BACKGROUND: The circumstances under which the glycemic index (GI) and glycemic load (GL) are derived do not reflect real-world eating behavior. Thus, the ecologic validity of these constructs is incompletely known. OBJECTIVE: This study examined the relation of dietary intake to glycemic response when foods are consumed under free-living conditions. DESIGN:Participants were 26 overweight or obese adults with type 2 diabetes who participated in a randomized trial of lifestyle modification. The current study includes baseline data, before initiation of the intervention. Participants wore a continuous glucose monitor and simultaneously kept a food diary for 3 d. The dietary variables included GI, GL, and intakes of energy, fat, protein, carbohydrate, sugars, and fiber. The glycemic response variables included AUC, mean and SD of continuous glucose monitoring (CGM) values, percentage of CGM values in euglycemic and hyperglycemic ranges, and mean amplitude of glycemic excursions. Relations between daily dietary intake and glycemic outcomes were examined. RESULTS: Data were available from 41 d of monitoring. Partial correlations, controlled for energy intake, indicated that GI or GL was significantly associated with each glycemic response outcome. In multivariate analyses, dietary GI accounted for 10% to 18% of the variance in each glycemic variable, independent of energy and carbohydrate intakes (P < 0.01). CONCLUSIONS: The data support the ecologic validity of the GI and GL constructs in free-living obese adults with type 2 diabetes. GI was the strongest and most consistent independent predictor of glycemic stability and variability.
RCT Entities:
BACKGROUND: The circumstances under which the glycemic index (GI) and glycemic load (GL) are derived do not reflect real-world eating behavior. Thus, the ecologic validity of these constructs is incompletely known. OBJECTIVE: This study examined the relation of dietary intake to glycemic response when foods are consumed under free-living conditions. DESIGN:Participants were 26 overweight or obese adults with type 2 diabetes who participated in a randomized trial of lifestyle modification. The current study includes baseline data, before initiation of the intervention. Participants wore a continuous glucose monitor and simultaneously kept a food diary for 3 d. The dietary variables included GI, GL, and intakes of energy, fat, protein, carbohydrate, sugars, and fiber. The glycemic response variables included AUC, mean and SD of continuous glucose monitoring (CGM) values, percentage of CGM values in euglycemic and hyperglycemic ranges, and mean amplitude of glycemic excursions. Relations between daily dietary intake and glycemic outcomes were examined. RESULTS: Data were available from 41 d of monitoring. Partial correlations, controlled for energy intake, indicated that GI or GL was significantly associated with each glycemic response outcome. In multivariate analyses, dietary GI accounted for 10% to 18% of the variance in each glycemic variable, independent of energy and carbohydrate intakes (P < 0.01). CONCLUSIONS: The data support the ecologic validity of the GI and GL constructs in free-living obese adults with type 2 diabetes. GI was the strongest and most consistent independent predictor of glycemic stability and variability.
Authors: J Salmerón; A Ascherio; E B Rimm; G A Colditz; D Spiegelman; D J Jenkins; M J Stampfer; A L Wing; W C Willett Journal: Diabetes Care Date: 1997-04 Impact factor: 19.112
Authors: Jiansong Bao; Fiona Atkinson; Peter Petocz; Walter C Willett; Jennie C Brand-Miller Journal: Am J Clin Nutr Date: 2011-02-16 Impact factor: 7.045
Authors: D J Jenkins; T M Wolever; R H Taylor; H Barker; H Fielden; J M Baldwin; A C Bowling; H C Newman; A L Jenkins; D V Goff Journal: Am J Clin Nutr Date: 1981-03 Impact factor: 7.045
Authors: Mariane de Mello Fontanelli; Cristiane Hermes Sales; Antonio Augusto Ferreira Carioca; Dirce Maria Marchioni; Regina Mara Fisberg Journal: Eur J Nutr Date: 2017-03-01 Impact factor: 5.614
Authors: Frank M Sacks; Vincent J Carey; Cheryl A M Anderson; Edgar R Miller; Trisha Copeland; Jeanne Charleston; Benjamin J Harshfield; Nancy Laranjo; Phyllis McCarron; Janis Swain; Karen White; Karen Yee; Lawrence J Appel Journal: JAMA Date: 2014-12-17 Impact factor: 56.272
Authors: Abimbola A Akintola; Raymond Noordam; Steffy W Jansen; Anton J de Craen; Bart E Ballieux; Christa M Cobbaert; Simon P Mooijaart; Hanno Pijl; Rudi G Westendorp; Diana van Heemst Journal: PLoS One Date: 2015-10-07 Impact factor: 3.240
Authors: Tanja Diederichs; Christian Herder; Sarah Roßbach; Michael Roden; Stefan A Wudy; Ute Nöthlings; Ute Alexy; Anette E Buyken Journal: Nutrients Date: 2017-06-10 Impact factor: 5.717
Authors: Nathalie V Kizirian; Janina Goletzke; Shannon Brodie; Fiona S Atkinson; Tania P Markovic; Glynis P Ross; Anette Buyken; Jennie P Brand-Miller Journal: BMJ Open Diabetes Res Care Date: 2017-03-29
Authors: Janina Goletzke; Christian Herder; Gesa Joslowski; Katja Bolzenius; Thomas Remer; Stefan A Wudy; Michael Roden; Wolfgang Rathmann; Anette E Buyken Journal: Diabetes Care Date: 2013-01-24 Impact factor: 19.112