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Cited by 1,061Food composition and propertiesNutritional Studies and DietDiet, Metabolism, and Disease

Glycemic index, glycemic load, and chronic disease risk—a meta-analysis of observational studies

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Barclay, Alan W, Petocz, Peter, McMillan-Price, Joanna, Flood, Victoria M, Prvan, Tania, Mitchell, Paul, Brand-Miller, Jennie C·2008·The American Journal of Clinical Nutrition
DOI 10.1093/ajcn/87.3.627
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Abstract

Background Inconsistent findings from observational studies have prolonged the controversy over the effects of dietary glycemic index (GI) and glycemic load (GL) on the risk of certain chronic diseases.Objective The objective was to evaluate the association between GI, GL, and chronic disease risk with the use of meta-analysis techniques.Design A systematic review of published reports identified a total of 37 prospective cohort studies of GI and GL and chronic disease risk. Studies were stratified further according to the validity of the tools used to assess dietary intake. Rate ratios (RRs) were estimated in a Cox proportional hazards model and combined by using a random-effects model.Results From 4 to 20 y of follow-up across studies, a total of 40 129 incident cases were identified. For the comparison between the highest and lowest quantiles of GI and GL, significant positive associations were found in fully adjusted models of validated studies for type 2 diabetes (GI RR = 1.40, 95% CI: 1.23, 1.59; GL RR = 1.27, 95% CI: 1.12, 1.45), coronary heart disease (GI RR = 1.25, 95% CI: 1.00, 1.56), gallbladder disease (GI RR = 1.26, 95% CI: 1.13, 1.40; GL RR = 1.41, 95% CI: 1.25, 1.60), breast cancer (GI RR = 1.08, 95% CI: 1.02, 1.16), and all diseases combined (GI RR = 1.14, 95% CI: 1.09, 1.19; GL RR = 1.09, 95% CI: 1.04, 1.15).Conclusions Low-GI and/or low-GL diets are independently associated with a reduced risk of certain chronic diseases. In diabetes and heart disease, the protection is comparable with that seen for whole grain and high fiber intakes. The findings support the hypothesis that higher postprandial glycemia is a universal mechanism for disease progression.

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  • Postprandial hyperglycemia is a known risk factor for the development of several health disorders including type 2 diabetes, obesity, oxidative stress, and cardiovascular diseases.

    “Postprandial hyperglycemia is a known risk factor for the development of several health disorders including type 2 diabetes, obesity, oxidative stress, and cardiovascular diseases.”

    From Acute effect of Ceylon cinnamon extract on postprandial glycemia: alpha-amylase inhibition, starch tolerance test in rats, and randomized crossover clinical trial in healthy volunteers (2014) · cites this paper as [2]

  • The findings of this study are broadly comparable with other reviews and meta-analyses on the association between dietary fibre and whole grains and one or more disease outcomes.

    “Our findings are broadly comparable with other reviews and meta analyses that have reported on the association between dietary fibre and whole grains and one or more disease outcomes.[25][26][27][28]”

    From Carbohydrate quality and human health: a series of systematic reviews and meta-analyses (2019) · cites this paper as [26]

  • An earlier meta-analysis concluded that low-GI diets were protective for diabetes, CHD, and colon and breast cancers.

    “An earlier meta-analysis that assessed the effect of dietary GI on several health outcomes including diabetes, CHD, and cancer also concluded that low-GI diets were protective for diabetes, CHD, and colon and breast cancers.62”

    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 [62]

  • Evidence of associations between high glycemic index/load diets and cancer risk is mixed.

    “However, evidence of their associations with cancer risk is mixed (28,34,35).”

    From Diabetes and Cancer (2010) · cites this paper as [28]

  • A majority of studies suggest that diets low in red and processed meats and higher in vegetables, fruits, and whole grains are associated with a lower risk of many types of cancer.

    “A majority of studies (despite different study designs and differing study populations) suggest that diets low in red and processed meats and higher in vegetables, fruits, and whole grains are associated with a lower risk of many types of cancer (17,28,29).”

    From Diabetes and Cancer (2010) · cites this paper as [28]

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Authors
Barclay, A. W., Petocz, P., McMillan-Price, J., Flood, V. M., Prvan, T., Mitchell, P., & Brand-Miller, J. C.
Affiliations
The University of Sydney (AU)
Corresponding author
Brand-Miller, Jennie C
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2008-03
Volume
87
Issue
3
Pages
627-637
ISSN
0002-9165 (ISSN-L)
DOI
10.1093/ajcn/87.3.627
OpenAlex
W2121976341
Cited by
1,061
References
63
Citations by year
2026: 17 · 2025: 24 · 2024: 25 · 2023: 26 · 2022: 52 · 2021: 45 · 2020: 56 · 2019: 64 · 2018: 53 · 2017: 60 · 2016: 65 · 2015: 79 · 2014: 82 · 2013: 87 · 2012: 92
FWCI
7.18
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
Funders
Economic and Social Research Council (ES/G007438/1)
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 › Diet, Metabolism, and Disease
Keywords
glycemic index, glycemic load, chronic disease risk, type 2 diabetes, coronary artery disease, gallbladder disease, breast cancer, postprandial blood glucose, whole grains, dietary fiber
MeSH terms
Adult, Aged, Blood Glucose, Breast Neoplasms, Chronic Disease, Coronary Disease, Diabetes Mellitus, Type 2, Dietary Carbohydrates, Female, Follow-Up Studies, Gallbladder Diseases, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Cohort Studies, Body Mass Index, Confidence Intervals, Proportional Hazards Models, Odds Ratio, Disease Progression, Glycemic Index

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