Meta-analysis of the health effects of using the glycaemic index in meal-planning.
Diabetes mellitus and CVD are some of the leading causes of mortality and morbidity. Accumulating data indicate that a diet characterised by low-glycaemic index (GI) foods may improve the management of diabetes or lipid profiles. The objective of the present meta-analysis was to critically analyse the scientific evidence that low-GI diets have beneficial effects on carbohydrate and lipid metabolism compared with high-GI diets. We searched for randomised controlled trials with a crossover or parallel design published in English between 1981 and 2003, investigating the effect of low-GI v. high-GI diets on markers for carbohydrate and lipid metabolism. Unstandardised differences in mean values were examined using the random effects model. The main outcomes were fructosamine, glycated Hb (HbA1c), HDL-cholesterol, LDL-cholesterol, total cholesterol and triacylglycerol. Literature searches identified sixteen studies that met the strict inclusion criteria. Low-GI diets significantly reduced fructosamine by -0.1 (95 % CI -0.20, 0.00) mmol/l (P=0.05), HbA1c by 0.27 (95 % CI -0.5, -0.03) % (P=0.03), total cholesterol by -0.33 (95 % CI -0.47, -0.18) mmol/l (P<0.0001) and tended to reduce LDL-cholesterol in type 2 diabetic subjects by -0.15 (95 % CI -0.31, -0.00) mmol/l (P=0.06) compared with high-GI diets. No changes were observed in HDL-cholesterol and triacylglycerol concentrations. No substantial heterogeneity was detected, suggesting that the effects of low-GI diets in these studies were uniform. Results of the present meta-analysis support the use of the GI as a scientifically based tool to enable selection of carbohydrate-containing foods to reduce total cholesterol and to improve overall metabolic control of diabetes.
School of Physiology, Nutrition and Consumer Sciences, North-West University, Potchefstroom, South Africa. vgeamo@puknet.puk.ac.za
A Maretha
AM
Opperman
Christina S
CS
Venter
Welma
W
Oosthuizen
Rachel L
RL
Thompson
Hester H
HH
Vorster
D001786:Blood Glucose / Q000032:analysis; D002784:Cholesterol / Q000378:metabolism; D003296:Cooking / Q000379:methods*; D004032:Diet; D004040:Dietary Carbohydrates / Q000378:metabolism; D004041:Dietary Fats / Q000378:metabolism; D019270:Fructosamine / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000032:analysis; D038321:Glycemic Index; D006801:Humans; D050356:Lipid Metabolism; D016032:Randomized Controlled Trials as Topic; D014280:Triglycerides / Q000378:metabolism
D001786:Blood Glucose; D002784:Cholesterol; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D019270:Fructosamine; D006442:Glycated Hemoglobin; D014280:Triglycerides