Shilpa N Bhupathiraju1, Deirdre K Tobias1, Vasanti S Malik1, An Pan1, Adela Hruby1, JoAnn E Manson1, Walter C Willett1, Frank B Hu1. 1. From the Departments of Nutrition (SNB, DKT, VSM, AH, WCW, and FBH) and Epidemiology (JEM, WCW, and FBH), Harvard School of Public Health, Boston, MA; the Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (AP); the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM); and the Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW and FBH).
Abstract
BACKGROUND: Epidemiologic evidence for the relation between carbohydrate quality and risk of type 2 diabetes (T2D) has been mixed. OBJECTIVE: We prospectively examined the association of dietary glycemic index (GI) and glycemic load (GL) with T2D risk. DESIGN: We prospectively followed 74,248 women from the Nurses' Health Study (1984-2008), 90,411 women from the Nurses' Health Study II (1991-2009), and 40,498 men from the Health Professionals Follow-Up Study (1986-2008) who were free of diabetes, cardiovascular disease, and cancer at baseline. Diet was assessed by using a validated questionnaire and updated every 4 y. We also conducted an updated meta-analysis, including results from our 3 cohorts and other studies. RESULTS: During 3,800,618 person-years of follow-up, we documented 15,027 cases of incident T2D. In pooled multivariable analyses, those in the highest quintile of energy-adjusted GI had a 33% higher risk (95% CI: 26%, 41%) of T2D than those in the lowest quintile. Participants in the highest quintile of energy-adjusted GL had a 10% higher risk (95% CI: 2%, 18%) of T2D. Participants who consumed a combination diet that was high in GI or GL and low in cereal fiber had an ~50% higher risk of T2D. In the updated meta-analysis, the summary RRs (95% CIs) comparing the highest with the lowest categories of GI and GL were 1.19 (1.14, 1.24) and 1.13 (1.08, 1.17), respectively. CONCLUSION: The updated analyses from our 3 cohorts and meta-analyses provide further evidence that higher dietary GI and GL are associated with increased risk of T2D.
BACKGROUND: Epidemiologic evidence for the relation between carbohydrate quality and risk of type 2 diabetes (T2D) has been mixed. OBJECTIVE: We prospectively examined the association of dietary glycemic index (GI) and glycemic load (GL) with T2D risk. DESIGN: We prospectively followed 74,248 women from the Nurses' Health Study (1984-2008), 90,411 women from the Nurses' Health Study II (1991-2009), and 40,498 men from the Health Professionals Follow-Up Study (1986-2008) who were free of diabetes, cardiovascular disease, and cancer at baseline. Diet was assessed by using a validated questionnaire and updated every 4 y. We also conducted an updated meta-analysis, including results from our 3 cohorts and other studies. RESULTS: During 3,800,618 person-years of follow-up, we documented 15,027 cases of incident T2D. In pooled multivariable analyses, those in the highest quintile of energy-adjusted GI had a 33% higher risk (95% CI: 26%, 41%) of T2D than those in the lowest quintile. Participants in the highest quintile of energy-adjusted GL had a 10% higher risk (95% CI: 2%, 18%) of T2D. Participants who consumed a combination diet that was high in GI or GL and low in cereal fiber had an ~50% higher risk of T2D. In the updated meta-analysis, the summary RRs (95% CIs) comparing the highest with the lowest categories of GI and GL were 1.19 (1.14, 1.24) and 1.13 (1.08, 1.17), respectively. CONCLUSION: The updated analyses from our 3 cohorts and meta-analyses provide further evidence that higher dietary GI and GL are associated with increased risk of T2D.
Authors: W C Willett; L Sampson; M J Stampfer; B Rosner; C Bain; J Witschi; C H Hennekens; F E Speizer Journal: Am J Epidemiol Date: 1985-07 Impact factor: 4.897
Authors: F B Hu; M J Stampfer; J E Manson; E Rimm; G A Colditz; B A Rosner; C H Hennekens; W C Willett Journal: N Engl J Med Date: 1997-11-20 Impact factor: 91.245
Authors: Supriya Krishnan; Lynn Rosenberg; Martha Singer; Frank B Hu; Luc Djoussé; L Adrienne Cupples; Julie R Palmer Journal: Arch Intern Med Date: 2007-11-26
Authors: S Salvini; D J Hunter; L Sampson; M J Stampfer; G A Colditz; B Rosner; W C Willett Journal: Int J Epidemiol Date: 1989-12 Impact factor: 7.196
Authors: NaNa Keum; Chen Yuan; Reiko Nishihara; Emilie Zoltick; Tsuyoshi Hamada; Alejandro Martinez Fernandez; Xuehong Zhang; Akiko Hanyuda; Li Liu; Keisuke Kosumi; Jonathan A Nowak; Iny Jhun; T Rinda Soong; Teppei Morikawa; Fred K Tabung; Zhi Rong Qian; Charles S Fuchs; Jeffrey A Meyerhardt; Andrew T Chan; Kimmie Ng; Shuji Ogino; Edward L Giovannucci; Kana Wu Journal: Int J Cancer Date: 2017-03-28 Impact factor: 7.396
Authors: Xiaosheng He; Kana Wu; Xuehong Zhang; Reiko Nishihara; Yin Cao; Charlie S Fuchs; Edward L Giovannucci; Shuji Ogino; Andrew T Chan; Mingyang Song Journal: Int J Cancer Date: 2019-05-21 Impact factor: 7.396
Authors: Sylvia H Ley; Andres V Ardisson Korat; Qi Sun; Deirdre K Tobias; Cuilin Zhang; Lu Qi; Walter C Willett; JoAnn E Manson; Frank B Hu Journal: Am J Public Health Date: 2016-07-26 Impact factor: 9.308