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Cited by 122Food composition and propertiesNutritional Studies and DietDiabetes, Cardiovascular Risks, and Lipoproteins

Low glycaemic index diets for coronary heart disease

Open access
Kelly, Sarah AM, Frost, Gary, Whittaker, Victoria, Summerbell, Carolyn D·2004·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd004467.pub2
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Abstract

BACKGROUND: The glycaemic index (GI) is a physiological measure of the ability of a carbohydrate to affect blood glucose. Interest is growing in the low GI carbohydrate concept for the clinical management of people at risk of, or with established coronary heart disease. There is a need to review the current evidence from controlled trials in this area. OBJECTIVES: The primary objective is to review the current evidence from RCTs that assess the relationship between the consumption of low glycaemic index diets and the effects on coronary heart disease and on risk factors for coronary heart disease. SEARCH STRATEGY: We searched CENTRAL (Issue 4, 2003), MEDLINE (1966 to 2003), EMBASE (1980 to 2003) and CINAHL (1982 to 2003). We also contacted experts in the field. SELECTION CRITERIA: We selected randomised controlled trials that assessed the effects of low glycaemic index diets, over a minimum of 4 weeks, on coronary heart disease (CHD) and risk factors. Participants included were adults who carry at least one major risk factor for coronary heart disease such as abnormal lipids, diabetes or being overweight. DATA COLLECTION AND ANALYSIS: Two of our research team independently assessed trial quality and extracted data. Authors of the included studies were contacted for additional information when this was appropriate. MAIN RESULTS: Fifteen randomised controlled trials met the inclusion criteria. No studies found reported the effect of low glycaemic index diets on CHD mortality or CHD events and morbidity. All fifteen included studies report the effect of low glycaemic index diets on major risk factors for CHD. Meta-analysis detected limited and weak evidence of a relationship between low glycaemic index diets and slightly lower total cholesterol, compared with higher glycaemic index diets. There is also limited and weak evidence of a small reduction in HbA1c after 12 weeks on low glycaemic index diets but not at 4 to 5 weeks. There is no evidence that low glycaemic index diets have an effect on LDL cholesterol or HDL cholesterol, triglycerides, fasting glucose or fasting insulin levels. REVIEWERS' CONCLUSIONS: The evidence from randomised controlled trials showing that low glycaemic index diets reduces coronary heart disease and CHD risk factors is weak. Many of the trials identified were short-term, of poor quality and conducted on small sample sizes. There is a need for well designed, adequately powered, randomised controlled studies, of greater than 12 weeks duration to assess the effects of low glycaemic index diets for CHD.

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  • Increased carbohydrate consumption as an isocaloric substitute for fat is associated with a significant decrease in HDL-cholesterol of 0.1 mmol/L (4 mg/dL) for every 10% energy substitution.

    “Increased carbohydrate consumption, as isocaloric substitution for fat, is associated with a significant decrease in HDL-C (0.1 mmol/L or 4 mg/dL for every 10% energy substitution).”

    From ESC/EAS Guidelines for the management of dyslipidaemias (2011) · cites this paper as [87]

  • Two subsequent studies reported lower triglyceride levels with low-GI diets.

    “however, 2 subsequent studies reported lower triglyceride levels with low-GI diets.422,423”

    From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [422]

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3 of the 120 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

  1. bajo indice glucemico en hiperlipidemicos]. Nutricion Hospitalaria 2003;18(6):331-5.
  2. Lafrance 1998 {published data only} Lafrance L, Rabasa-Lhoret R, Poisson D, Ducros F, Chiasson J-L. The effects of different glycaemic index foods and dietary fibre intake on glycaemic control in type 1 diabetic patients on intensive insulin therapy. Diabetic Medicine 1998;15:972-8.
  3. Laitinen 1993 {published data only} Laitinen JH, Ahola IE, Sarkkinen ES, Winberg RL, Harmaakorpi- IIvonen PA, Uusitupa MI. Impact of intensified dietary therapy on energy and nutrient intakes and fatty acid composition of serum lipids in patients with recently diagnosed non-insulin-dependant diabetes mellitus. Diabetes Spectrum 1995;8:102-3.
  4. Lerman-Garber 1995 {published data only} Lerman-Garber I, Gulias-Herrero A, Palma ME, Valles VE, Guerrero LA, Garcia EG, et al.Response to high carbohydrate and high monounsaturated fat diets in hypertriglyceridemic non-insulin dependent diabetic patients with poor glycemic control. Diabetes, Nutrition and Metabolism -Clinical and Experimental 1995;8: 339-45.
  5. Scholz 2003 {published data only} Scholz S, Chantelau E. Glycemic index and insulin dosage on intensive insulin therapy [Glykamischer index und insulindosierung bei intensivierter insulin-therapie]. Interistische Praxis 2003;43(2):389-96.

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Authors
Kelly, S. A., Frost, G., Whittaker, V., & Summerbell, C. D.
Affiliations
  • Newcastle University (GB)
  • Hammersmith Hospital (GB)
  • Teesside University (GB)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
John Wiley & Sons, Ltd
Published
2004-10-18
Issue
4
Pages
CD004467-CD004467
ISSN
1361-6137 (ISSN-L)
DOI
10.1002/14651858.cd004467.pub2
OpenAlex
W1948043424
Cited by
122
References
120
Citations by year
2025: 1 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 4 · 2016: 3 · 2015: 8 · 2014: 8 · 2013: 9 · 2012: 8
Type
reference entry
Language
en
Update notices
new_version (2017-07-31)
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • Durham Research Online (Durham University) (acceptedVersion)
  • Teesside University Research Portal (Teesside University) (submittedVersion, cc-by-nc-nd)
  • Durham Research Online (Durham University) (submittedVersion, cc-by)
  • Newcastle University ePrints (Newcastle Univesity)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
low glycemic index diet, coronary artery disease, cardiovascular risk factors, total cholesterol, HbA1c, LDL cholesterol, HDL cholesterol, triglycerides, fasting blood glucose, fasting insulin, blood glucose, dietary carbohydrates, diabetes mellitus, overweight, dyslipidemia, coronary heart disease mortality
MeSH terms
Blood Glucose, Cholesterol, Coronary Disease, Dietary Carbohydrates, Fasting, Humans, Glycemic Index

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