Dietary glycemic index, glycemic load, and digestible carbohydrate intake are not associated with risk op type 2 diabetes in eight European countries
Sluijs, I. van der; Beulens, J.W.J. ; Schouw, Y.T. van der; Buckland, G. ; Kuijsten, A. ; Schulze, M.B. ; Amiano, P. ; Ardanaz, E. ; Balkau, B. ; Boeing, H. ; Gavrila, D. ; Feskens, E.J.M. - \ 2013
The Journal of Nutrition 143 (2013)1. - ISSN 0022-3166 - p. 93 - 99.
fiber intake - energy-intake - life-style - nutrition - cancer - women - mellitus - cohort - prevention - disease
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.
Fish Consumption, n-3 Fatty Acids, and Colorectal Cancer: A Meta-Analysis of Prospective Cohort Studies
Geelen, A. ; Schouten, J.M. ; Kamphuis, C. ; Stam, B.E. ; Burema, J. ; Renkema, J.M.S. ; Bakker, E.J. ; Veer, P. van 't; Kampman, E. - \ 2007
American Journal of Epidemiology 166 (2007). - ISSN 0002-9262 - p. 1116 - 1125.
colon-cancer - meat consumption - dietary habits - vitamin-d - gastrointestinal cancers - singapore chinese - rectal-cancer - risk-factors - fiber intake - life-style
Animal studies show favorable effects of n-3 fatty acids on inflammation and cancer, but results from epidemiologic studies appear to be inconsistent. The authors conducted meta-analyses of prospective cohort studies that evaluated the association between fish consumption or n-3 fatty acids and colorectal cancer incidence or mortality. Random-effects models were used, and heterogeneity between study results was explored through stratified analyses. The pooled relative risks for the highest compared with the lowest fish consumption category were 0.88 (95% confidence interval: 0.78, 1.00) for colorectal cancer incidence (14 studies) and 1.02 (95% confidence interval: 0.90, 1.16) for colorectal cancer mortality (four studies). The pooled relative risks for colorectal cancer incidence were 0.96 (95% confidence interval: 0.92, 1.00) for each extra occurrence of fish consumption per week (seven studies) and 0.97 (95% confidence interval: 0.92, 1.03) for each extra 100 g of fish consumed per week (four studies). Stratified analysis showed that the pooled relative risk for colorectal cancer incidence was more pronounced for women and in studies with a large exposure contrast. In cohort studies, fish consumption was shown to slightly reduce colorectal cancer risk. Existing evidence that n-3 fatty acids inhibit colorectal carcinogenesis is in line with these results, but few data are available addressing this association.
Dietary glycaemic index from an epidemiological point of view
Feskens, E.J.M. ; Du, H. - \ 2006
International Journal of Obesity 30 (2006). - ISSN 0307-0565 - p. S66 - S71.
coronary-heart-disease - impaired glucose-tolerance - middle-aged women - insulin-resistance - carbohydrate intake - fiber intake - cholesterol concentration - cardiovascular-disease - diabetic-patients - risk-factors
The concept of glycaemic index (GI) was developed 25 years ago by Jenkins and co-workers in 1981 and first studied to help diabetic patients with blood glucose control. In 1997 two epidemiological studies were published showing that high GI food consumption is associated with an increased risk of type 2 diabetes. At the same time the concept of the glycaemic load (GL) was introduced, based on GI and total carbohydrate intake. Since then, many studies have been conducted to investigate the role of dietary GI and GL in the prevention and management of type 2 diabetes, cardiovascular disease, obesity and other chronic diseases such as cancer. The current review will focus on the epidemiological evidence obtained so far. In addition, several key methodological issues will be addressed, such as the dietary assessment method used, the application of the international GI and GL table, and the correlated dietary patterns