Journal
AMERICAN JOURNAL OF CLINICAL NUTRITION
Volume 100, Issue 1, Pages 218-232Publisher
OXFORD UNIV PRESS
DOI: 10.3945/ajcn.113.079533
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Funding
- NIH [P01 CA87969, P01 CA055075, R01 HL034594, UM1 CA176726, DK58845, HL60712]
- American Heart Association [13POST14370012]
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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 metaanalyses provide further evidence that higher dietary GI and GL are associated with increased risk of T2D.
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