Association between dietary glycemic index, glycemic load, and body mass index in the Inter99 study: is underreporting a problem?
BACKGROUND
The few studies examining the potential associations between glycemic index (GI), glycemic load (GL), and body mass index (BMI) have provided no clear pictures. Underreporting of energy intake may be one explanation for this.


OBJECTIVE
We examined the associations between GI, GL, and BMI by focusing on the confounding factor of total energy intake and the effect of exclusion of low energy reporters (LERs).


METHODS
This was a cross-sectional study of 6334 subjects aged 30-60 y. Dietary intake was estimated from a food-frequency questionnaire. GI and GL were estimated by using white bread as the reference food. Underreporting of energy intake was assessed as reported energy intake divided by basal metabolic rate (EI/BMR); LERs were defined as those having an EI/BMR < 1.14. Univariate and multiple linear regression models were used to test for associations between GI, GL, and BMI. The confounders were sex, age, smoking, physical activity, alcohol intake, and energy intake. All analyses were conducted on 1) the entire population and 2) a subsample excluding LERs.


RESULTS
In the univariate analyses of the entire population, GL was inversely associated with BMI. No association was observed for GI. After full adjustment (including energy intake), both GI and GL were positively associated with BMI. When LERs were excluded, GL was positively associated with BMI in all analyses, and GI was positively associated with BMI in the multiple analyses.


CONCLUSIONS
We showed a positive association between GI, GL, and BMI. Energy adjustment and the exclusion of LERs significantly affected the results of the analysis; thus, we stress the importance of energy adjustment.
Lau
Cathrine
C
Steno Diabetes Center, Gentofte, Denmark.
Toft
Ulla
U
Tetens
Inge
I
Richelsen
Bjørn
B
Jørgensen
Torben
T
Borch-Johnsen
Knut
K
Glümer
Charlotte
C
D000328:Adult; D000428:Alcohol Drinking; D000704:Analysis of Variance; D001481:Basal Metabolism / Q000502:physiology*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D002149:Energy Intake / Q000502:physiology*; D015444:Exercise / Q000502:physiology; D005260:Female; D038321:Glycemic Index; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012650:Self Disclosure; D012907:Smoking; D011795:Surveys and Questionnaires
D001786:Blood Glucose