Associations of Glycemic Index and Glycemic Load with Cardiovascular Disease: Updated Evidence from Meta-analysis and Cohort Studies
- PMID: 35119682
- DOI: 10.1007/s11886-022-01635-2
Associations of Glycemic Index and Glycemic Load with Cardiovascular Disease: Updated Evidence from Meta-analysis and Cohort Studies
Abstract
Purpose of review: Diet and lifestyle patterns are considered major contributory factors for cardiovascular disease (CVD) and mortality. In particular, consuming a diet higher in carbohydrates (not inclusive of fruits and vegetables, but more processed carbohydrates) has been associated with metabolic abnormalities that subsequently may increase the risk of CVD and related mortality. Glycemic index (GI) and glycemic load (GL) are values given to foods based on how fast the body converts carbohydrates into glucose also referred to as the glycemic burden of carbohydrates from foods. Conflicting associations of how high GI and GL influence CVDs have been observed even in high-quality meta-analysis studies. We synthesize and report the associations of high GI and GL with various CVDs by sex, obesity, and geographical locations using an updated review of meta-analysis and observational studies.
Recent findings: We identified high GI or high GL is associated with an increased risk of CVD events including diabetes (DM), metabolic syndrome (MS), coronary heart disease (CHD), stroke, and stroke mortality in the general population, and the risk of CVD outcomes appears to be stratified by sex, obesity status, and preexisting CVD. Both high GI and GL are associated with DM and CHD in the general population. However, high GI is strongly associated with DM/MS, while high GL is strongly associated with an increased risk of CHD in females. In addition, high GL is also associated with incident stroke, and appears to be associated with CVD mortality in subjects with preexisting CVD or high BMI and all-cause mortality in non-obese DM subjects. However, high GI appears to be associated with CVD or all-cause mortality only in females without CVD. High GI/GL is an important risk factor for CVD outcomes in the general population. High GI seems to be markedly associated with DM/MS, and it may enhance the risk of CVD or all-cause mortality in both sexes and predominately females. Although both high GI and high GL are risk factors for CHD in females, high GL is associated with CVD outcomes in at-risk populations for CVD. These data suggest that while high GI increases the propensity of CVD risk factors and mortality in healthy individuals, high GL contributes to the risk of severe heart diseases including CVD or all-cause mortality, particularly in at-risk populations. These data indicate dietary interventions designed for focusing carbohydrate quality by lowering both GI and GL are recommended for preventing CVD outcomes across all populations.
Keywords: All-cause mortality; Body mass index; Cardiovascular disease; Diabetes; Glycemic index; Glycemic load; Heart disease; Obesity; Stroke.
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Similar articles
-
Carbohydrate quality, glycemic index, glycemic load and cardiometabolic risks in the US, Europe and Asia: A dose-response meta-analysis.Nutr Metab Cardiovasc Dis. 2020 Jun 9;30(6):853-871. doi: 10.1016/j.numecd.2019.12.050. Epub 2020 Jan 13. Nutr Metab Cardiovasc Dis. 2020. PMID: 32278608
-
Dietary glycemic index, glycemic load, and refined carbohydrates are associated with risk of stroke: a prospective cohort study in urban Chinese women.Am J Clin Nutr. 2016 Nov;104(5):1345-1351. doi: 10.3945/ajcn.115.129379. Epub 2016 Oct 12. Am J Clin Nutr. 2016. PMID: 27733400 Free PMC article.
-
Dietary glycemic load and glycemic index and risk of coronary heart disease and stroke in Dutch men and women: the EPIC-MORGEN study.PLoS One. 2011;6(10):e25955. doi: 10.1371/journal.pone.0025955. Epub 2011 Oct 5. PLoS One. 2011. PMID: 21998729 Free PMC article. Clinical Trial.
-
Glycemic index, glycemic load, and chronic disease risk--a meta-analysis of observational studies.Am J Clin Nutr. 2008 Mar;87(3):627-37. doi: 10.1093/ajcn/87.3.627. Am J Clin Nutr. 2008. PMID: 18326601 Review.
-
Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature.Eur J Clin Nutr. 2006 Oct;60(10):1145-59. doi: 10.1038/sj.ejcn.1602435. Epub 2006 May 3. Eur J Clin Nutr. 2006. PMID: 16670693 Review.
Cited by
-
Associations of sex hormone ratios with metabolic syndrome and inflammation in US adult men and women.Front Endocrinol (Lausanne). 2024 Apr 10;15:1384603. doi: 10.3389/fendo.2024.1384603. eCollection 2024. Front Endocrinol (Lausanne). 2024. PMID: 38660513 Free PMC article.
-
Genetically predicted dietary macronutrient intakes and atrial fibrillation risk: a Mendelian randomization study.Eur J Med Res. 2024 Apr 12;29(1):227. doi: 10.1186/s40001-024-01781-z. Eur J Med Res. 2024. PMID: 38609963 Free PMC article.
-
Relationship between dietary glycemic index and glycemic load and sperm-quality parameters in Iranian men: a cross-sectional study.BMC Nutr. 2024 Feb 26;10(1):34. doi: 10.1186/s40795-024-00840-2. BMC Nutr. 2024. PMID: 38409138 Free PMC article.
-
Thirty Obesity Myths, Misunderstandings, and/or Oversimplifications: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022.Obes Pillars. 2022 Aug 10;3:100034. doi: 10.1016/j.obpill.2022.100034. eCollection 2022 Sep. Obes Pillars. 2022. PMID: 37990730 Free PMC article.
-
Beneficial glycaemic effects of high-amylose barley bread compared to wheat bread in type 2 diabetes.Eur J Clin Nutr. 2024 Mar;78(3):243-250. doi: 10.1038/s41430-023-01364-x. Epub 2023 Nov 8. Eur J Clin Nutr. 2024. PMID: 37940671 Free PMC article. Clinical Trial.
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
-
- Mukherjee D, Eagle KA. Improving quality of cardiovascular care in the real world: how can we remove the barriers? Am J Manag Care. 2004;10(7 Pt 2):471–2. - PubMed
-
- Dwivedi AK, Dubey P, Cistola DP, Reddy SY. Association between obesity and cardiovascular outcomes: updated evidence from meta-analysis studies. Curr Cardiol Rep. 2020;22(4):25. https://doi.org/10.1007/s11886-020-1273-y . - DOI - PubMed
-
- Liu B, Du Y, Wu Y, Snetselaar LG, Wallace RB, Bao W. Trends in obesity and adiposity measures by race or ethnicity among adults in the United States 2011–18: population based study. BMJ. 2021;372: n365. https://doi.org/10.1136/bmj.n365 . - DOI - PubMed - PMC
-
- Lee SE, Han K, Kang YM, Kim SO, Cho YK, Ko KS, et al. Trends in the prevalence of metabolic syndrome and its components in South Korea: findings from the Korean National Health Insurance Service Database (2009–2013). PLoS ONE. 2018;13(3): e0194490. https://doi.org/10.1371/journal.pone.0194490 . - DOI - PubMed - PMC
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials