title: Dietary glycemic index, glycemic load and incidence of type 2 diabetes in Japanese men and women: the Japan Public Health Center-based Prospective Study.
abstract: BACKGROUND
  Japanese diets contain a relatively high amount of carbohydrates, and its high dietary glycemic index and glycemic load may raise the risk of diabetes in the Japanese population. The current study evaluated the associations between the dietary glycemic index, glycemic load, and the risk of type 2 diabetes in a population based cohort in Japan.
  
  
  METHODS
  We observed 27,769 men and 36,864 women (45-75 y) who participated in the second survey of the Japan Public Health Center-based Prospective Study. The dietary glycemic index and glycemic load were estimated using a food-frequency questionnaire. The development of diabetes was reported in a questionnaire administered five years later, and the associations were analyzed using logistic regression after controlling for age, area, total energy intake, smoking status, family history of diabetes, physical activity, hypertension, BMI, alcohol intake, magnesium, calcium, dietary fiber and coffee intake, and occupation.
  
  
  RESULTS
  The dietary glycemic load was positively associated with the risk of diabetes among women: the multivariable-adjusted odds ratio comparing the highest vs. the lowest quartile was 1.52 (95% CI, 1.13-2.04; P-trend = 0.01). The association was implied to be stronger among women with BMI < 25 than the women with BMI ≥ 25. The dietary glycemic index was positively associated with the risk of diabetes among men with a high intake of total fat: the multivariable-adjusted odds ratio comparing the highest vs. the lowest quartile was 1.46 (95% CI, 0.94-2.28; P-trend = 0.04). Among women with a high total fat intake, those in the first and second quartiles of the dietary glycemic index had a significant reduced risk of diabetes, compared with those in the first quartile who had a lower total fat level (multivariable-adjusted odds ratio = 0.59 with 95% CI, 0.37-0.94, and odds ratio = 0.63 with 95% CI, 0.40-0.998 respectively).
  
  
  CONCLUSIONS
  The population-based cohort study in Japan indicated that diets with a high dietary glycemic load increase the risk of type 2 diabetes among women. Total fat intake may modify the association between the dietary glycemic index and the risk of type 2 diabetes among men and women.
authors.affiliation: Department of Health Promotion, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama 351-0197, Japan. oba@niph.go.jp.
authors.forename: Shino
authors.initials: S
authors.lastname: Oba
authors.forename: Akiko
authors.initials: A
authors.lastname: Nanri
authors.forename: Kayo
authors.initials: K
authors.lastname: Kurotani
authors.forename: Atsushi
authors.initials: A
authors.lastname: Goto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kato
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mizoue
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Noda
authors.forename: Manami
authors.initials: M
authors.lastname: Inoue
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Tsugane
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D038321:Glycemic Index / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D011446:Prospective Studies; D011634:Public Health; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004043:Dietary Fiber