of intake in comparison with the lowest quintile ( OR = 1.73 , 95%CI 1.13–2.67 , p for trend = 0.048 ) while no association with glycemic index was evident . These results were confirmed after exclusion of women reporting to be on a diet or affected with diabetes , and when Hormone Replacement Therapy at the date of mammographic examination used to assess MBD was considered . The effect was particularly evident among leaner women , although no interaction was found . A positive association was suggested for increasing simple sugar and total carbohydrates intakes limited to the highest quintiles . In this Italian population we observed an association between glycemic load , total and rapidly absorbed carbohydrates and high MBD . These novel results warrant further investigations Background The role of a low glycemic index ( GI ) diet in the management of adolescent obesity remains controversial . In this study , we aim to evaluate the impact of low GI diet versus a conventional Chinese diet on the body mass index ( BMI ) and other obesity indices of obese adolescents . Methods Obese adolescents aged 15–18 years were identified from population -recruited , territory-wide surveys . Obesity was defined as BMI ≥95th percentile of Hong Kong local age- and sex-specific references . Eligible subjects were r and omized to either an intervention with low GI diet ( consisting of 45 - 50 % carbohydrate , 30 - 35 % fat and 15 - 20 % protein ) or conventional Chinese diet as control ( consisting of 55 - 60 % carbohydrate , 25 - 30 % fat and 10 - 15 % protein ) . We used r and om intercept mixed effects model to compare the differential changes across the time points from baseline to month 6 between the 2 groups . Results 104 obese adolescents were recruited ( 52 in low GI group and 52 in control group ; 43.3 % boys ) . Mean age was 16.7 ± 1.0 years and 16.8 ±1.0 years in low GI and control group respectively . 58.7 % subjects completed the study at 6 months ( 65.4 % in low GI group and 51.9 % in control group ) . After adjustment for age and sex , subjects in the low GI group had a significantly greater reduction in obesity indices including BMI , body weight and waist circumference ( WC ) compared to subjects in the control group ( all p < 0.05 ) . After further adjustment for physical activity levels , WC was found to be significantly lower in the low GI group compared to the conventional group ( p = 0.018 ) . Conclusion Low GI diet in the context of a comprehensive lifestyle modification program may be an alternative to conventional diet in the management of obese adolescents . Trial registration number Clinical Trials.gov Ref . No : There is some evidence that plasma insulin and postload plasma glucose may be associated with risk of pancreatic cancer . Glycemic index and glycemic load are measures , which allow the carbohydrate content of individual foods to be classified according to their postpr and ial glycemic effects and hence their effects on circulating insulin levels . Therefore , we examined pancreatic cancer risk in association with glycemic index ( GI ) , glycemic load ( GL ) , and intake of dietary carbohydrate and sugar in a prospect i ve cohort of 49,613 Canadian women enrolled in the National Breast Screening Study ( NBSS ) who completed a self-administered food frequency question naire between 1980 and 1985 . Linkages to national cancer and mortality data bases yielded data on cancer incidence and deaths , with follow-up ending between 1998 and 2000 . During a mean 16.5 years of follow-up , we observed 112 incident pancreatic cancer cases . There was no association between overall glycemic index , glycemic load , total carbohydrate and total sugar intake and pancreatic cancer risk . In multivariate adjusted models , the hazard ratio ( HR ) for the highest versus lowest quartile levels of overall GI and GL were 1.43 ( 95 % confidence interval [CI]=0.56–3.65 , Ptrend=0.58 ) and 0.80 ( 95 % CI=0.45–1.41 , Ptrend=0.41 ) , respectively . Our data suggest that overall glycemic index and glycemic load , as well as total sugar and total carbohydrate intake , are not associated with pancreatic cancer risk . However , given the limited literature regarding the role of diet in the etiology of pancreatic cancer , particularly with respect to glycemic index/load , further investigation is warranted BACKGROUND The incidence of type 2 diabetes increases markedly for obese children after puberty . However , the effect of dietary composition on body weight and diabetes risk factors has not been studied in adolescents . OBJECTIVE To compare the effects of an ad libitum , reduced-glycemic load ( GL ) diet with those of an energy-restricted , reduced-fat diet in obese adolescents . DESIGN R and omized control trial consisting of a 6-month intervention and a 6-month follow-up . MAIN OUTCOME MEASURES Body composition ( body mass index [ BMI ; calculated as weight in kilograms divided by the square of height in meters ] and fat mass ) and insulin resistance ( homeostasis model assessment ) were measured at 0 , 6 , and 12 months . Seven-day food diaries were used as a process measure . SUBJECTS Sixteen obese adolescents aged 13 to 21 years . Intervention Experimental ( reduced-GL ) treatment emphasized selection of foods characterized by a low to moderate glycemic index , with 45 % to 50 % of energy from carbohydrates and 30 % to 35 % from fat . In contrast , conventional ( reduced-fat ) treatment emphasized selection of low-fat products , with 55 % to 60 % of energy from carbohydrates and 25 % to 30 % from fat . RESULTS Fourteen subjects completed the study ( 7 per group ) . The GL decreased significantly in the experimental group , and dietary fat decreased significantly in the conventional group ( P<.05 for both ) . At 12 months , mean + /- SEM BMI ( -1.3 + /- 0.7 vs 0.7 + /- 0.5 ; P = .02 ) and fat mass ( -3.0 + /- 1.6 vs 1.8 + /- 1.0 kg ; P = .01 ) had decreased more in the experimental compared with the conventional group , differences that were material ly unchanged in an intention-to-treat model ( n = 16 ) ( BMI , P = .02 ; fat mass , P = .01 ) . Insulin resistance as measured by means of homeostasis model assessment increased less in the experimental group during the intervention period ( -0.4 + /- 0.9 vs 2.6 + /- 1.2 ; P = .02 ) . In post hoc analyses , GL was a significant predictor of treatment response among both groups ( R2 = 0.51 ; P = .006 ) , whereas dietary fat was not ( R2 = 0.14 ; P = .22 ) . CONCLUSIONS An ad libitum reduced-GL diet appears to be a promising alternative to a conventional diet in obese adolescents . Large-scale r and omized controlled trials are needed to further evaluate the effectiveness of reduced-GL and -glycemic index diets in the treatment of obesity and prevention of type 2 diabetes Background Given the recognized health effects of visceral fat , the underst and ing of how diet can modulate changes in the phenotype “ waist circumference for a given body mass index ( WC BMI ) ” , a proxy measure of visceral adiposity , is deemed necessary . Hence , the objective of the present study was to assess the association between dietary factors and prospect i ve changes in visceral adiposity as measured by changes in the phenotype WC BMI . Methods and Findings We analyzed data from 48,631 men and women from 5 countries participating in the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) study .  Anthropometric measurements were obtained at baseline and after a median follow-up time of 5.5 years . WC BMI was defined as the residuals of waist circumference regressed on body mass index , and annual change in WC BMI ( ΔWC BMI , cm/y ) was defined as the difference between residuals at follow-up and baseline , divided by follow-up time . The association between energy , energy density ( ED ) , macronutrients , alcohol , glycemic index ( GI ) , glycemic load ( GL ) , fibre and ΔWC BMI was modelled using centre-specific adjusted linear regression , and r and om-effects meta-analyses to obtain pooled estimates . Men and women with higher ED and GI diets showed significant increases in their WC BMI , compared to those with lower ED and GI [ 1 kcal/g greater ED predicted a ΔWC BMI of 0.09 cm ( 95 % CI 0.05 to 0.13 ) in men and 0.15 cm ( 95 % CI 0.09 to 0.21 ) in women ; 10 units greater GI predicted a ΔWC BMI of 0.07 cm ( 95 % CI 0.03 to 0.12 ) in men and 0.06 cm ( 95 % CI 0.03 to 0.10 ) in women ] . Among women , lower fibre intake , higher GL , and higher alcohol consumption also predicted a higher ΔWC BMI . Conclusions Results of this study suggest that a diet with low GI and ED may prevent visceral adiposity , defined as the prospect i ve changes in WC BMI . Additional effects may be obtained among women of low alcohol , low GL , and high fibre intake BACKGROUND & AIMS The role of glycemic index of the diet in glucose control and cardiovascular prevention is still not clear . The aim of this study was to determine the effects of hypocaloric diets with different glycemic indexes and glycemic loads on endothelial function and glycemic variability in nondiabetic participants at increased cardiovascular risk . METHODS Forty nondiabetic obese participants were r and omly assigned to a three-month treatment with either a low glycemic index ( LGI ; n=19 ) or high glycemic index ( HGI ; n=21 ) hypocaloric diet with similar macronutrient and fiber content . Endothelial function was measured as flow-mediated dilatation ( FMD ) of the brachial artery before and after dieting . In addition , 48-h continuous subcutaneous glucose monitoring was done before and after dieting in a subgroup of 24 participants . RESULTS The amount of weight loss after dieting was similar in both groups . The glycemic index of the diet significantly influenced the FMD ( P<0.005 ) . In particular , the change of FMD was 2.3±2.6 % following the LGI diet , and -0.9±3.6 % after the HGI diet ( P<0.005 ) . The mean 48-h glycemia decreased significantly after dietary treatment ( P<0.05 ) , but no significant effect of the glycemic index of the diet on results was observed . The glycemic index of the diet significantly influenced the 48-h glycemic variability measured as coefficient of variability ( CV% ; P<0.001 ) . The CV% decreased after the LGI diet ( from 23.5 to 20.0 % ) and increased after the HGI diet ( from 23.6 to 26.6 % ) . The change in percentage of FMD was inversely correlated with the change in the 48-h glycemic CV% ( r=-0.45 ; P<0.05 ) . CONCLUSIONS Endothelial function and glycemic variability ameliorate in association with the adherence to an LGI hypocaloric diet in nondiabetic obese persons . CLINICAL TRIAL REGISTRATION NUMBER IS RCT N56834511
No significant changes were observed for blood lipids , anthropometric measures , HbA1c and fasting glucose .
The present systematic review provides evidence for beneficial effects of long-term interventions administering a low glycemic index/load diet with respect to fasting insulin and pro-inflammatory markers such as C-reactive protein which might prove to be helpful in the primary prevention of obesity-associated diseases
AIM The aim of the present meta- analysis was to investigate the long-term effects of glycemic index-related diets in the management of obesity with a special emphasis on the potential benefits of low glycemic index/load ( GI/GL ) in the prevention of obesity-associated risks .