Glycemic index, glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women.

BACKGROUND Increasing evidence suggests an important role of carbohydrate quality in the development of type 2 diabetes. OBJECTIVE Our objective was to prospectively examine the association between glycemic index, glycemic load, and dietary fiber and the risk of type 2 diabetes in a large cohort of young women. DESIGN In 1991, 91249 women completed a semiquantitative food-frequency questionnaire that assessed dietary intake. The women were followed for 8 y for the development of incident type 2 diabetes, and dietary information was updated in 1995. RESULTS We identified 741 incident cases of confirmed type 2 diabetes during 8 y (716 300 person-years) of follow-up. After adjustment for age, body mass index, family history of diabetes, and other potential confounders, glycemic index was significantly associated with an increased risk of diabetes (multivariate relative risks for quintiles 1-5, respectively: 1, 1.15, 1.07, 1.27, and 1.59; 95% CI: 1.21, 2.10; P for trend = 0.001). Conversely, cereal fiber intake was associated with a decreased risk of diabetes (multivariate relative risks for quintiles 1-5, respectively: 1, 0.85, 0.87, 0.82, and 0.64; 95% CI: 0.48, 0.86; P for trend = 0.004). Glycemic load was not significantly associated with risk in the overall cohort (multivariate relative risks for quintiles 1-5, respectively: 1, 1.31, 1.20, 1.14, and 1.33; 95% CI: 0.92, 1.91; P for trend = 0.21). CONCLUSIONS A diet high in rapidly absorbed carbohydrates and low in cereal fiber is associated with an increased risk of type 2 diabetes.

[1]  Pd redaction.  The prevention or delay of type 2 diabetes. , 2003, Caring : National Association for Home Care magazine.

[2]  K. O'dea,et al.  Effect of co-ingestion of fat on the metabolic responses to slowly and rapidly absorbed carbohydrates , 2004, Diabetologia.

[3]  N. Kohno,et al.  Relationship between development of diabetes and family history by gender in Japanese-Americans. , 2003, Diabetes research and clinical practice.

[4]  J. Manson,et al.  Alcohol drinking patterns and risk of type 2 diabetes mellitus among younger women. , 2003, Archives of internal medicine.

[5]  T. Wolever,et al.  Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance. , 2003, The American journal of clinical nutrition.

[6]  Paul Knekt,et al.  Whole-grain and fiber intake and the incidence of type 2 diabetes. , 2003, The American journal of clinical nutrition.

[7]  D. Bowen,et al.  Family history of diabetes as a potential public health tool. , 2003, American journal of preventive medicine.

[8]  P. Raskin,et al.  Report of the expert committee on the diagnosis and classification of diabetes mellitus. , 1999, Diabetes care.

[9]  A. Mokdad,et al.  Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. , 2003, JAMA.

[10]  D. Couper,et al.  Dietary fiber intake and glycemic index and incidence of diabetes in African-American and white adults: the ARIC study. , 2002, Diabetes care.

[11]  J. Skyler,et al.  Diabetes trends in the USA , 2002, Diabetes/metabolism research and reviews.

[12]  Lawrence A Leiter,et al.  Effect of wheat bran on glycemic control and risk factors for cardiovascular disease in type 2 diabetes. , 2002, Diabetes care.

[13]  Simin Liu.  Intake of Refined Carbohydrates and Whole Grain Foods in Relation to Risk of Type 2 Diabetes Mellitus and Coronary Heart Disease , 2002, Journal of the American College of Nutrition.

[14]  J. Manson,et al.  Glycemic index, glycemic load, and risk of type 2 diabetes. , 2002, The American journal of clinical nutrition.

[15]  K. Alberti,et al.  Alcohol consumption and the incidence of type II diabetes , 2002, Journal of epidemiology and community health.

[16]  D. Ludwig,et al.  The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. , 2002, JAMA.

[17]  F Vinicor,et al.  The continuing epidemics of obesity and diabetes in the United States. , 2001, JAMA.

[18]  F. Hu,et al.  Diet and risk of Type II diabetes: the role of types of fat and carbohydrate , 2001, Diabetologia.

[19]  G A Colditz,et al.  Physical activity and television watching in relation to risk for type 2 diabetes mellitus in men. , 2001, Archives of internal medicine.

[20]  J. Manson,et al.  Dietary glycemic load assessed by food-frequency questionnaire in relation to plasma high-density-lipoprotein cholesterol and fasting plasma triacylglycerols in postmenopausal women. , 2001, The American journal of clinical nutrition.

[21]  Anson,et al.  DIET , LIFESTYLE , AND THE RISK OF TYPE 2 DIABETES MELLITUS IN WOMEN , 2001 .

[22]  A. Astrup,et al.  Redefining Type 2 diabetes: ‘Diabesity’ or ‘Obesity Dependent Diabetes Mellitus’? , 2000, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[23]  M. Engelgau,et al.  Diabetes trends in the U.S.: 1990-1998. , 2000, Diabetes care.

[24]  T. Sellers,et al.  Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. , 2000, The American journal of clinical nutrition.

[25]  S. Blair,et al.  The association between physical activity, physical fitness, and type 2 diabetes mellitus , 2000, Comprehensive therapy.

[26]  J. Kampert,et al.  Alcohol intake and incidence of type 2 diabetes in men. , 2000, Diabetes care.

[27]  M. Noakes,et al.  Diets high and low in glycemic index versus high monounsaturated fat diets: effects on glucose and lipid metabolism in NIDDM , 1999, European Journal of Clinical Nutrition.

[28]  D Spiegelman,et al.  Dietary fat and coronary heart disease: a comparison of approaches for adjusting for total energy intake and modeling repeated dietary measurements. , 1999, American journal of epidemiology.

[29]  G. Frost,et al.  Insulin sensitivity in women at risk of coronary heart disease and the effect of a low glycemic diet. , 1998, Metabolism: clinical and experimental.

[30]  Walter C. Willett,et al.  Reproducibility and Validity of Food-Frequency Questionnaires , 1998 .

[31]  J. Papadakis,et al.  Smoking, Diabetes and Hyperlipidaemia , 1998, Journal of the Royal Society of Health.

[32]  L. Goodyear,et al.  Exercise, glucose transport, and insulin sensitivity. , 1998, Annual review of medicine.

[33]  E. Rimm,et al.  Dietary Fiber, Glycemic Load, and Risk of NIDDM in Men , 1997, Diabetes Care.

[34]  W C Willett,et al.  Adjustment for total energy intake in epidemiologic studies. , 1997, The American journal of clinical nutrition.

[35]  G A Colditz,et al.  Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. , 1997, JAMA.

[36]  J. Kampert,et al.  Physical activity in the prevention of non-insulin-dependent diabetes mellitus. , 1997, World review of nutrition and dietetics.

[37]  G. Frost,et al.  Preliminary report The effect of low-glycemic carbohydrate on insulin and glucose response in vivo and in vitro in patients with coronary heart disease , 1996 .

[38]  G. Denyer,et al.  Development of insulin resistance in the rat is dependent on the rate of glucose absorption from the diet. , 1996, The Journal of nutrition.

[39]  G. Frost,et al.  The effect of low-glycemic carbohydrate on insulin and glucose response in vivo and in vitro in patients with coronary heart disease. , 1996, Metabolism: clinical and experimental.

[40]  G. Denyer,et al.  Amylopectin starch promotes the development of insulin resistance in rats. , 1995, Journal of NutriLife.

[41]  J. Miller,et al.  The glycaemic index of foods containing sugars: comparison of foods with naturally-occurring v. added sugars , 1995, British Journal of Nutrition.

[42]  G A Colditz,et al.  Reproducibility and validity of a self-administered physical activity questionnaire. , 1994, International journal of epidemiology.

[43]  D Feskanich,et al.  Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire. , 1993, Journal of the American Dietetic Association.

[44]  B. Rosner,et al.  Familial Clustering of Insulin Sensitivity , 1992, Diabetes.

[45]  W C Willett,et al.  A prospective study of exercise and incidence of diabetes among US male physicians. , 1992, JAMA.

[46]  T. Wolever,et al.  Beneficial Effect of a Low Glycaemic Index Diet in Type 2 Diabetes , 1992, Diabetic medicine : a journal of the British Diabetic Association.

[47]  G. Slama,et al.  The Use of Low Glycaemic Index Foods Improves Metabolic Control of Diabetic Patients over Five Weeks , 1992, Diabetic medicine : a journal of the British Diabetic Association.

[48]  G A Colditz,et al.  Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. , 1992, American journal of epidemiology.

[49]  T. Wolever,et al.  Beneficial Effect of Low-Glycemic Index Diet in Overweight NIDDM Subjects , 1992, Diabetes Care.

[50]  J. Manson,et al.  Physical activity and incidence of non-insulin-dependent diabetes mellitus in women , 1991, The Lancet.

[51]  R. Paffenbarger,et al.  Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. , 1991, The New England journal of medicine.

[52]  M. Alpsten,et al.  A small dose of soluble alginate-fiber affects postprandial glycemia and gastric emptying in humans with diabetes. , 1991, The Journal of nutrition.

[53]  V. Vuksan,et al.  Glycemic Index of Foods in Individual Subjects , 1990, Diabetes Care.

[54]  G A Colditz,et al.  Food-based validation of a dietary questionnaire: the effects of week-to-week variation in food consumption. , 1989, International journal of epidemiology.

[55]  J. Manson,et al.  A prospective study of moderate alcohol drinking and risk of diabetes in women. , 1988, American journal of epidemiology.

[56]  A. Thorburn,et al.  Application of glycemic index to mixed meals. , 1988, The American journal of clinical nutrition.

[57]  T. Wolever,et al.  Metabolic effects of a low-glycemic-index diet. , 1987, The American journal of clinical nutrition.

[58]  S. Lillioja,et al.  In Vivo Insulin Action Is Familial Characteristic in Nondiabetic Pima Indians , 1987, Diabetes.

[59]  T. Wolever,et al.  Low-glycemic index diet in hyperlipidemia: use of traditional starchy foods. , 1987, The American journal of clinical nutrition.

[60]  G. Slama,et al.  Insulinemic and glycemic indexes of six starch-rich foods taken alone and in a mixed meal by type 2 diabetics. , 1987, The American journal of clinical nutrition.

[61]  Meir J. Stampfer,et al.  Total energy intake: implications for epidemiologic analyses. , 1986, American journal of epidemiology.

[62]  T. Wolever,et al.  The use of the glycemic index in predicting the blood glucose response to mixed meals. , 1986, The American journal of clinical nutrition.

[63]  J. Little,et al.  Low glycemic index carbohydrate foods in the management of hyperlipidemia. , 1985, The American journal of clinical nutrition.

[64]  W. Willett,et al.  Reproducibility and validity of a semiquantitative food frequency questionnaire. , 1985, American journal of epidemiology.

[65]  G. Hitman,et al.  Diabetes and hyperlipidaemia , 1984 .

[66]  W. Willett,et al.  Test of the National Death Index. , 1984, American journal of epidemiology.

[67]  W. Willett,et al.  Cigarette smoking, relative weight, and menopause. , 1983, American journal of epidemiology.

[68]  T. Wolever,et al.  Glycemic Response to Wheat Products: Reduced Response to Pasta but No Effect of Fiber , 1983, Diabetes Care.

[69]  T. Wolever,et al.  Glycemic index of foods: a physiological basis for carbohydrate exchange. , 1981, The American journal of clinical nutrition.

[70]  W. Horwitz.  Official Methods of Analysis , 1980 .

[71]  P. Tothill,et al.  EFFECT OF GEL FIBRE ON GASTRIC EMPTYING AND ABSORPTION OF GLUCOSE AND PARACETAMOL , 1979, The Lancet.

[72]  J. Dilawari,et al.  Dietary fibres, fibre analogues, and glucose tolerance: importance of viscosity. , 1978, British medical journal.

[73]  A. Brodribb,et al.  Diverticular disease: three studies. Part III - Metabolic effect of bran in patients with diverticular disease. , 1976, British medical journal.