Ruixin Zhu1, Thomas M Larsen1, Mikael Fogelholm2, Sally D Poppitt3, Pia S Vestentoft1, Marta P Silvestre3,4, Elli Jalo2, Santiago Navas-Carretero5,6,7, Maija Huttunen-Lenz8, Moira A Taylor9, Gareth Stratton10, Nils Swindell10, Mathijs Drummen11, Tanja C Adam11, Christian Ritz1, Jouko Sundvall12, Liisa M Valsta13, Roslyn Muirhead14, Shannon Brodie14, Teodora Handjieva-Darlenska15, Svetoslav Handjiev15, J Alfredo Martinez6,7,16,17, Ian A Macdonald18, Margriet S Westerterp-Plantenga11, Jennie Brand-Miller14, Anne Raben19,20. 1. Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark. 2. Department of Food and Nutrition, University of Helsinki, Helsinki, Finland. 3. Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand. 4. CINTESIS, Nova Medical School, Universidade Nova de Lisboa, Lisboa, Portugal. 5. Centre for Nutrition Research, University of Navarra, Pamplona, Spain. 6. Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain. 7. IdisNA Instituto for Health Research, Pamplona, Spain. 8. Institute for Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany. 9. Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, Nottingham, U.K. 10. Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, U.K. 11. Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands. 12. Department of Government Services, Forensic Toxicology Unit, Biochemistry Laboratory, Finnish Institute for Health and Welfare, Helsinki, Finland. 13. Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland. 14. School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia. 15. Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria. 16. Department of Nutrition and Physiology, University of Navarra, Pamplona, Spain. 17. Precision Nutrition and Cardiometabolic Health Program, IMDEA-Food Institute (Madrid Institute for Advanced Studies), CEI UAM + CSIC, Madrid, Spain. 18. Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, U.K. 19. Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark ara@nexs.ku.dk. 20. Steno Diabetes Center Copenhagen, Gentofte, Denmark.
Abstract
OBJECTIVE: To examine longitudinal and dose-dependent associations of dietary glycemic index (GI), glycemic load (GL), and fiber with body weight and glycemic status during 3-year weight loss maintenance (WLM) in adults at high risk of type 2 diabetes. RESEARCH DESIGN AND METHODS: In this secondary analysis we used pooled data from the PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World (PREVIEW) randomized controlled trial, which was designed to test the effects of four diet and physical activity interventions. A total of 1,279 participants with overweight or obesity (age 25-70 years and BMI ≥25 kg ⋅ m-2) and prediabetes at baseline were included. We used multiadjusted linear mixed models with repeated measurements to assess longitudinal and dose-dependent associations by merging the participants into one group and dividing them into GI, GL, and fiber tertiles, respectively. RESULTS: In the available-case analysis, each 10-unit increment in GI was associated with a greater regain of weight (0.46 kg ⋅ year-1; 95% CI 0.23, 0.68; P < 0.001) and increase in HbA1c. Each 20-unit increment in GL was associated with a greater regain of weight (0.49 kg ⋅ year-1; 0.24, 0.75; P < 0.001) and increase in HbA1c. The associations of GI and GL with HbA1c were independent of weight change. Compared with those in the lowest tertiles, participants in the highest GI and GL tertiles had significantly greater weight regain and increases in HbA1c. Fiber was inversely associated with increases in waist circumference, but the associations with weight regain and glycemic status did not remain robust in different analyses. CONCLUSIONS: Dietary GI and GL were positively associated with weight regain and deteriorating glycemic status. Stronger evidence on the role of fiber is needed.
OBJECTIVE: To examine longitudinal and dose-dependent associations of dietary glycemic index (GI), glycemic load (GL), and fiber with body weight and glycemic status during 3-year weight loss maintenance (WLM) in adults at high risk of type 2 diabetes. RESEARCH DESIGN AND METHODS: In this secondary analysis we used pooled data from the PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World (PREVIEW) randomized controlled trial, which was designed to test the effects of four diet and physical activity interventions. A total of 1,279 participants with overweight or obesity (age 25-70 years and BMI ≥25 kg ⋅ m-2) and prediabetes at baseline were included. We used multiadjusted linear mixed models with repeated measurements to assess longitudinal and dose-dependent associations by merging the participants into one group and dividing them into GI, GL, and fiber tertiles, respectively. RESULTS: In the available-case analysis, each 10-unit increment in GI was associated with a greater regain of weight (0.46 kg ⋅ year-1; 95% CI 0.23, 0.68; P < 0.001) and increase in HbA1c. Each 20-unit increment in GL was associated with a greater regain of weight (0.49 kg ⋅ year-1; 0.24, 0.75; P < 0.001) and increase in HbA1c. The associations of GI and GL with HbA1c were independent of weight change. Compared with those in the lowest tertiles, participants in the highest GI and GL tertiles had significantly greater weight regain and increases in HbA1c. Fiber was inversely associated with increases in waist circumference, but the associations with weight regain and glycemic status did not remain robust in different analyses. CONCLUSIONS: Dietary GI and GL were positively associated with weight regain and deteriorating glycemic status. Stronger evidence on the role of fiber is needed.
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