Glycemic index, glycemic load, and risk of type 2 diabetes: results from 3 large US cohorts and an updated meta-analysis
Open accessAbstract
Background Epidemiologic evidence for the relation between carbohydrate quality and risk of type 2 diabetes (T2D) has been mixed.Objective We prospectively examined the association of dietary glycemic index (GI) and glycemic load (GL) with T2D risk.Design We prospectively followed 74,248 women from the Nurses' Health Study (1984-2008), 90,411 women from the Nurses' Health Study II (1991-2009), and 40,498 men from the Health Professionals Follow-Up Study (1986-2008) who were free of diabetes, cardiovascular disease, and cancer at baseline. Diet was assessed by using a validated questionnaire and updated every 4 y. We also conducted an updated meta-analysis, including results from our 3 cohorts and other studies.Results During 3,800,618 person-years of follow-up, we documented 15,027 cases of incident T2D. In pooled multivariable analyses, those in the highest quintile of energy-adjusted GI had a 33% higher risk (95% CI: 26%, 41%) of T2D than those in the lowest quintile. Participants in the highest quintile of energy-adjusted GL had a 10% higher risk (95% CI: 2%, 18%) of T2D. Participants who consumed a combination diet that was high in GI or GL and low in cereal fiber had an ~50% higher risk of T2D. In the updated meta-analysis, the summary RRs (95% CIs) comparing the highest with the lowest categories of GI and GL were 1.19 (1.14, 1.24) and 1.13 (1.08, 1.17), respectively.Conclusion The updated analyses from our 3 cohorts and meta-analyses provide further evidence that higher dietary GI and GL are associated with increased risk of T2D.
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The quality of carbohydrate-rich foods is linked to cardiometabolic risk.
“the quality of carbohydrate-rich foods is linked to risk (Figure 6, Figure 7).152-160”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [158]
Poor quality carbohydrates are associated with long-term weight gain, diabetes, and CVD.
“Consistent with this constellation of adverse effects, poor quality carbohydrates are associated with long-term weight gain, diabetes, and CVD.29, 89, 158, 167”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [158]
Total carbohydrate consumption has little relation to cardiometabolic health.
“While total carbohydrate consumption has little relation to cardiometabolic health, the quality of carbohydrate-rich foods is linked to risk (Figure 6, Figure 7).152-160”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [158]
A meta-analysis of observational studies indicated that high-glycemic index foods are associated with T2DM.
“A meta-analysis of observational studies indicated that high–glycemic index (GI) foods are associated with T2DM (103).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [103]
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Are Liquid Sugars Different from Solid Sugar in Their Ability to Cause Metabolic Syndrome?
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Sugar sweetened beverages and cardiometabolic health
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Emerging roles of β-cell mitochondria in type-2-diabetes
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- Authors
- Bhupathiraju, S. N., Tobias, D. K., Malik, V. S., Pan, A., Hruby, A., Manson, J. E., Willett, W. C., & Hu, F. B.
- Affiliations
- Brigham and Women's Hospital (US)
- ORCID
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2014-07
- Volume
- 100
- Issue
- 1
- Pages
- 218-232
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC4144100
- OpenAlex
- W2089851317
- Cited by
- 402
- References
- 61
- Citations by year
- 2026: 16 · 2025: 16 · 2024: 26 · 2023: 22 · 2022: 35 · 2021: 36 · 2020: 38 · 2019: 45 · 2018: 45 · 2017: 45 · 2016: 43 · 2015: 25 · 2014: 9
- FWCI
- 4.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- NIH (P01 CA87969, P01 CA055075, R01 HL034594, UM1 CA176726, DK58845, HL60712)
- American Heart Association (13POST14370012)
- 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, type 2 diabetes, cereal fiber, diabetes risk, Nurses' Health Study, Health Professionals Follow-up Study, meta-analysis
- MeSH terms
- Blood Glucose, Energy Intake, Diabetes Mellitus, Type 2, Follow-Up Studies, Humans, Surveys and Questionnaires, Risk Factors, United States, Reproducibility of Results, Nutrition Assessment, Incidence, Glycemic Index
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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