Dietary glycaemic index, glycaemic load and subsequent changes of weight and waist circumference in European men and women

Objectives:To investigate whether dietary glycaemic index (GI) and glycaemic load (GL) were associated with subsequent weight and waist circumference change.Design:Population-based prospective cohort study.Setting:Five European countries, which are Denmark, Germany, Italy, The Netherlands and the United Kingdom.Participants:A total of 89 432 participants, aged 20–78 years (mean =53 years) at baseline and followed for 1.9–12.5 years (mean=6.5 years). All participants were free of self-reported cancer, cardiovascular diseases and diabetes at baseline.Methods:Glycaemic index and GL were calculated on the basis of dietary intake assessed by food frequency questionnaires and by using a GI table developed for this study with published GI values as the main sources. Anthropometric data were collected both at baseline and at the end of follow-up. Multiple linear regression analyses were conducted in each centre and random-effect meta-analyses were used to combine the effects. Adjustment was made for baseline anthropometrics, demographic and lifestyle factors, follow-up duration and other dietary factors.Results:Mean GI and GL were 57 and 134, respectively. Associations of GI and GL with subsequent changes of weight and waist circumference were heterogeneous across centres. Overall, with every 10-unit higher in GI, weight increased by 34 g per year (95% confidence interval (CI): −47, 115) and waist circumference increased by 0.19 cm per year (95% CI: 0.11, 0.27). With every 50-unit higher in GL, weight increased by 10 g per year (95% CI: −65, 85) and waist circumference increased by 0.06 cm per year (95% CI: −0.01, 0.13).Conclusions:Our findings do not support an effect of GI or GL on weight change. The positively significant association between GI, not GL, and subsequent gain in waist circumference may imply a beneficial role of lower GI diets in the prevention of abdominal obesity. However, further studies are needed to confirm this finding given the small effect observed in this study.

[1]  J. DeLany,et al.  Long-term effects of 2 energy-restricted diets differing in glycemic load on dietary adherence, body composition, and metabolism in CALERIE: a 1-y randomized controlled trial. , 2007, The American journal of clinical nutrition.

[2]  C. Stokes,et al.  No effect of a diet with a reduced glycaemic index on satiety, energy intake and body weight in overweight and obese women , 2008, International Journal of Obesity.

[3]  C. L. Kien,et al.  Prediction of daily energy expenditure during a feeding trial using measurements of resting energy expenditure, fat-free mass, or Harris-Benedict equations. , 2004, The American journal of clinical nutrition.

[4]  N E Day,et al.  Validation of dietary assessment methods in the UK arm of EPIC using weighed records, and 24-hour urinary nitrogen and potassium and serum vitamin C and carotenoids as biomarkers. , 1997, International journal of epidemiology.

[5]  A. Astrup,et al.  Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple vs complex carbohydrates on body weight and blood lipids: the CARMEN study. The Carbohydrate Ratio Management in European National diets. , 2000, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[6]  A. Astrup,et al.  The role of low-fat diets in body weight control: a meta-analysis of ad libitum dietary intervention studies , 2000, International Journal of Obesity.

[7]  Matthias Briel,et al.  Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. , 2006, Archives of internal medicine.

[8]  L. Baur,et al.  Low glycaemic index or low glycaemic load diets for overweight and obesity. , 2007, The Cochrane database of systematic reviews.

[9]  W. D. Jackson,et al.  Prolongation of satiety after low versus moderately high glycemic index meals in obese adolescents. , 2003, Pediatrics.

[10]  F Berrino,et al.  Relative validity and reproducibility of a food frequency dietary questionnaire for use in the Italian EPIC centres. , 1997, International journal of epidemiology.

[11]  Philippe Pibarot,et al.  Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. , 2008, Arteriosclerosis, thrombosis, and vascular biology.

[12]  W. Willett,et al.  An 18-mo randomized trial of a low-glycemic-index diet and weight change in Brazilian women. , 2007, The American journal of clinical nutrition.

[13]  E. Riboli,et al.  The evaluation of the diet/disease relation in the EPIC study: considerations for the calibration and the disease models. , 2008, International journal of epidemiology.

[14]  N Slimani,et al.  The EPIC nutrient database project (ENDB): a first attempt to standardize nutrient databases across the 10 European countries participating in the EPIC study , 2007, European Journal of Clinical Nutrition.

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

[16]  Dietary energy density determined by eight calculation methods in a nationally representative United States population. , 2005, The Journal of nutrition.

[17]  Arne Astrup,et al.  Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. , 2008, The New England journal of medicine.

[18]  A. Blokstra,et al.  Cohort profile: the Doetinchem Cohort Study. , 2008, International journal of epidemiology.

[19]  R. Ross,et al.  Abdominal obesity, muscle composition, and insulin resistance in premenopausal women. , 2002, The Journal of clinical endocrinology and metabolism.

[20]  J. Seidell,et al.  Cost-effective measures to prevent obesity: epidemiological basis and appropriate target groups , 2005, The Proceedings of the Nutrition Society.

[21]  Mark A Pereira,et al.  Effects of a low-glycemic load diet on resting energy expenditure and heart disease risk factors during weight loss. , 2004, JAMA.

[22]  D. van der A,et al.  Dietary glycaemic index: A review of the physiological mechanisms and observed health impacts , 2006, Acta cardiologica.

[23]  A. Astrup,et al.  Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? , 2004, The Lancet.

[24]  N E Day,et al.  European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection , 2002, Public Health Nutrition.

[25]  H. Boeing,et al.  Reproducibility and relative validity of energy and macronutrient intake of a food frequency questionnaire developed for the German part of the EPIC project. European Prospective Investigation into Cancer and Nutrition. , 1997, International journal of epidemiology.

[26]  D. van der A,et al.  Glycemic index and glycemic load in relation to food and nutrient intake and metabolic risk factors in a Dutch population. , 2008, The American journal of clinical nutrition.

[27]  Influence of high-carbohydrate mixed meals with different glycemic indexes on substrate utilization during subsequent exercise in women. , 2006, The American journal of clinical nutrition.

[28]  D Kromhout,et al.  The Dutch EPIC food frequency questionnaire. II. Relative validity and reproducibility for nutrients. , 1997, International journal of epidemiology.

[29]  N Slimani,et al.  Pilot phase studies on the accuracy of dietary intake measurements in the EPIC project: overall evaluation of results. European Prospective Investigation into Cancer and Nutrition. , 1997, International journal of epidemiology.

[30]  H. Aberg,et al.  Oral contraceptives and back pain in women in a Swedish community. , 1997, International journal of epidemiology.

[31]  F. Clavel-Chapelon,et al.  European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study: rationale, design and population characteristics , 2002, Public Health Nutrition.

[32]  S. Vinoy,et al.  Beneficial effects of a 5-week low-glycaemic index regimen on weight control and cardiovascular risk factors in overweight non-diabetic subjects , 2007, British Journal of Nutrition.

[33]  D. van der A,et al.  Reproducibility and relative validity of dietary glycaemic index and glycaemic load assessed by the food-frequency questionnaire used in the Dutch cohorts of the European Prospective Investigation into Cancer and Nutrition , 2009, British Journal of Nutrition.

[34]  I. Ockene,et al.  Association between dietary carbohydrates and body weight. , 2005, American journal of epidemiology.

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

[36]  H Boeing,et al.  Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the German part of the EPIC project. European Prospective Investigation into Cancer and Nutrition. , 1997 .

[37]  E. Feskens,et al.  Methodological challenges in the application of the glycemic index in epidemiological studies using data from the European Prospective Investigation into Cancer and Nutrition. , 2009, The Journal of nutrition.

[38]  B. Heitmann,et al.  Glycemic index and glycemic load in relation to changes in body weight, body fat distribution, and body composition in adult Danes. , 2006, The American journal of clinical nutrition.

[39]  D Kromhout,et al.  The Dutch EPIC food frequency questionnaire. I. Description of the questionnaire, and relative validity and reproducibility for food groups. , 1997, International journal of epidemiology.

[40]  D. Ludwig.  Dietary glycemic index and the regulation of body weight , 2003, Lipids.

[41]  F. Hu,et al.  Prospective study of dietary energy density and weight gain in women. , 2008, The American journal of clinical nutrition.

[42]  A. Miller,et al.  Overweight, obesity and fat distribution in 50- to 64-year-old participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) , 2002, Public Health Nutrition.

[43]  N Slimani,et al.  Structure of the standardized computerized 24-h diet recall interview used as reference method in the 22 centers participating in the EPIC project. European Prospective Investigation into Cancer and Nutrition. , 1999, Computer methods and programs in biomedicine.

[44]  P. Katzmarzyk,et al.  Variability in Waist Circumference Measurements According to Anatomic Measurement Site , 2009, Obesity.

[45]  A. Astrup,et al.  Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple vs complex carbohydrates on body weight and blood lipids: the CARMEN study , 2000, International Journal of Obesity.

[46]  G. Berglund,et al.  Misreporting of energy: prevalence, characteristics of misreporters and influence on observed risk estimates in the Malmö Diet and Cancer cohort , 2005, British Journal of Nutrition.

[47]  N. Day,et al.  EPIC-Norfolk: study design and characteristics of the cohort. European Prospective Investigation of Cancer. , 1999, British journal of cancer.