Dietary Glycemic Index and Glycemic Load, Carbohydrate and Fiber Intake, and Measures of Insulin Sensitivity, Secretion, and Adiposity in the Insulin Resistance Atherosclerosis Study
Author:
Liese Angela D.1, Schulz Mandy12, Fang Fang1, Wolever Thomas M.S.3, D’Agostino Ralph B.4, Sparks Karen C.1, Mayer-Davis Elizabeth J.15
Affiliation:
1. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina 2. Department of Epidemiology, German Institute of Human Nutrition, University of Potsdam, Potsdam-Rehbruecke, Germany 3. Department of Nutritional Sciences, University of Toronto, Toronto, Canada 4. Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina 5. Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
Abstract
OBJECTIVE—We studied the association of digestible carbohydrates, fiber intake, glycemic index, and glycemic load with insulin sensitivity (SI), fasting insulin, acute insulin response (AIR), disposition index, BMI, and waist circumference.
RESEARCH DESIGN AND METHODS—Data on 979 adults with normal (67%) and impaired (33%) glucose tolerance from the Insulin Resistance Atherosclerosis Study (1992–1994) were analyzed. Usual dietary intake was assessed via a 114-item interviewer-administered food frequency questionnaire from which nutrient intakes were estimated. Published glycemic index values were assigned to food items and average dietary glycemic index and glycemic load calculated per subject. SI and AIR were determined by frequently sampled intravenous glucose tolerance test. Disposition index was calculated by multiplying SI with AIR. Multiple linear regression modeling was employed.
RESULTS—No association was observed between glycemic index and SI, fasting insulin, AIR, disposition index, BMI, or waist circumference after adjustment for demographic characteristics or family history of diabetes, energy expenditure, and smoking. Associations observed for digestible carbohydrates and glycemic load, respectively, with SI, insulin secretion, and adiposity (adjusted for demographics and main confounders) were entirely explained by energy intake. In contrast, fiber was associated positively with SI and disposition index and inversely with fasting insulin, BMI, and waist circumference but not with AIR.
CONCLUSION—Carbohydrates as reflected in glycemic index and glycemic load may not be related to measures of insulin sensitivity, insulin secretion, and adiposity. Fiber intake may not only have beneficial effects on insulin sensitivity and adiposity, but also on pancreatic functionality.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
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