The relationship between carbohydrate quality and the prevalence of metabolic syndrome: challenges of glycemic index and glycemic load

To estimate the prevalence of metabolic syndrome (MetS) and its components in adults and older adults residents of So Paulo, the association of MetS with the glycemic index (GI) and glycemic load (GL) and the foods that contribute to dietary GI and GL in this population. Data from 591 adults and older adults participants in the Health Survey of So Paulo were used. This is a cross-sectional, population-based study with a complex multistage sample design of residents in the urban area of the municipality. Dietary consumption data, anthropometric measurements, blood pressure and blood samples were collected. The associations between GI, GL and MetS and its components were tested using logistic regression models, considering the sample design of the study. The prevalence of MetS in the adult and older adults residents of So Paulo was 30.3%. There was no association between GI, GL and MetS. GI and GL were positively associated with low high-density lipoprotein cholesterol (HDL-c), OR = 1.113 (95% CI 1.007-1.230) and OR = 1.019 (95% CI 1.002-1.037), respectively. GL was inversely associated with high blood pressure and this association differed by age group (OR = 0.981; 95% CI 0.964-0.998). Foods that most contributed to dietary GI and GL were sugar, white rice and French bread. Considering the high prevalence of low HDL-c in the population of So Paulo, GI and GL may contribute to the nutritional therapy of this dyslipidemia. However, findings should be treated with caution, considering several conflicting results between studies.