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Meta-analysis of the health effects of using the glycaemic index in meal-planning

Published online by Cambridge University Press:  09 March 2007

A. Maretha Opperman ,
Christina S. Venter ,
Welma Oosthuizen ,
Rachel L. Thompson  and
Hester H. Vorster
A. Maretha Opperman*
Affiliation:
School for Physiology, Nutrition and Consumer Sciences, North-West University, Potchefstroom, South Africa
Christina S. Venter
Affiliation:
School for Physiology, Nutrition and Consumer Sciences, North-West University, Potchefstroom, South Africa
Welma Oosthuizen
Affiliation:
School for Physiology, Nutrition and Consumer Sciences, North-West University, Potchefstroom, South Africa
Rachel L. Thompson
Affiliation:
Public Health Nutrition, Institute of Human Nutrition, University of Southampton, UK
Hester H. Vorster
Affiliation:
School for Physiology, Nutrition and Consumer Sciences, North-West University, Potchefstroom, South Africa
*
*Corresponding author: fax + 27 18 299 2464, Email vgeamo@puknet.puk.ac.za
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Abstract

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Diabetes mellitus and CVD are some of the leading causes of mortality and morbidity. Accumulating data indicate that a diet characterised by low-glycaemic index (GI) foods may improve the management of diabetes or lipid profiles. The objective of the present meta-analysis was to critically analyse the scientific evidence that low-GI diets have beneficial effects on carbohydrate and lipid metabolism compared with high-GI diets. We searched for randomised controlled trials with a crossover or parallel design published in English between 1981 and 2003, investigating the effect of low-GI v. high-GI diets on markers for carbohydrate and lipid metabolism. Unstandardised differences in mean values were examined using the random effects model. The main outcomes were fructosamine, glycated Hb (HbA1c), HDL-cholesterol, LDL-cholesterol, total cholesterol and triacylglycerol. Literature searches identified sixteen studies that met the strict inclusion criteria. Low-GI diets significantly reduced fructosamine by –0·1 (95 % CI –0·20, 0·00) mmol/l (P=0·05), HbA1c by 0·27 (95 % CI –0·5, –0·03) % (P=0·03), total cholesterol by –0·33 (95 % CI –0·47, –0·18) mmol/l (P>0·0001) and tended to reduce LDL-cholesterol in type 2 diabetic subjects by –0·15 (95 % CI –0·31, –0·00) mmol/l (P=0·06) compared with high-GI diets. No changes were observed in HDL-cholesterol and triacylglycerol concentrations. No substantial heterogeneity was detected, suggesting that the effects of low-GI diets in these studies were uniform. Results of the present meta-analysis support the use of the GI as a scientifically based tool to enable selection of carbohydrate-containing foods to reduce total cholesterol and to improve overall metabolic control of diabetes.

Keywords

Glycaemic indexFructosamineGlycated haemoglobinHigh-density lipoprotein-cholesterolLow-density lipoprotein-cholesterolTotal cholesterolTriacylglycerol
Type
Review article
Information
British Journal of Nutrition , Volume 92 , Issue 3 , September 2004 , pp. 367 - 381
Copyright
Copyright © The Nutrition Society 2004

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