Skip to main content
SpringerLink
Log in

Dietary glycaemic index and glycaemic load in a rural elderly population (60–74 years of age) and their relationship with cardiovascular risk factors

  • Original Contribution
  • Published:
European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

To examine the association between dietary glycaemic index (GI) and dietary glycaemic load (GL) with cardiovascular disease (CVD) risk factors in a rural elderly population.

Methods

A cross-sectional study was conducted in 343 subjects (60–74 years) residing in a Spanish rural area (Priego de Córdoba). Subjects were selected using stratified random sampling. Food intake was assessed using a validated food frequency questionnaire (FFQ). We assigned GI values to each item of the FFQ to estimate dietary GI and GL. Multivariate linear regression models were fitted to assess the association between GI/GL with CVD risk factors (blood glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, apolipoprotein A1, body mass index, waist circumference and blood pressure). The potential modifying effect of sex, smoking status, diabetes and medication has been explored.

Results

A statistically significant inverse association between dietary GI and blood glucose was found in the multivariate model (p = 0.029): for every 10 unit increment of GI, serum glucose levels decreased by 0.2 units. However, statistical significance was lost after controlling for diabetes or hypoglycaemic medication. In the crude model, dietary GL was associated with triglycerides (ß for every 10 GL units increase = 0.70, p = 0.005), but statistical significance was lost in the multivariate model (p = 0.508). No associations were found between dietary GI/GL and the rest of the variables studied.

Conclusions

Neither dietary GI nor GL were associated with CVD risk factors in the study population of Priego de Córdoba. Results obtained suggest the necessity to consider the diagnosis of diabetes in these studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ApoA:

Apolipoprotein A1

BMI:

Body mass index

CVD:

Cardiovascular disease

FFQ:

Food frequency questionnaire

GI:

Glycaemic index

GL:

Glycaemic load

HDL-c:

High-density lipoprotein cholesterol

LDL-c:

Low-density lipoprotein cholesterol

MUFAs:

Monounsaturated fatty acids

PUFAs:

Polyunsaturated fatty acids

SFAs:

Saturated fatty acids

References

  1. Mendis S, Alwan A (2011) A prioritized research agenda for prevention and control of noncommunicable diseases. World Health Organisation, Geneva

    Google Scholar 

  2. Instituto Nacional de Estadística (2011) Defunciones según causa de muerte. 2011. http://www.ine.es. Accessed 23 June 2011

  3. Serra-Majem L, Román B, Estruch R (2006) Scientific evidence of interventions using the mediterranean diet: a systematic review. Nutr Rev 64(2):S27–S46

    Article  Google Scholar 

  4. Kones R (2011) Primary prevention of coronary heart disease: integration of new data, evolving views, revised goals, and role of rosuvastatin in management. A comprehensive survey. Drug Des Devel Ther 5:325–380

    Article  Google Scholar 

  5. Nicklas TA, O’Neil CE, Fulgoni VL III (2012) Diet quality is inversely related to cardiovascular risk factors in adults. J Nutr 142(12):2112–2118. doi:10.3945/jn.112.164889

    Article  CAS  Google Scholar 

  6. Aston LM (2006) Glycaemic index and metabolic disease risk. Proc Nutr Soc 65:125–134

    Article  CAS  Google Scholar 

  7. Mann J, McAuley K (2007) Carbohydrates: is the advice to eat less justified for diabetes and cardiovascular health? Curr Opin Lipidol 18(1):9–12

    Article  CAS  Google Scholar 

  8. Denova-Gutiérrez E, Huitrón-Bravo G, Talavera JO, Castañón S, Gallegos-Carrido K, Flores Y et al (2010) Dietary glycemic index, dietary glycemic load, blood lipids, and coronary heart disease. J Nutr Metab. doi:10.1155/2010/170680

    Google Scholar 

  9. Burger KN, Beulens JW, Boer JM, Spijkerman AM (2011) Dietary glycemic load and glycemic index and risk of coronary heart disease and stroke in Dutch men and women: the EPIC-MORGEN study. PLoS ONE 6(10):e25955

    Article  CAS  Google Scholar 

  10. Jenkins D, Kendall C, Augustin L, Franceschi S, Hamidi M, Marchie A et al (2002) Glycemic index: overview of implications in health and disease. Am J Clin Nutr 76:266S–273S

    CAS  Google Scholar 

  11. Du H, van der A DL, van Bakel M, van der Kallen C, Blaak E, van Greevenbroek M et al (2008) Glycemic index and glycemic load in relation to food and nutrient intake and metabolic risk factors in a Dutch population. Am J Clin Nutr 87:655–661

    CAS  Google Scholar 

  12. Livesey G, Taylor R, Hulshof T, Howlett J (2008) Glycemic response and health–a systematic review and meta-analysis: the database, study characteristics, and macronutrient intakes. Am J Clin Nutr 87(1):223S–236S

    CAS  Google Scholar 

  13. Brand-Miller J, McMillan-Price J, Steinbeck K, Caterson I (2009) Dietary glycemic index: health implications. J Am Coll Nutr 28(Suppl):446S–449S

    Article  CAS  Google Scholar 

  14. Ma X-Y, Liu J-P, Song Z-Y (2012) Glycemic load, glycemic index and risk of cardiovascular diseases: meta-analysis of prospective studies. Atherosclerosis 223(2):491–496

    Article  CAS  Google Scholar 

  15. Dong JY, Zhang YH, Wang P, Qin LQ (2012) Meta-analysis of dietary glycemic load and glycemic index in relation to risk of coronary heart disease. Am J Cardiol 109(11):1608–1613. doi:10.1016/j.amjcard.2012.01.385

    Article  CAS  Google Scholar 

  16. Goff LM, Cowland DE, Hooper L, Frost GS (2013) Low glycaemic index diets and blood lipids: a systematic review and meta-analysis of randomised controlled trials. Nutr Metab Cardiovasc Dis 23(1):1–10. doi:10.1016/j.numecd.2012.06.002

    Article  CAS  Google Scholar 

  17. Wolever TMS (2013) Is glycaemic index (GI) a valid measure of carbohydrate quality? Eur J Clin Nutr 67:522–531

    Article  CAS  Google Scholar 

  18. Ros Rahola E (1992) Tratamiento dietético de las hiperlipidemias. In: Jarpyo (ed) Manual de las clínicas de lípidos españolas. Sociedad Española de Ateroesclerosis, Barcelona

  19. Mullen BJ, Krantzler NJM, Grivetti LE, Schutz HG, Meiselman HL (1984) Validity of a food frequency questionnaire for the determination of individual food intake. Am J Clin Nutr 39:136–143

    CAS  Google Scholar 

  20. Willet WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, Hennekens CH, Speizer FE (1985) Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 122:51–65

    Google Scholar 

  21. Suárez MP, Ruíz-López MD, Olea MF (1993) Raciones por fotografía. Departamento de Nutrición y Bromatología, Facultad de farmacia, Granada

    Google Scholar 

  22. Serge Hercberg, Michèle Deheeger SUVIMAX (1994) Portion alimentaires. Manuel photos pour l´estimation des quantités. Polytechnica, París

  23. Ruiz-López MD, Artacho R (2006) Programa informático para valoración de dietas “Nutrire”. Proyecto de innovación docente. Universidad de Granada, Granada

    Google Scholar 

  24. Stewart A, Marfell-Jones M, Olds T, de Ridder H (2011) International standards for anthropometric assessment. ISAK, Lower Hutt

    Google Scholar 

  25. Louie JC, Flood V, Turner N, Everingham C, Gwynn J (2011) Methodology for adding glycemic index values to 24-hour recalls. Nutrition 27(1):59–64

    Article  Google Scholar 

  26. Atkinson FS, Foster-Powell K, Brand-Miller JC (2008) International tables of glycemic index and glycemic load values: 2008. Diabetes Care 31(12):2281–2283

    Article  Google Scholar 

  27. Wolever TM, Nguyen PM, Chiasson JL, Hunt JA, Josse RG, Palmason C, Rodger NW, Ross SA, Ryan EA, Tan MH (1994) Determinants of diet glycemic index calculated retrospectively from diet records of 342 individuals with non-insulin-dependent diabetes mellitus. Am J Clin Nutr 59(6):1265–1269

    CAS  Google Scholar 

  28. Salmeron J, Manson JE, Stampfer MJ, Colditz GA, Wing AL, Willett WC (1997) Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. JAMA 277(6):472–477

    Article  CAS  Google Scholar 

  29. Willett WC, Howe GR, Kushi LH (1997) Adjustment for total energy intake in epidemiological studies. Am J Clin Nutr 65(4 Suppl):1220S–1228S

    CAS  Google Scholar 

  30. van Bakel MM, Kaaks R, Feskens EJ, Rohrmann S, Welch AA, Pala V et al (2009) Dietary glycaemic index and glycaemic load in the European prospective investigation into cancer and nutrition. Eur J Clin Nutr 63(Suppl 4):S188–S205. doi:10.1038/ejcn.2009.81

    Article  Google Scholar 

  31. Méndez M, Covas MI, Marrugat J, Vila J, Schöder H (2009) Glycemic load, glycemic index, and body mass index in Spanish adults. Am J Clin Nutr 89:316–322

    Article  Google Scholar 

  32. Howlett J, Ashwell M (2008) Glycemic response and health: summary of a workshop. Am J Clin Nutr 87(1):212S–216S

    CAS  Google Scholar 

  33. Buyken AE, Flood V, Empson M, Rochtchina E, Barclay AW, Brand-Miller J, Mitchell P (2010) Carbohydrate nutrition and inflammatory disease mortality in older adults. Am J Clin Nutr 92(3):634–643. doi:10.3945/ajcn.2010.29390

    Article  CAS  Google Scholar 

  34. Aparicio A, Robles F, López-Sobaler AM, Ortega RM (2013) Dietary glycaemic load and odds of depression in a group of institutionalized elderly people without antidepressant treatment. Eur J Nutr 52(3):1059–1066. doi:10.1007/s00394-012-0412-7

    Article  CAS  Google Scholar 

  35. Mirrahimi A, de Souza RJ, Chiavaroli L, Sievenpiper JL, Beyene J, Hanley AJ, Augustin LS, Kendall CW, Jenkins DJ (2012) Associations of glycemic index and load with coronary heart disease events: a systematic review and meta-analysis of prospective cohorts. J Am Heart Assoc. 1(5):e000752. doi:10.1161/JAHA.112.000752

    Article  Google Scholar 

  36. Kristo AS, Matthan NR, Lichtenstein AH (2013) Effect of diets differing in glycemic index and glycemic load on cardiovascular risk factors: review of randomized controlled-feeding trials. Nutrients 5:1071–1080. doi:10.3390/nu5041071

    Article  CAS  Google Scholar 

  37. Murakami K, McCaffrey TA, Livingstone MB (2013) Dietary glycaemic index and glycaemic load in relation to food and nutrient intake and indices of body fatness in British children and adolescents. Br J Nutr 110(8):1512–1523

    Article  CAS  Google Scholar 

  38. Weickert MO (2012) What dietary modification best improves insulin sensitivity and why? Clin Endocrinol (Oxf) 77(4):508–512. doi:10.1111/j.1365-2265.2012.04450.x

    Article  CAS  Google Scholar 

  39. Barba G, Sieri S, Russo MD, Donatiello E, Formisano A, Lauria F et al (2012) Glycaemic index and body fat distribution in children: the results of the ARCA Project. Nutr Metab Cardiovasc Dis 22(1):28–34. doi:10.1016/j.numecd.2010.03.007

    Article  CAS  Google Scholar 

  40. Rossi M, Bosetti C, Talamini R, Lagiou P, Negri E, Franceschi S et al (2010) Glycemic index and glycemic load in relation to body mass index and waist to hip ratio. Eur J Nutr 49(8):459–464. doi:10.1007/s00394-010-0104-0

    Article  Google Scholar 

  41. Du H, van der A DL, van Bakel MM, Slimani N, Forouhi NG, Wareham NJ et al (2009) Dietary glycaemic index, glycaemic load and subsequent changes of weight and waist circumference in European men and women. Int J Obes (Lond) 33(11):1280–1288. doi:10.1038/ijo.2009.163

    Article  CAS  Google Scholar 

  42. Thomas DE, Elliot EJ, Baur L (2007) Low glycaemic index or low glycaemic load diets for overweight and obesity. Cochrane Database Syst Rev 3(3):CD005105

  43. Brand-Miller J, Buyken AE (2012) The glycemic index issue. Curr Opin Lipidol 23(1):62–67. doi:10.1097/MOL.013e32834ec705

    Article  CAS  Google Scholar 

  44. Shikany JM, Tinker LF, Neuhouser ML, Ma Y, Patterson RE, Phillips LS et al (2010) Association of glycemic load with cardiovascular disease risk factors: the Women’s Health Initiative Observational Study. Nutrition 26(6):641–647

    Article  CAS  Google Scholar 

  45. Gopinath B, Flood VM, Rochtchina E, Baur LA, Smith W, Mitchell P (2012) Influence of high glycemic index and glycemic load diets on blood pressure during adolescence. Hypertension 59(6):1272–1277

    Article  CAS  Google Scholar 

  46. Levitan EB, Cook NR, Stampfer MJ, Ridker PM, Rexrode KM, Buring JE et al (2008) Dietary glycemic index, dietary glycemic load, blood lipids, and C-reactive protein. Metabolism 57(3):437–443

    Article  CAS  Google Scholar 

  47. van Dam RM, Visscher AW, Feskens EJ, Verhoef P, Kromhout D (2000) Dietary glycemic index in relation to metabolic risk factors and incidence of coronary heart disease: the Zutphen Elderly Study. Eur J Clin Nutr 54(9):726–731

    Article  Google Scholar 

  48. Oxlund AL, Heitmann BL (2006) Glycaemic index and glycaemic load in relation to blood lipids—6 years of follow-up in adult Danish men and women. Public Health Nutr 9(6):737–745

    Article  Google Scholar 

  49. Ma Y, Li Y, Chiriboga DE, Olendzki BC, Hebert JR, Li W et al (2006) Association between carbohydrate intake and serum lipids. J Am Coll Nutr 25(2):155–163

    Article  CAS  Google Scholar 

  50. Bouché C, Rizkalla SW, Luo J, Vidal H, Veronese A, Pacher N et al (2002) Five-week, low-glycemic index diet decreases total fat mass and improves plasma lipid profile in moderately overweight nondiabetic men. Diabetes Care 25:822–828

    Article  Google Scholar 

  51. Mosdøl A, Witte DR, Frost G, Marmot MG, Brunner EJ (2007) Dietary glycemic index and glycemic load are associated with high-density-lipoprotein cholesterol at baseline but not with increased risk of diabetes in the Whitehall II study. Am J Clin Nutr 86(4):988–994

    Google Scholar 

  52. Goletzke J, Buyken AE, Goppinath B, Rochtchina E, Barclay AW, Gheng G, Brand-Miller JC, Mitchell P (2013) Carbohydrate quality is not associated with liver enzyme activity and plasma TAG and HDL concentrations over 5 years in an older population. Br J Nutr 110(5):918–925. doi:10.101017/S0007114512005867

    Article  CAS  Google Scholar 

  53. Liu S, Willett WC, Stampfer MJ, Hu FB, Franz M, Sampson L et al (2000) A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Am J Clin Nutr 71(6):1455–1461

    CAS  Google Scholar 

  54. Nakashima M, Sakurai M, Nakamura K, Miura K, Yoshita K, Morikawa Y et al (2010) Dietary glycemic index, glycemic load and blood lipid levels in middle-aged Japanese men and women. J Atheroscler Thromb 17(10):1082–1095

    Article  CAS  Google Scholar 

  55. Radhika G, Ganesan A, Sathya RM, Sudha V, Mohan V (2009) Dietary carbohydrates, glycemic load and serum high-density lipoprotein cholesterol concentrations among South Indian adults. Eur J Clin Nutr 63(3):413–420

    Article  CAS  Google Scholar 

  56. Van Rompay MI, McKeown NM, Castaneda-Sceppa C, Ordovás JM, Tucker KL (2013) Carbohydrate nutrition differs by diabetes status and is associated with dyslipidemia in Boston Puerto Rican adults without diabetes. J Nutr 143(2):182–186

    Article  Google Scholar 

  57. Choi H, Song S, Kim J, Chung J, Yoon J, Paik HY et al (2012) High carbohydrate intake was inversely associated with high-density lipoprotein cholesterol among Korean adults. Nutr Res 32(2):100–106

    Article  CAS  Google Scholar 

  58. Slyper A, Jurva J, Pleuss J, Hoffmann R, Gutterman D (2005) Influence of glycemic load on HDL cholesterol in youth. Am J Clin Nutr 81(2):376–379

    CAS  Google Scholar 

  59. Huffman FG, Zarini GG, Cooper V (2010) Dietary glycemic index and load in relation to cardiovascular disease risk factors in Cuban American population. Int J Food Sci Nutr 61(7):690–701

    Article  Google Scholar 

  60. Reaven GM (2005) Insulin resistance, the insulin resistance syndrome, and cardiovascular disease. Panminerva Med 47(4):201–210

    CAS  Google Scholar 

Download references

Acknowledgments

MD R.-L. and R. A. contributed to the design of the study. F. A. collected the data. I. C.-Q. and R. A. analysed data and wrote the draft of the manuscript. E.M. provided expert advice, analysed data and helped in the draft of the manuscript. MD R.-L. and R. A. participated in the critical revision of the paper. All authors contributed to the preparation of the final manuscript and approved the final version. The authors have no conflict of interest to report.

Author information

Authors and Affiliations

  1. Department of Nutrition and Food Science, School of Pharmacy, University of Granada, Campus Universitario de la Cartuja, 18071, Granada, Spain

    Itandehui Castro-Quezada, Reyes Artacho & María Dolores Ruiz-López

  2. Andalusian School of Public Health, Cuesta del Observatorio, Campus Universitario de la Cartuja, 18080, Granada, Spain

    Esther Molina-Montes

  3. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

    Esther Molina-Montes

  4. Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Granada, Spain

    Esther Molina-Montes

  5. Unidad de Gestión Clínica, Centro de Salud, Priego de Córdoba, Córdoba, Spain

    Francisca Aguilera Serrano

  6. Institute of Nutrition and Food Technology, Centro de Investigación Biomédica, Parque Tecnológico de Ciencias de la Salud, University of Granada, Avenida del Conocimiento s/n, 18100, Armilla, Granada, Spain

    María Dolores Ruiz-López

Authors
  1. Itandehui Castro-Quezada
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Reyes Artacho
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Esther Molina-Montes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Francisca Aguilera Serrano
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. María Dolores Ruiz-López
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Reyes Artacho.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 90 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Castro-Quezada, I., Artacho, R., Molina-Montes, E. et al. Dietary glycaemic index and glycaemic load in a rural elderly population (60–74 years of age) and their relationship with cardiovascular risk factors. Eur J Nutr 54, 523–534 (2015). https://doi.org/10.1007/s00394-014-0733-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00394-014-0733-9

Keywords

Search

Navigation