Creator: Macrina Ghali, PharmD Candidate 2021, Florida A&M College, School of Pharmacy and Pharmaceutical Sciences
Researchers analyzed contributors in 5 continents to find out the affiliation between glycemic index and heart problems.
The glycemic index is how a lot 50 grams of carbohydrates elevate blood glucose, relying on the meals eaten. Earlier information has proven the good thing about a low glycemic index weight-reduction plan within the prevention and therapy of diabetes. Low glycemic index diets have been related to decrease postprandial glucose ranges, decrease serum levels of cholesterol, and decrease blood strain, lowering diabetes and heart problems (CVD). Research have additionally proven the advantages of high-fiber and whole-grain meals on continual illness prevention. Nevertheless, there’s not sufficient information to find out an affiliation between low glycemic index meals and CVD. Moreover, earlier research concerning CVD have solely been carried out in Western nations, limiting generalizability to low-income sufferers in non-Western nations. The Potential City Rural Epidemiology (PURE) examine was a big, worldwide examine that included contributors from 20 nations over 5 continents to evaluate the cardiovascular affect of glycemic index and glycemic load.
The PURE examine included 137,851 contributors aged 35 to 70 years previous from 4 high-income nations, eleven middle-income nations, and 5 low-income nations. A questionnaire with 3,200 meals gadgets was used to document every participant’s meals consumption. The “bread scale” was used to outline the glycemic index, with white bread being 100. Analysts measured every affected person’s glycemic load by multiplying the common internet carbohydrate consumption by the glycemic index and dividing it by 100. The first consequence for the examine was a composite of main cardiovascular occasions or dying from any trigger. Researchers carried out a subgroup evaluation based on financial area, geographic area, intercourse, BMI, smoking, and train standing to find out if there have been variations within the affiliation. Meals with the best glycemic index had been consumed by contributors in China, Africa, and Southeast Asia.
Over a median of 9.5 years of follow-up, the first consequence occurred in 14,075 contributors, dying occurred in 8,780 contributors, and no less than one main cardiovascular occasion occurred in 8,252 contributors. There was a constructive affiliation between the first consequence and excessive glycemic index amongst sufferers with out pre-existing CVD (HR 1.21, 95% CI 1.11 – 1.34) and sufferers with pre-existing CVD (HR 1.51, 95% CI 1.25 – 1.82). A better glycemic index was additionally related to an elevated threat of dying from cardiovascular and non-cardiovascular causes. Nevertheless, for top glycemic load, a constructive affiliation was solely seen for main cardiovascular occasions and dying in these with pre-existing CVD. Among the many subgroups, a extra vital affiliation was seen amongst contributors with a BMI higher than 25 (P = 0.01). Greater financial areas had stronger associations to the first consequence (HR 1.93, 95% CI 1.05 – 3.53).
This examine’s weak point is the grouping of meals into glycemic index classes, which can have affected the precision relying on meals variability. Because of the number of meals from all around the world, it was tough for researchers to assign a worth to every meals merchandise precisely. One other weak point was the shortcoming to periodically assess weight-reduction plan modifications which will have been altered in the course of the examine’s length and affected outcomes. In distinction, this examine’s strengths included contributors from many nations with various diets and earnings statuses, permitting for generalizability. Moreover, this examine emphasised glycemic index and glycemic load affect in predicting heart problems and mortality threat. Clinicians ought to educate sufferers on the affect of their weight-reduction plan selections and supply wholesome alternate options. Total, outcomes confirmed that sufferers consuming diets with a low glycemic index and cargo had been at a decrease threat of growing heart problems and dying.
- Excessive glycemic index meals are related to an elevated threat of heart problems and mortality throughout many areas with various diets and financial standing.
- Diets excessive within the glycemic index might enhance postprandial glucose ranges in sufferers with an elevated BMI, additional strengthening heart problems threat.
- Implementing a high-fiber and whole-grain weight-reduction plan reduces heart problems and mortality in sufferers with and with out pre-existing heart problems.
Jenkins DJA, Dehghan M, Mente A, et al. Glycemic Index, Glycemic Load, and Cardiovascular Illness and Mortality[ 2021 February 24]. N Engl J Med. 2021;10.1056/NEJMoa2007123.
Model-Miller J, Hayne S, Petocz P, Colagiuri S. Low-glycemic index diets within the administration of diabetes: a meta-analysis of randomized managed trials. Diabetes Care 2003;26:2261-7.
Macrina Ghali, PharmD Candidate 2021, Florida A&M College, School of Pharmacy and Pharmaceutical Sciences