Journal
JOURNAL OF NUTRITION
Volume 143, Issue 1, Pages 93-99Publisher
OXFORD UNIV PRESS
DOI: 10.3945/jn.112.165605
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Funding
- EU [LSHM_CT_2006_037197]
- Netherlands Agency from the Board of the University Medical Center Utrecht [IGE05012]
- Board of the University Medical Center Utrecht
- Dutch Ministry of Public Health, Welfare and Sports
- Netherlands Cancer Registry
- LK Research Funds
- Dutch Prevention Funds
- Dutch Zorg Onderzoek Nederland
- World Cancer Research Fund
- Statistics Netherlands (The Netherlands)
- Cancer Research UK
- Swedish Research Council
- Novo nordisk
- Swedish Heart Lung Foundation
- Swedish Diabetes Association
- Danish Cancer Society
- Deutsche Krebshilfe
- Associazione Italiana per la Ricerca sul Cancro
- Asturias Regional Government
- Health Research Fund of the Spanish Ministry of Health
- CIBER en Epidemiologia y Salud Publica, Spain
- Murcia Regional Government [6236]
- AIRE-ONLUS Ragusa
- AVIS-Ragusa
- Sicilian Regional Government
- Medical Research Council [MC_UU_12015/1] Funding Source: researchfish
- MRC [MC_UU_12015/1] Funding Source: UKRI
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The association of glycemic index (GI) and glycemic load (GL) with the risk of type 2 diabetes remains unclear. We investigated associations of dietary GI, GL, and digestible carbohydrate with incident type 2 diabetes. We performed a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition Study, including a random subcohort (n = 16,835) and incident type 2 diabetes cases (n = 12,403). The median follow-up time was 12 y. Baseline dietary intakes were assessed using country-specific dietary questionnaires. Country-specific HR were calculated and pooled using random effects meta-analysis. Dietary GI, GL, and digestible carbohydrate in the subcohort were (mean +/- SD) 56 +/- 4, 127 +/- 23, and 226 +/- 36 g/d, respectively. After adjustment for confounders, GI and GL were not associated with incident diabetes [HR highest vs. lowest quartile (HRQ4) for GI: 1.05 (95% CI = 0.96, 1.16); HRQ4 for GL: 1.07 (95% CI = 0.95, 1.20)]. Digestible carbohydrate intake was not associated with incident diabetes [HRQ4: 0.98(95% CI = 0.86, 1.10)]. In additional analyses, we found that discrepancies in the GI value assignment to foods possibly explain differences in GI associations with diabetes within the same study population. In conclusion, an expansion of the GI tables and systematic GI value assignment to foods may be needed to improve the validity of GI values derived in such studies, after which GI associations may need reevaluation. Our study shows that digestible carbohydrate intake is not associated with diabetes risk and suggests that diabetes risk with high-GI and -GL diets may be more modest than initial studies suggested. J. Nutr. 143: 93-99, 2013.
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