title: The relationship between carbohydrate quality and the prevalence of metabolic syndrome: challenges of glycemic index and glycemic load.
abstract: OBJECTIVE
  To estimate the prevalence of metabolic syndrome (MetS) and its components in adults and older adults residents of São Paulo, the association of MetS with the glycemic index (GI) and glycemic load (GL) and the foods that contribute to dietary GI and GL in this population.
  
  
  METHODS
  Data from 591 adults and older adults participants in the Health Survey of São Paulo were used. This is a cross-sectional, population-based study with a complex multistage sample design of residents in the urban area of the municipality. Dietary consumption data, anthropometric measurements, blood pressure and blood samples were collected. The associations between GI, GL and MetS and its components were tested using logistic regression models, considering the sample design of the study.
  
  
  RESULTS
  The prevalence of MetS in the adult and older adults residents of São Paulo was 30.3%. There was no association between GI, GL and MetS. GI and GL were positively associated with low high-density lipoprotein cholesterol (HDL-c), OR = 1.113 (95% CI 1.007-1.230) and OR = 1.019 (95% CI 1.002-1.037), respectively. GL was inversely associated with high blood pressure and this association differed by age group (OR = 0.981; 95% CI 0.964-0.998). Foods that most contributed to dietary GI and GL were sugar, white rice and French bread.
  
  
  CONCLUSIONS
  Considering the high prevalence of low HDL-c in the population of São Paulo, GI and GL may contribute to the nutritional therapy of this dyslipidemia. However, findings should be treated with caution, considering several conflicting results between studies.
authors.affiliation: Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, 01246-904, Sao Paulo, SP, Brazil.
authors.forename: Mariane
authors.initials: M
authors.lastname: de Mello Fontanelli
authors.affiliation: Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, 01246-904, Sao Paulo, SP, Brazil.
authors.forename: Cristiane Hermes
authors.initials: CH
authors.lastname: Sales
authors.affiliation: Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, 01246-904, Sao Paulo, SP, Brazil.
authors.forename: Antonio Augusto Ferreira
authors.initials: AAF
authors.lastname: Carioca
authors.affiliation: Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, 01246-904, Sao Paulo, SP, Brazil.
authors.forename: Dirce Maria
authors.initials: DM
authors.lastname: Marchioni
authors.affiliation: Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, 01246-904, Sao Paulo, SP, Brazil. rfisberg@usp.br.
authors.forename: Regina Mara
authors.initials: RM
authors.lastname: Fisberg
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D001939:Bread / Q000009:adverse effects; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D004040:Dietary Carbohydrates / Q000009:adverse effects*; D000073417:Dietary Sugars / Q000009:adverse effects; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D005511:Food Handling; D038321:Glycemic Index; D000067940:Glycemic Load; D006801:Humans; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D008875:Middle Aged; D009749:Nutrition Surveys; D012275:Oryza / Q000009:adverse effects; D015995:Prevalence; D012639:Seeds / Q000009:adverse effects; D014504:Urban Health / Q000208:ethnology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D004040:Dietary Carbohydrates; D000073417:Dietary Sugars
keywords: Cross-sectional studies; Glycemic Index; Glycemic Load; Metabolic Syndrome; Prevalence