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Cited by 214Diet, Metabolism, and DiseaseDiet and metabolism studiesFood composition and properties

High-carbohydrate–low-glycaemic index dietary advice improves glucose disposition index in subjects with impaired glucose tolerance

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Wolever, Thomas M. S., Mehling, Christine·2002·British Journal of Nutrition
DOI 10.1079/bjn2002568
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Abstract

Controversy exists about the optimal amount and source of dietary carbohydrate for managing insulin resistance. Therefore, we compared the effects on insulin sensitivity (S I), pancreatic responsivity (AIR glu) and glucose disposition index (DI=SI×AIRglu) of dietary advice aimed at reducing the amount or altering the source of dietary carbohydrate in subjects with impaired glucose tolerance (IGT). Subjects were randomized to high-carbohydrate–high-glycaemic index (GI) (high-GI, n 11), high-carbohydrate–low-GI (low-GI, n 13), or low-carbohydrate–high-monounsaturated fat (MUFA, n 11) dietary advice, with S I, AIR glu and DI measured using a frequently sampled, intravenous glucose tolerance test before and after 4 months treatment. Carbohydrate and fat intakes and diet GI, respectively, were: high-GI, 53 %, 28 %, 83; low-GI, 55 %, 25 %, 76; MUFA, 47 %, 35 %, 82. Weight changes on each diet differed significantly from each other: high-GI, -0·49 (SEM 0·29) KG; LOW-GI, -0·19 (sem 0·40) kg; MUFA +0·27 (sem 0·45) kg. Blood lipids did not change, but glycated haemoglobin increased significantly on MUFA, 0·02 (sem 0·11) %, relative to low-GI, -0·19 (sem 0·08) %, and high-GI, -0·13 (sem 0·14) %. Diastolic blood pressure fell by 8 mmHg on low-GI relative to MUFA (P=0·038). Although S I and AIR glu did not change significantly, DI, a measure of the ability of β-cells to overcome insulin resistance by increasing insulin secretion, increased on low-GI by >50 % (P=0·02). After adjusting for baseline values, the increase in DI on low-GI, 0·17 (sem 0·07), was significantly greater than those on MUFA, -0·09 (sem 0·08) and high-GI, -0·03 (sem 0·02) (P=0·019). Thus, the long-term effects of altering the source of dietary carbohydrate differ from those of altering the amount. High-carbohydrate–low-GI dietary advice improved β-cell function in subjects with IGT, and may, therefore, be useful in the management of IGT.

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  • The average of three trials of the reference food reduces the variation of mean glycaemic index values.

    “The average of three trials of the reference food has been shown to reduce the variation of mean GI values (Wolever et al. 1991(Wolever et al. , 2002)).”

    From Glycaemic index methodology (2005) · cites this paper as Wolever et al. 2002

    The Methods describe using food records to give dietary advice, and the Results report dietary GI and glucose disposition outcomes. Neither section addresses trials of a reference food or whether averaging three trials reduces variation in mean GI values (searched: reference food, three trials, and variability). (LLM, conf=0.76)

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  • In an interlaboratory GI study, laboratories using venous blood returned CI of 50%, compared with 30% in laboratories using capillary blood.

    “This has been confirmed directly in the interlaboratory study of GI, in which laboratories taking venous blood returned CI of .50 %, compared with , 30 % in all laboratories using capillary blood (Wolever et al. 2002(Wolever et al. , 2004)).”

    From Glycaemic index methodology (2005) · cites this paper as Wolever et al. 2002

    The Methods and Results passages (page numbers unavailable) describe a dietary intervention and glucose disposition measurements, not an interlaboratory GI study. Searches for venous and capillary sampling, interlaboratory variation, and the 50% versus 30% confidence intervals found no passage addressing the claim. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • No differences have been observed in glycaemic response between males and females.

    “No differences have been observed in glycaemic response between males and females (Wolever et al. 2002).”

    From Glycaemic index methodology (2005) · cites this paper as Wolever et al. 2002

    Table 1 lists the men-to-women ratios of the study groups, but does not compare glycaemic responses between men and women. The Results report comparisons between glucose-tolerance and diet groups, not between sexes. Searches for sex-specific glucose responses found no supporting passage in our copy; page numbers were not available. (LLM, conf=0.73)

    Experimental — accuracy not yet measured

  • Reducing GI or GL in the context of diets low in saturated fat can improve CHD risk factors including BMI, blood pressure, and serum cholesterol.

    “Over the last 3 decades, clinical trials have demonstrated that reducing the GI or glycemic load (GL), the product of GI and the available carbohydrate content of a food,13 in the context of diets low in saturated fat, can improve CHD risk factors including body mass index (BMI), blood pressure, and serum cholesterol.14–24”

    From Associations of Glycemic Index and Load With Coronary Heart Disease Events: A Systematic Review and Meta‐Analysis of Prospective Cohorts (2012) · cites this paper as [23]

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Research works printed but not linked: 1

  1. World Health Organization (1980) WHO Expert Committee on Diabetes Mellitus. Second Report. pp. 8 -14. Technical Report Series no. 646. Geneva: World Health Organization.

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Authors
Wolever, T. M. S., & Mehling, C.
Affiliations
St. Michael's Hospital (CA)
Corresponding author
Wolever, Thomas M. S.
ORCID
Wolever, Thomas M. S.
Venue
British Journal of Nutrition
Publisher
Cambridge University Press (CUP)
Published
2002-05
Volume
87
Issue
5
Pages
477-487
ISSN
  • 0007-1145 (ISSN-L)
  • 1475-2662
DOI
10.1079/bjn2002568
OpenAlex
W2098985975
Cited by
214
References
43
Citations by year
2025: 1 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 10 · 2019: 4 · 2018: 14 · 2017: 6 · 2016: 2 · 2015: 6 · 2014: 8 · 2013: 8 · 2012: 12
FWCI
9.18
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified, 1773 d)
Locations
  • British Journal Of Nutrition (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • U.S. Department of Health and Human Services
  • U.S. Department of Agriculture
  • Canadian Diabetes Association
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
  • Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
Keywords
impaired glucose tolerance, dietary carbohydrates, glycemic index, insulin sensitivity, monounsaturated fatty acids, insulin resistance, beta-cell function, insulin secretion, dietary recommendations, weight change, HbA1c, blood pressure, type 2 diabetes prevention, dietary fat composition, weight gain, serum lipids, intravenous glucose tolerance
MeSH terms
Insulin Secretion, Adult, Aged, Blood Glucose, Blood Pressure, Body Weight, Energy Intake, Dietary Carbohydrates, Fatty Acids, Monounsaturated, Female, Glucose Tolerance Test, Glycated Hemoglobin, Humans, Insulin, Insulin Resistance, Male, Middle Aged

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