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Randomized Controlled Trial
. 2011 Dec;94(6):1519-24.
doi: 10.3945/ajcn.111.020354. Epub 2011 Nov 9.

Continuous glucose monitoring to assess the ecologic validity of dietary glycemic index and glycemic load

Anthony N Fabricatore  1 , Cara B Ebbeling, Thomas A Wadden, David S Ludwig
Affiliations
Randomized Controlled Trial

Continuous glucose monitoring to assess the ecologic validity of dietary glycemic index and glycemic load

Anthony N Fabricatore et al. Am J Clin Nutr. 2011 Dec.

Abstract

Background: The circumstances under which the glycemic index (GI) and glycemic load (GL) are derived do not reflect real-world eating behavior. Thus, the ecologic validity of these constructs is incompletely known.

Objective: This study examined the relation of dietary intake to glycemic response when foods are consumed under free-living conditions.

Design: Participants were 26 overweight or obese adults with type 2 diabetes who participated in a randomized trial of lifestyle modification. The current study includes baseline data, before initiation of the intervention. Participants wore a continuous glucose monitor and simultaneously kept a food diary for 3 d. The dietary variables included GI, GL, and intakes of energy, fat, protein, carbohydrate, sugars, and fiber. The glycemic response variables included AUC, mean and SD of continuous glucose monitoring (CGM) values, percentage of CGM values in euglycemic and hyperglycemic ranges, and mean amplitude of glycemic excursions. Relations between daily dietary intake and glycemic outcomes were examined.

Results: Data were available from 41 d of monitoring. Partial correlations, controlled for energy intake, indicated that GI or GL was significantly associated with each glycemic response outcome. In multivariate analyses, dietary GI accounted for 10% to 18% of the variance in each glycemic variable, independent of energy and carbohydrate intakes (P < 0.01).

Conclusions: The data support the ecologic validity of the GI and GL constructs in free-living obese adults with type 2 diabetes. GI was the strongest and most consistent independent predictor of glycemic stability and variability.

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Figures

FIGURE 1.
FIGURE 1.
Scatter plots showing the relation between dietary glycemic index and glycemic response variables, including AUC (A), mean of glucose values (B), SD of glucose values (C), percentage of values in the euglycemic range (ie, 70–180 mg/dL; D), percentage of values in the hyperglycemic range (ie, >180 mg/dL; E), and MAGE (F). Lines of best fit were derived from bivariate Pearson's correlations. MAGE, mean amplitude of glycemic excursions.
See this image and copyright information in PMC

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