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Meta-Analysis
. 2017 Jul 31;7(7):CD004467.
doi: 10.1002/14651858.CD004467.pub3.

Low glycaemic index diets for the prevention of cardiovascular disease

Christine Clar  1 , Lena Al-Khudairy, Emma Loveman, Sarah Am Kelly, Louise Hartley, Nadine Flowers, Roberta Germanò, Gary Frost, Karen Rees
Affiliations
Meta-Analysis

Low glycaemic index diets for the prevention of cardiovascular disease

Christine Clar et al. Cochrane Database Syst Rev. .

Abstract

Background: The glycaemic index (GI) is a physiological measure of the ability of a carbohydrate to affect blood glucose. Interest is growing in this area for the clinical management of people at risk of, or with, established cardiovascular disease. There is a need to review the current evidence from randomised controlled trials (RCTs) in this area. This is an update of the original review published in 2008.

Objectives: To assess the effect of the dietary GI on total mortality, cardiovascular events, and cardiovascular risk factors (blood lipids, blood pressure) in healthy people or people who have established cardiovascular disease or related risk factors, using all eligible randomised controlled trials.

Search methods: We searched CENTRAL, MEDLINE, Embase and CINAHL in July 2016. We also checked reference lists of relevant articles. No language restrictions were applied.

Selection criteria: We selected RCTs that assessed the effects of low GI diets compared to diets with a similar composition but a higher GI on cardiovascular disease and related risk factors. Minimum trial duration was 12 weeks. Participants included were healthy adults or those at increased risk of cardiovascular disease, or previously diagnosed with cardiovascular disease. Studies in people with diabetes mellitus were excluded.

Data collection and analysis: Two reviewers independently screened and selected studies. Two review authors independently assessed risk of bias, evaluated the overall quality of the evidence using GRADE, and extracted data following the Cochrane Handbook for Systematic Reviews of Interventions. We contacted trial authors for additional information. Analyses were checked by a second reviewer. Continuous outcomes were synthesized using mean differences and adverse events were synthesized narratively.

Main results: Twenty-one RCTs were included, with a total of 2538 participants randomised to low GI intervention (1288) or high GI (1250). All 21 included studies reported the effect of low GI diets on risk factors for cardiovascular disease, including blood lipids and blood pressure.Twenty RCTs (18 of which were newly included in this version of the review) included primary prevention populations (healthy individuals or those at high risk of CVD, with mean age range from 19 to 69 years) and one RCT was in those diagnosed with pre-existing CVD (a secondary prevention population, with mean age 26.9 years). Most of the studies did not have an intervention duration of longer than six months. Difference in GI intake between comparison groups varied widely from 0.6 to 42.None of the included studies reported the effect of low GI dietary intake on cardiovascular mortality and cardiovascular events such as fatal and nonfatal myocardial infarction, unstable angina, coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, and stroke. The unclear risk of bias of most of the included studies makes overall interpretation of the data difficult. Only two of the included studies (38 participants) reported on adverse effects and did not observe any harms (low-quality evidence).

Authors' conclusions: There is currently no evidence available regarding the effect of low GI diets on cardiovascular disease events. Moreover, there is currently no convincing evidence that low GI diets have a clear beneficial effect on blood lipids or blood pressure parameters.

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Conflict of interest statement

CC: None known.

LAK: None known.

EL: None known.

SAMK: None known.

LH: None known.

NF: None known.

RG: None known.

GF: None of the relationships described are felt to be a conflict of interest regarding this publication. Consultancy for appetite regulation with Unilever; grant application to Nestle on modified cereal fibre and glycaemic control (awaiting outcome); patent on compounds and their effects on appetite control and insulin sensitivity (WO2014020344 A1).

KR: None known.

Figures

1
1
Ongoing: 1 study (3 records) Awaiting classification: 5 studies (5 records) Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1: Low GI versus control (primary prevention), Outcome 1: Total cholesterol (mmol/L) change
1.2
1.2. Analysis
Comparison 1: Low GI versus control (primary prevention), Outcome 2: HDL Cholesterol (mmol/L) change
1.3
1.3. Analysis
Comparison 1: Low GI versus control (primary prevention), Outcome 3: LDL cholesterol (mmol/L) change
1.4
1.4. Analysis
Comparison 1: Low GI versus control (primary prevention), Outcome 4: Triglycerides (mmol/L) change
1.5
1.5. Analysis
Comparison 1: Low GI versus control (primary prevention), Outcome 5: Systolic blood pressure (mmHg) change
1.6
1.6. Analysis
Comparison 1: Low GI versus control (primary prevention), Outcome 6: Diastolic blood pressure (mmHg) change
1.10
1.10. Analysis
Comparison 1: Low GI versus control (primary prevention), Outcome 10: Weight change (kg)
1.11
1.11. Analysis
Comparison 1: Low GI versus control (primary prevention), Outcome 11: BMI change (kg/m2)
2.1
2.1. Analysis
Comparison 2: Low GI versus control (secondary prevention), Outcome 1: Total cholesterol (mmol/L) change
2.2
2.2. Analysis
Comparison 2: Low GI versus control (secondary prevention), Outcome 2: HDL Cholesterol (mmol/L) change
2.3
2.3. Analysis
Comparison 2: Low GI versus control (secondary prevention), Outcome 3: LDL cholesterol (mmol/L) change
2.4
2.4. Analysis
Comparison 2: Low GI versus control (secondary prevention), Outcome 4: Triglycerides (mmol/L) change
2.5
2.5. Analysis
Comparison 2: Low GI versus control (secondary prevention), Outcome 5: Systolic blood pressure (mmHg) change
2.6
2.6. Analysis
Comparison 2: Low GI versus control (secondary prevention), Outcome 6: Diastolic blood pressure (mmHg) change
2.7
2.7. Analysis
Comparison 2: Low GI versus control (secondary prevention), Outcome 7: Weight change (kg)
2.8
2.8. Analysis
Comparison 2: Low GI versus control (secondary prevention), Outcome 8: BMI change (kg.m2)
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Armendariz‐Anguiano 2011 {published data only}
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Bellisle 2007 {published data only}
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DiOGenes 2011 low protein {published data only}
    1. Aller EE, Larsen TM, Claus H, Lindroos AK, Kafatos A, Pfeiffer A, et al. Weight loss maintenance in overweight subjects on ad libitum diets with high or low protein content and glycemic index: the DIOGENES trial 12-month results. International Journal of Obesity 2014;28(12):1511-7. - PubMed
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Ghani 2014a high insulin {published data only}
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Ghani 2014 low insulin {published data only}
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    1. Ghani RA, Shyam S, Arshad F, Wahab NA, Chinna K, Safii NS, et al. The influence of fasting insulin level in post-gestational diabetes mellitus women receiving low-glycaemic-index diets. Nutrition & Diabetes 2014;4(2):e107. - PMC - PubMed
    1. Shyam S, Arshad F, Abdul Ghani R, Abdul Wahab N, Barakatun Nisak M, Safii N, et al. Women with previous gestational diabetes mellitus achieve clinically significant weight loss on low glycaemic index diets. In: Obesity Reviews. Vol. 15. 2014:92.
Hönemann 2010 {published data only}
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McMillan‐Price 2006 high CHO {published data only}
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McMillan‐Price 2006 high protein {published data only}
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Melanson 2012 {published data only}
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Philippou 2008 {published data only}
    1. Philippou E, McGowan BM, Brynes AE, Dornhorst A, Leeds AR, Frost GS. The effect of a 12-week low glycaemic index diet on heart disease risk factors and 24 h glycaemic response in healthy middle-aged volunteers at risk of heart disease: a pilot study. European Journal of Clinical Nutrition 2008;62:145-9. - PubMed
Philippou 2009 {published data only}
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Philippou 2009a {published data only}
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Raatz 2005 {published data only}
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Randolph 2014 {published data only}
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RISCK 2010 high MUFA {published data only}
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RISCK 2010 low fat {published data only}
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Shikany 2005 {published data only}
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Sichieri 2007 {published data only}
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Solomon 2010 {published data only}
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Venn 2010 {published data only}
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Wolever 2002 {published and unpublished data}
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References to studies excluded from this review

Abbasi 2000 {published data only}
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Abete 2008 {published data only}
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Agus 2000 {published data only}
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Alfenas 2005 {published data only}
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Alfenas 2012 {published data only}
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Argiana 2011 {published data only}
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Aston 2008 {published data only}
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Bahadori 2005 {published data only}
    1. Bahadori B, Yazdani-Biuki B, Krippl P, Brath H, Uitz E, Wascher TC. Low-fat, high carbohydrate (low glycaemic index) diet induces weight loss and preserves lean body mass in obese healthy subjects: results of a 24 week study. Diabetes, Obesity and Metabolism 2005;7:290-3. - PubMed
Barakatun 2010 {published data only}
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Barkoukis 2002 {published data only}
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Bouche 2002 {published data only}
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Brand 1991 {published data only}
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Brynes 2003 {published data only}
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Calle‐Pascual 1988 {published and unpublished data}
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Carels 2005 {published data only}
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Chanteleau 1985 {published data only}
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Cheong 2009 {published data only}
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Chiavaroli 2016 {published data only}
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Clapp 1998 {published data only}
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Colagiuri 1986 {published data only}
    1. Colagiuri S, Miller JJ, Holliday JL, Phelan E. Comparison of plasma glucose, serum Insulin, and C-peptide responses to three isocaloric breakfasts in non-insulin-dependant diabetic subjects. Diabetes Care 1986;9:250-5. - PubMed
Collier 1986 {published data only}
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Collier 1988 {published data only}
    1. Collier GR, Giudici S, Kalmusky J, Wolever TMS, Helman G, Wesson V, et al. Low glycaemic index starchy foods improve glucose control and lower serum cholesterol in diabetic children. Diabetes, Nutrition and Metabolism - Clinical and Experimental 1988;1:11-9.
Coulston 1984 {published data only}
    1. Coulston AM, Hollenbeck CB, Liu GC, Williams RA, Starich GH, Mazzaferri EL, et al. Effect of source of dietary carbohydrate on plasma glucose, insulin, and gastric inhibitory polypeptide responses to test meals in subjects with noninsulin-dependant diabetes mellitus. American Society of Clinical Nutrition 1984;40:965-70. - PubMed
Crapo 1981 {published data only}
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De Rougemont 2007 {published data only}
    1. De Rougemont A, Normand S, Nazare JA, Skilton MR, Sothier M, Vinoy S, et al. Beneficial effects of a 5-week low-glycaemic index regimen on weight control and cardiovascular risk factors in overweight non-diabetic subjects. British Journal of Nutrition 2007;98:1288-98. - PubMed
Dumesnil 2001 {published data only}
    1. Dumesnil JG, Turgeon J, Tremblay A, Poirer P, Gilbert M, Gagnon L, et al. Effect of a low-glycaemic Index-low-fat-high protein diet on the atherogenic metabolic risk profile of abdominally obese men. British Journal of Nutrition 2001;86:557-68. - PubMed
Ebbeling 2003 {published data only}
    1. Ebbeling CB, Leidig MM, Sinclair KB, Hangen JP, Ludwig DS. A reduced glycemic load diet in the treatment of adolescent obesity. Archives of Pediatrics and Adolescent Medicine 2003;157:773-9. - PubMed
Ebbeling 2005 {published data only}
    1. Ebbeling CB, Leidig MM, Sinclair KB, Seger-Shippee LG, Feldman HA, Ludwig DS. Effects of an ad libitum low glycemic load diet on cardiovascular disease risk factors in obese young adults. American Journal of Clinical Nutrition 2005;81:976-82. - PubMed
Fontvielle 1988 {published data only}
    1. Fontvieille AM, Acosta M, Rizkalla SW, Bornet F, David P, Letanoux M, et al. A moderate switch from high to low glycaemic-index foods for 3 weeks improves the metabolic control of Type I (IDDM) diabetic subjects. Diabetes, Nutrition and Metabolism - Clinical and Experimental 1988;1:139-43.
Fontvielle 1992 {published data only}
    1. Fontvielle AM, Rizkalla SW, Penfornis A, Acosta M, Bornet FRJ, Slama G. The use of low glycaemic index foods improves metabolic control of diabetic patients over five weeks. Diabetic Medicine 1992;9:444-50. - PubMed
Frost 1994 {published data only}
    1. Frost G, Wilding J, Beecham J. Dietary advice based on the glycaemic index improves dietary profile and metabolic control in type 2 diabetic patients. Diabetic Medicine 1994;11:397-401. - PubMed
Frost 1996 {published data only}
    1. Frost G, Keogh B, Smith D, Akinsanya K, Leeds A. The effect of low-glycemic carbohydrate on insulin and glucose response in vivo and in vitro in patients with coronary heart disease. Metabolism 1996;45(6):669-72. - PubMed
Frost 1998a {published data only}
    1. Frost G, Leeds A, Trew G, Margara R, Dornhurst A. Insulin sensitivity in women at risk of coronary heart disease and the effect of a low glycemic diet. Metabolism 1998;47(10):1245-51. - PubMed
Frost 1998b {published data only}
    1. Frost GE, Keogh BE, Smith D, Leeds AR, Dornhorst A. Reduced adipocyte insulin sensitivity in Caucasian and Asian subjects with coronary heart disease. Diabetic Medicine 1998;15:1003-9. - PubMed
Frost 1999 {published data only}
    1. Frost G, Leeds AA, Dore CJ, Madeiros S, Brading S, Dornhurst A. Glycaemic index as a determinant of serum HDL-cholesterol concentration. Lancet 1999;353:1045-8. - PubMed
Fuh 1990 {published data only}
    1. Fuh MMT, Lee MMS, Jeng CY, Ma F, Chen I, Reavem GM. Effect of low fat-high carbohydrate diets in hypertensive patients with non-insulin-dependent diabetes mellitus. American Journal of Hypertension 1990;3:527-32. - PubMed
Garg 1988 {published data only}
    1. Garg A, Bonanome A, Grundy SM, Zhang ZU, Unger RH. Comparison of a high-carbohydrate diet with a high-monounsaturated-fat diet in patients with non-insulin-dependent diabetes mellitus. New England Journal of Medicine 1988;13:828-35. - PubMed
Garg 1992 {published data only}
    1. Garg A, Grundy SM, Unger RH. Comparison of effects of high and low carbohydrate diets on plasma lipoproteins and insulin sensitivity in patients with mild NIDDM. Diabetes 1992;41:1278-85. - PubMed
Garg 1994 {published data only}
    1. Garg A, Bantle JP, Henry RR, Coulston AM, Griver KA, Raatz SK, et al. Effects of varying carbohydrate content of diet in patients with non-insulin-dependant diabetes mellitus. JAMA 1994;271:1420-9. - PubMed
Giacco 2000 {published data only}
    1. Giacco R, Parillo M, Rivellese AA, Lasorella G, Giacco A, D'Episcopo L, et al. Long-term dietary treatment with increased amounts of fiber-rich low-glycemic index natural foods improves blood glucose control and reduces the number of hypoglycemic events in type 1 diabetic patients. Diabetes Care 2000;23(10):1461-6. - PubMed
Gilbertson 2001 {published data only}
    1. Gilbertson HR, Brand-Miller JC, Thornburn AW, Evans S, Chondros P, Werther GA. The effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes. Diabetes Care 2001;24(7):1137-43. - PubMed
Gilbertson 2003 {published data only}
    1. Gilbertson HR, Thornburn AW, Brand-Miller JC, Chondros P, Werther GA. Effect of low glycaemic-index dietary advice on dietary quality and food choice in children with type 1 diabetes. American Journal of Clinical Nutrition 2003;77:83-90. - PubMed
Golay 1992 {published data only}
    1. Golay A, Koellreutter B, Bloise D, Assal JP, Wursch P. The effect of muesli or cornflakes at breakfast on carbohydrate metabolism in type 2 diabetic patients. Diabetes Research and Clinical Practice 1992;15:135-42. - PubMed
Grant 2010 {published data only}
    1. Grant S, Wolever TMS, O'Connor DL, Josse RG. The effect of a low glycemic index diet on gestational hyperglycemia: a pilot trial. Federation of the American Societies of Experimental Biology Journal 2010;19(11):15-22.
Gutschall 2009 {published data only}
    1. Gutschall MD, Miller CK, Mitchell DC, Lawrence FR. A randomized behavioural trial targeting glycaemic index improves dietary, weight and metabolic outcomes in patients with type 2 diabetes. Public Health Nutrition 2009;12:1846-54. - PubMed
Heilbronn 2002 {published data only}
    1. Heilbronn LK, Noakes M, Clifton PM. The effect of high- and low-glycemic index energy restricted diets on plasma lipid and glucose profiles in type 2 diabetic subjects with varying glycemic control. Journal of the American College of Nutrition 2002;21(2):120-7. - PubMed
Herrmann 2001 {published data only}
    1. Herrmann TS, Bean ML, Black TM, Wang P, Coleman RA. High glycemic index carbohydrate diet alters the diurnal rhythm of leptin but not insulin concentrations. Experimental Biology & Medicine 2001;226:1037-44. - PubMed
Hollenbeck 1985 {published data only}
    1. Hollenbeck CB, Riddle MC, Connor WE, Leklem JE. The effects of subject-selected high carbohydrate, low fat diets on glycemic control in insulin dependant diabetes mellitus. American Society for Clinical Nutrition 1985;41:293-8. - PubMed
Jarvi 1995 {published data only}
    1. Jarvi AE, Karlstrom BE, Granfeldt YE, Bjorck IME, Vessby BOH, Asp LN. The influence of food structure on postprandial metabolism in patients with non-insulin-dependant diabetes mellitus. American Journal of Clinical Nutrition 1995;61:837-43. - PubMed
Jarvi 1999 {published data only}
    1. Jarvi A, Karlstrom B, Granfeldt Y, Bjorck I, Asp NG, Vessby B. Improved glycemic control and lipid profile and normalized fibrinolytic activity on a low glycemic index diet in type 2 diabetic patients. Diabetes Care 1999;22:10-8. - PubMed
Jenkins 1985 {published data only}
    1. Jenkins DJA, Wolever TMS, Kalmusky J, Giudici S, Giordano C, Wong GS, et al. Low glycemic index carbohydrate foods in the management of hyperlipidemia. American Journal of Clinical Nutrition 1985;42:604-17. - PubMed
Jenkins 1987a {published data only}
    1. Jenkins DJA, Wolever TMS, Collier GR, Ocana A, Rao AV, Buckley G, et al. Metabolic effects of a low-glycemic-index diet. American Society for Clinical Nutrition 1987;46:968-75. - PubMed
Jenkins 1987b {published data only}
    1. Jenkins DJA, Wolever TMS, Kalmusky J, Guidici S, Giordano C, Patten R, et al. Low glycemic index diet in hyperlipidemia: use of traditional starchy foods. American Journal of Clinical Nutrition 1987;46:66-71. - PubMed
Jenkins 1988 {published data only}
    1. Jenkins DJA, Wolever TMS, Buckley G, Lam KY, Giudici S, Kalmusky J, et al. Low glycemic index starchy foods in the diabetic diet. American Journal of Clinical Nutrition 1988;48:248-54. - PubMed
Jenkins 2002a {published data only}
    1. Jenkins DJA, Kendall CWC, Augustin LSA, Martini MC, Axelsen M, Faulkner D, et al. Effect of wheat bran on glycemic control and risk factors for cardiovascular disease in type 2 diabetes. Diabetes Care 2002;25:1522-8. - PubMed
Jenkins 2002b {published data only}
    1. Jenkins AL, Jenkins DJA, Zdravkovic U, Wursch P, Vuksan V. Depression of the glycemic index by high levels of B-glucan fiber in two functional foods tested in type 2 diabetes. European Journal of Clinical Nutrition 2002;56:622-8. - PubMed
Jenkins 2008 {published data only}
    1. Jenkins DJ, Kendall CW, McKeown-Eyssen G, Josse RG, Silverberg J, Booth GL, et al. Effect of a low-glycemic index or a high-cereal fiber diet on type 2 diabetes: a randomized trial. JAMA 2008;300:2742-53. - PubMed
Jensen 2008 {published data only}
    1. Jensen L, Sloth B, Krog-Mikkelsen I, Flint A, Raben A, Tholstrup T, et al. A low-glycemic-index diet reduces plasma plasminogen activator inhibitor-1 activity, but not tissue inhibitor of proteinases-1 or plasminogen activator inhibitor-1 protein, in overweight women. American Journal of Clinical Nutrition 2008;87:97-105. - PubMed
Jeppesen 1997 {published data only}
    1. Jeppensen J, Schaaf P, Jones C, Zhou MY, Chen IYD, Reaven GM. Effects of low-fat, high-carbohydrate diets on risk factors for ischemic heart disease in postmenopausal women. American Society for Clinical Nutrition 1997;65:1027-33. - PubMed
Jimenez‐Cruz 2003a {published data only}
    1. Jimenez-Cruz A, Bacardi-Gascon M, Turnbull WH, Rosales G, Severino-Lugo I. A flexible, low-glycemic index Mexican-style diet in overweight and obese subjects with type 2 diabetes improves metabolic parameters during a 6-week treatment period. Diabetes Care 2003;26(7):1967-70. - PubMed
Jiminez‐Cruz 2003b {published data only}
    1. Jiminez-Cruz A, Seimandi-Mora H, Bacardi-Gascon M. Effect of low glycemic index diet in hyperlipidemia [Efecto de dietas con bajo indice glucemico en hiperlipidemicos]. Nutricion Hospitalaria 2003;18(6):331-5. - PubMed
Jiminez‐Cruz 2004 {published data only}
    1. Jiminez-Cruz A, Turnbull WH, Bacardi-Gascon MB, Rosales-Garay P. A high fiber, moderate-glycemic index, Mexican style diet improves dyslipidemia in individuals with type 2 diabetes. Nutrition Research 2004;24(1):19-27.
Kabir 2002 {published data only}
    1. Kabir M, Oppert J-M, Vidal H, Bruzzo F, Fiquet C, Wursch P, et al. Four-week low-glycemic index breakfast with a modest amount of soluble fibers in type 2 diabetic men. Metabolism 2002;51(7):819-26. - PubMed
    1. Kabir M, Rizkalla SW, Oppert J-M, Wursch P, Bruzzo F, Slama G. Chronic effects of a low glycemic index starch breakfast on glucose and lipid metabolism in type 2 diabetic men: results of a controlled study. Diabetes 1999;48(Suppl 1):A461.
Kelly 2011 {published data only}
    1. Kelly KR, Haus JM, Solomon TP, Patrick-Melin AJ, Cook M, Rocco M, et al. A low-glycemic index diet and exercise intervention reduces TNF(alpha) in isolated mononuclear cells of older, obese adults. Journal of Nutrition 2011;141:1089-94. - PMC - PubMed
Kendall 2012 {published data only}
    1. Kendall CWC, Augustin LS, Mitchell S, Sahye-Pudaruth S, Coveney J, Cerovic A, et al. Effect of pulses as part of a low glycemic index diet compared to a high fiber diet on HbA1c and blood lipids in type 2 diabetes. Federation of the American Societies of Experimental Biology Journal 2012;26:5.
Kiens 1996 {published data only}
    1. Kiens B, Richter EA. Types of carbohydrate in an ordinary diet affect insulin action and muscle substrates in humans. American Journal of Clinical Nutrition 1996;63:47-53. - PubMed
Komindr 2001 {published data only}
    1. Komindr S, Ingsriswang S, Lerdvuthisopon N, Boontawee A. Effect of long-term intake of Asian food with different glycaemic indices on diabetic control and protein conservation in type 2 diabetic patients. Journal of the Medical Association of Thailand 2001;84(1):85-97. - PubMed
Krog‐Mikkelsen 2011 {published data only}
    1. Krog-Mikkelsen I, Sloth B, Dimitrov D, Tetens I, Bjorck I, Flint A, et al. A low glycemic index diet does not affect postprandial energy metabolism but decreases postprandial insulinemia and increases fullness ratings in healthy women. Journal of Nutrition 2011;141:1679-84. - PubMed
Kwak 2012 {published data only}
    1. Kwak JH, Paik JK, Kim HI, Kim OY, Shin DY, Kim HJ, et al. Dietary treatment with rice containing resistant starch improves markers of endothelial function with reduction of postprandial blood glucose and oxidative stress in patients with prediabetes or newly diagnosed type 2 diabetes. Atherosclerosis 2012;224:457-64. - PubMed
Lafrance 1998 {published data only}
    1. Lafrance L, Rabasa-Lhoret R, Poisson D, Ducros F, Chiasson J-L. The effects of different glycaemic index foods and dietary fibre intake on glycaemic control in type 1 diabetic patients on intensive insulin therapy. Diabetic Medicine 1998;15:972-8. - PubMed
LaHaye 2005 {published data only}
    1. LaHaye SA, Hollett PM, Vyselaar JR, Shakchi M, Lahey KA, Day AG. Comparison between a low glycemic load diet and a Canada Food Guide diet in cardiac rehabilitation patients in Ontario. Canadian Journal of Cardiology 2005;21(6):489-94. - PubMed
Laitinen 1993 {published data only}
    1. Laitinen JH, Ahola IE, Sarkkinen ES, Winberg RL, Harmaakorpi-IIvonen PA, Uusitupa MI. Impact of intensified dietary therapy on energy and nutrient intakes and fatty acid composition of serum lipids in patients with recently diagnosed non-insulin-dependant diabetes mellitus. Diabetes Spectrum 1995;8:102-3. - PubMed
Leinonen 2000 {published data only}
    1. Leinonen KS, Poutanen KS, Mykkanen HM. Rye bread decreases serum total and LDL cholesterol in men with moderately elevated serum cholesterol. Journal of Nutrition 2000;130:164-70. - PubMed
Lerman‐Garber 1995 {published data only}
    1. Lerman-Garber I, Gulias-Herrero A, Palma ME, Valles VE, Guerrero LA, Garcia EG, et al. Response to high carbohydrate and high monounsaturated fat diets in hypertriglyceridemic non-insulin dependent diabetic patients with poor glycemic control. Diabetes, Nutrition and Metabolism - Clinical and Experimental 1995;8:339-45.
Lieberman 2003 {published data only}
    1. Lieberman S. Natural methods for accelerating weight loss: the low glycemic index diet, green tea, chromium, and 5-hydroxytryptophan. Alternative and Complementary Therapies 2003;9(6):307-11.
Liu 2000 {published data only}
    1. Liu S, Willett WC, Stampfer MJ, Hu FB, Franz M, Sampson L, et al. A prospective study of dietary glycemic load, carbohydrate intake and risk of coronary heart disease in US women. American Journal of Clinical Nutrition 2000;71(6):1455-61. - PubMed
Liu 2002 {published data only}
    1. Liu S, Manson JE, Buring JE, Stampfer MJ, Willett WC, Ridker PM. Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women. American Journal of Clinical Nutrition 2002;75(3):492-8. - PubMed
Ludwig 1999 {published data only}
    1. Ludwig DS, Majzoub JA, Al-Zahrani A, Dallal GE, Blanco I, Roberts SB. High glycemic index foods, overeating, and obesity. Pediatrics 1999;103(3):E26. - PubMed
Lunetta 1996 {published data only}
    1. Lunetta M, Mauro MD. Different effect of acute and chronic oral metformin administration on glucose and insulin response to bread and to pasta in non-insulin dependent diabetic patients. Diabetes Research and Clinical Practice 1996;33:53-8. - PubMed
Luscombe 1999 {published data only}
    1. Luscombe ND, Noakes M, Clifton PM. Diets high and low in glycemic index versus high monounsaturated fat diets: effects on glucose and lipid metabolism in NIDDM. European Journal of Clinical Nutrition 1999;53:473-8. - PubMed
Marsh 2010 {published data only}
    1. Marsh KA, Steinbeck KS, Atkinson FS, Petocz P, Brand-Miller JC. Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. American Journal of Clinical Nutrition 2010;92:83-92. - PubMed
Morales 1997 {published data only}
    1. Morales LM, Semprun-Fereira M, Ryder E, Valbuena H, Rincon E, Fernandez V, et al. Improved triglyceride control with low glycaemic index-high carbohydrate modified-lipid diet in a hypertriglyceridaemic child. Acta Paediatrica 1997;86:772-4. - PubMed
Nazare 2010 {published data only}
    1. Nazare JA, De Rougemont A, Normand S, Sauvinet V, Sothier M, Vinoy S, et al. Effect of postprandial modulation of glucose availability: short-and long-term analysis. British Journal of Nutrition 2010;103:1461-70. - PubMed
Pacy 1984 {published data only}
    1. Pacy PJ, Dodson PM, Kubicki AJ, Fletcher RF, Taylor KG. Effect of a high fibre, high carbohydrate dietary regimen on serum lipids and lipoproteins in type II hypertensive diabetic patients. Diabetes Research 1984;1:159-63. - PubMed
Patel 2004 {published data only}
    1. Patel VC, Aldridge RD, Leeds A, Dornhorst A, Frost GS. Retrospective analysis of the impact of a low glycaemic index diet on hospital stay following coronary artery bypass grafting: a hypothesis. Journal of Human Nutrition and Dietetics 2004;17(3):241-7. - PubMed
Patel 2011a {published data only}
    1. Patel JV, Hughes EA, Lip GY, Gill PS. Diabetes Health, Residence & Metabolism in Asians: the DHRMA study, research into foods from the Indian subcontinent - a blinded, randomised, placebo controlled trial. BMC Cardiovascular Disorders 2011;11:70. - PMC - PubMed
Percheron 1997 {published data only}
    1. Percheron C, Colette C, Avignon A, Monnier L. Metabolic responses to high carbohydrate breakfasts in obese patients with impaired glucose tolerance. Comparison of meals containing dairy products and fruits versus bread. Nutrition Research 1997;17:797-806.
Pereira 2002 {published data only}
    1. Pereira MA, Jacobs DR, Pins JJ, Raatz SK, Gross MD, Slavin JL, et al. Effext of whole grains on insulin sensitivity in overweight hyperinsulinemic adults. American Journal of Clinical Nutrition 2002;75(5):848-55. - PubMed
Pereira 2004 {published data only}
    1. Pereira MA, Swain J, Goldfine AB, Rifai N, Ludwig DS. Effects of a low glycemic index load diet on resting energy expenditure and heart disease risk factors during weight loss. JAMA 2004;292(20):2482-90. - PubMed
Perichart‐Perera 2012 {published data only}
    1. Perichart-Perera O, Balas-Nakash M, Rodriguez-Cano A, Legorreta-Legorreta J, Parra-Covarrubias A, Vadillo-Ortega F. Low glycemic index carbohydrates versus all types of carbohydrates for treating diabetes in pregnancy: a randomized clinical trial to evaluate the effect of glycemic control. International Journal of Endocrinology 2012;Epub 2012 Nov 29:296017. - PMC - PubMed
Pittas 2005 {published data only}
    1. Pittas AG, Das SK, Hajduk CL, Golden J, Saltzman E, Stark PC, et al. A low glycemic load diet facilitates greater weight loss in overweight adults with high insulin secretion but not in overweight adults with low insulin secretion in the CALERIE trial. Diabetes Care 2005;28(12):2939-41. - PubMed
Poppitt 2002 {published data only}
    1. Poppitt SD, Keogh GF, Prentice AM, Williams DEM, Sonnemans HMW, Valk EEJ, et al. Long-term effects of ad libitum low-fat, high-carbohydrate diets on body weight and serum lipids in overweight subjects with metabolic syndrome. American Society for Clinical Nutrition 2002;75:11-20. - PubMed
Rabasa‐Lhoret 1999 {published data only}
    1. Rabasa-Lhoret R, Garon J, Langelier H, Poisson D, Chiasson JL. Effects of meal carbohydrate content on insulin requirements in type 1 diabetic patients treated intensively with the basal-bolus (ultralente- regular) insulin regimen. Diabetes Care 1999;22:667-73. - PubMed
Rasmussen 1993 {published data only}
    1. Rasmussen OW, Thomsen C, Hansen KW, Vesterlund M, Winther E, Hermansen K. Effects on blood pressure, glucose, and lipid levels of a high-monounsaturated fat diet compared with a high-carbohydrate diet in NIDDM subjects. Diabetes Care 1993;16:1564-71. - PubMed
Runchey 2012 {published data only}
    1. Runchey SS, Pollak MN, Valsta LM, Coronado GD, Schwarz Y, Breymeyer KL, et al. Glycemic load effect on fasting and post-prandial serum glucose, insulin, IGF-1 and IGFBP-3 in a randomized, controlled feeding study. European Journal of Clinical Nutrition 2012;66:1146-52. - PMC - PubMed
Runchey 2013 {published data only}
    1. Runchey SS, Valsta LM, Schwarz Y, Wang C, Song X, Lampe JW, et al. Effect of low- and high-glycemic load on circulating incretins in a randomized clinical trial. Metabolism: Clinical and Experimental 2013;62:188-95. - PMC - PubMed
Sacks 2013 {published data only}
    1. Sacks FM, Appel LJ, Carey VJ, Anderson CA, Charleston J, Copeland P, et al. Effect of dietary carbohydrate (amount and type) on risk factors for cardiovascular disease and diabetes: the omnicarb trial. Circulation 2013;127(Suppl 12):A016.
Salmeron 1997 {published data only}
    1. Salmeron J, Ascherio A, Rimm EB, Colditz GA, Spiegelman D, Jenkins DJ, et al. Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care 1997;20(4):545-50. - PubMed
Santacroce 1990 {published data only}
    1. Santacroce G, Forlani G, Giangiulio S, Galuppi V, Pagani M, Vannini P. Long-term effects of eating sucrose on metabolic control of type 1 (insulin-dependent) diabetic outpatients. Acta Diabetologica Latina 1990;27:365-70. - PubMed
Scholz 2003 {published data only}
    1. Scholz S, Chantelau E. Glycemic index and insulin dosage on intensive insulin therapy [Glykämischer Index und Insulindosierung bei intensivierter Insulin-Therapie]. Interistische Praxis 2003;43(2):389-96.
Sciarrone 1993 {published data only}
    1. Sciarrone SEG, Martin T, Strahan LJ, Beilin VB, Burke V, Rogers P, et al. Ambulatory blood pressure and heart rate responses to vegetarian meals. Journal of Hypertension 1993;11:227-85. - PubMed
Sharafetdinov 1997 {published data only}
    1. Sharafetdinov KhKh, Meshcheriakova VA, Plotnikova OA. Change in postprandial glycemia as affected by various carbohydrate-containing products in patients with type II diabetes mellitus [Izmenenie poslepishchevoi glikemii pod vliianiem nekotorykh uglevodsoderzhashchikh produktov u bol'nykh sakharnym diabetom II tipa]. Voprosny Pitania 1997;1:27-30. - PubMed
Shikany 2009 {published data only}
    1. Shikany JM, Phadke RP, Redden DT, Gower BA. Effects of low- and high-glycemic index/glycemic load diets on coronary heart disease risk factors in overweight/obese men. Metabolism: Clinical and Experimental 2009;58:1793-801. - PMC - PubMed
Shyam 2013 {published data only}
    1. Shyam S, Arshad F, Abdul Ghani R, Wahab NA, Safii NS, Nisak MY, et al. Low glycaemic index diets improve glucose tolerance and body weight in women with previous history of gestational diabetes: a six months randomized trial. Nutrition Journal 2013;12:68. - PMC - PubMed
Singh 1991 {published data only}
    1. Singh RB, Rastogi SS, Sircar AR, Mehta PJ, Sharma KK. Dietary strategies for risk factor modification to prevent cardiovascular diseases. Nutrition 1991;7:210-5. - PubMed
Slabber 1994 {published data only}
    1. Slabber M, Barnard HC, Kuyl JM, Dannhauser A, Schall R. Effects of a low-insulin response, energy restricted diet on weight loss and plasma insulin concentrations in hyperinsulinemic obese females. American Journal of Clinical Nutrition 1994;60:48-53. - PubMed
Sloth 2004 {published data only}
    1. Sloth B, Krog-Mikkelson I, Flint A, Tetens I, Bjorck I, Vinoy S, et al. No difference in body weight decrease between a low-glycemic-index and a high-glycemic-index diet but reduced LDL cholesterol after 10-wk ad libitum intake of the low glycemic-index diet. American Journal of Clinical Nutrition 2004;80:337-47. - PubMed
Spieth 2000 {published data only}
    1. Spieth LE, Harnish JD, Lenders CM, Raezer LB, Pereira MA, Hangen SJ, et al. A low glycemic index diet in the treatment of pediatric obesity. Archives of Pediatrics and Adolescent Medicine 2000;154:947-51. - PubMed
Taghrid 2004 {published and unpublished data}
    1. Huet D, Rizkalla SW, Rigoir A, Veronese A, Pacher N, Slama G. Metabolic effects of chronic low glycemic index diet in type 2 diabetes. Diabetes 2001;50(Suppl 2):A367.
    1. Rizkalla SW, Taghrid L, Laromiguiere M, Huet D, Boillot J, Rigoir A, et al. Improved plasma glucose control, whole-body glucose utilization, and lipid profile on a low-glycemic index diet in type 2 diabetic men: a randomized controlled trial. Diabetes Care 2004;27(8):1866-72. - PubMed
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Tovar 2012 {published data only}
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Tsihlias 2000 {published and unpublished data}
    1. Tsihlias EB, Gibbs AL, McBurney MI, Wolever TMS. Comparison of high-and low-glycemic index breakfast cereals with monounsaturated fat in the long-term dietary management of type 2 diabetes. American Journal of Clinical Nutrition 2000;72(2):439-49. - PubMed
Van Horn 1991 {published data only}
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Visek 2011 {published data only}
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Vrolix 2010 {published data only}
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Wolever 1992a {published data only}
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Wolever 1992b {published data only}
    1. Wolever TMS, Jenkins DJA, Vuksan V, Jenkins AL, Wong GS, Josse RG. Beneficial effect of low-glycaemic index diet in type 2 diabetes. Diabetic Medicine 1992;9:451-8. - PubMed
Wolever 1995 {published data only}
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Wolever 2008 {published data only}
    1. Wolever TM, Mehling C, Chiasson JL, Josse RG, Leiter LA, Maheux P, et al. Low glycaemic index diet and disposition index in type 2 diabetes (the Canadian trial of carbohydrates in diabetes): a randomised controlled trial. Diabetologia 2008;51:1607-15. - PubMed
Yang 2002 {published data only}
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Yusof 2009 {published data only}
    1. Yusof BN, Talib RA, Kamaruddin NA, Karim NA, Chinna K, Gilbertson H. A low-GI diet is associated with a short-term improvement of glycaemic control in Asian patients with type 2 diabetes. Diabetes, Obesity & Metabolism 2009;11:387-96. - PubMed
Zhang 2010 {published data only}
    1. Zhang Z, Lanza E, Kris-Etherton PM, Colburn NH, Bagshaw D, Rovine MJ, et al. A high legume low glycemic index diet improves serum lipid profiles in men. Lipids 2010;45:765-75. - PMC - PubMed

References to studies awaiting assessment

Boyadjieva 2015 {published data only}
    1. Boyadjieva N, Handjieva-Darlenska T, Karamfilova V, Kamenov Z. No effect of glycemic index (low vs. high) on ghrelin and leptin in obesity. In: Obesity Facts. Vol. 8. 2015:39.
Cayanan 2015 {published data only}
    1. Cayanan E, Marhsall N, Yee B, Wong K, Djavadkhani Y, Grunstein R, Hoyos C. Effectiveness of two maintenance diets following a very low energy diet to reduce cardio-metabolic risk In obese sleep apnea patients: a randomized controlled trial. Sleep and Biological Rhythms 2015;13:56.
Giroux 2015 {published data only}
    1. Giroux I, Azzi S, Lavigne-Robichaud M, Comtois E, Blaine S, Whebby B, et al. The effect of a 6-month lifestyle education program on dietary behaviors in rural adults with prediabetes. In: Canadian Journal of Dietetic Practice & Research. Vol. 73. 2015:e2.
Karl 2015 {published data only}
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References to other published versions of this review

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