title: Glycemic index, glycemic load, and blood pressure: a systematic review and meta-analysis of randomized controlled trials.
abstract: Background:High blood pressure is a strong risk factor for cardiovascular disease.Objective:The aim of this study was to determine the associations of dietary glycemic index (GI) and glycemic load (GL) with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in healthy individuals.Design:A systematic review and meta-analysis of randomized controlled trials (RCTs) was carried out. Databases were searched for eligible RCTs in 2 phases. MEDLINE, Embase, CAB Abstracts, BIOSIS, ISI Web of Science, and the Cochrane Library were searched from January 1990 to December 2009. An updated search was undertaken with the use of MEDLINE and Embase from January 2010 to September 2016. Trials were included if they reported author-defined high- and low-GI or -GL diets and blood pressure, were of ≥6 wk duration, and comprised healthy participants without chronic conditions. Data were extracted and analyzed with the use of Stata statistical software. Pooled estimates and 95% CIs were calculated with the use of weighted mean differences and random-effects models.Results:Data were extracted from 14 trials comprising 1097 participants. Thirteen trials provided information on differences in GI between control and intervention arms. A median reduction in GI of 10 units reduced the overall pooled estimates for SBP and DBP by 1.1 mm Hg (95% CI: -0.3, 2.5 mm Hg;P= 0.11) and 1.3 mm Hg (95% CI: 0.2 mm Hg, 2.3;P= 0.02), respectively. Nine trials reported information on differences in GL between arms. A median reduction in GL of 28 units reduced the overall pooled estimates for SBP and DBP by 2.0 mm Hg (95% CI: 0.2, 3.8 mm Hg;P= 0.03) and 1.4 mm Hg (95% CI: 0.1, 2.6 mm Hg;P= 0.03), respectively.Conclusions:This review of healthy individuals indicated that a lower glycemic diet may lead to important reductions in blood pressure. However, many of the trials included in the analysis reported important sources of bias. This trial was registered at PROSPERO as CRD42016049026.
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, and c.e.l.evans@leeds.ac.uk.
authors.forename: Charlotte El
authors.identifier: 0000-0002-4065-4397
authors.initials: CE
authors.lastname: Evans
authors.affiliation: Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom; and.
authors.forename: Darren C
authors.identifier: 0000-0001-7035-3096
authors.initials: DC
authors.lastname: Greenwood
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, and.|Division of Epidemiology, School of Public Health and Primary Care, the Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Diane E
authors.identifier: 0000-0002-5884-3372
authors.initials: DE
authors.lastname: Threapleton
authors.affiliation: Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom; and.
authors.forename: Chris P
authors.identifier: 0000-0003-4732-382X
authors.initials: CP
authors.lastname: Gale
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, and.
authors.forename: Christine L
authors.identifier: 0000-0003-1206-5189
authors.initials: CL
authors.lastname: Cleghorn
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, and.
authors.forename: Victoria J
authors.identifier: 0000-0003-0282-2932
authors.initials: VJ
authors.lastname: Burley
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D038321:Glycemic Index; D000067940:Glycemic Load; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: blood pressure; diet; glycemic index; glycemic load; systematic review