Journal List > Korean J Nutr > v.42(7) > 1043789

Kim, Lee, Hong, and Yu: Association between Glycemic Index, Glycemic Load, Dietary Carbohydrates and Diabetes from Korean National Health and Nutrition Examination Survey 2005

Abstract

The purpose of this study was to establish an association between glycemic index (GI), glycemic load (GL), dietary carbohydrates and diabetes with the context of the current population dietary practice in Korea. The subjects of 3,389 adults (male 1,430, female 1,959) were divided into normal (serum fasting glucose < 100 mg/dL), impaired glucose tolerance (100 ≤ serum fasting glucose < 126 mg/dL), diabetes (serum fasting glucose > 126 mg/dL) by serum fasting glucose. Anthropometric and hematologic factors, and nutrient intakes, dietary glycemic index (DGI), dietary glycemic load (DGL) were assessed. Multiple logistic regression model was used to determine the odds ratios (ORs) and 95% confidence intervals for relationship of DGI, DGL, carbohydrates intakes, and diabetes. DGI and DGL were not significantly correlated with impaired glucose tolerance and diabetes. However, the risk of impaired glucose tolerance and diabetes showed a tendency to increase as increase of DGI after multivariate adjustment (age, education, income, region area, diabetes family history, smoking, drinking, exercise, energy intake) in male. The risk of impaired glucose tolerance and diabetes showed a tendency to increase in the DGI 71.1-74.8 after multivariate adjustment in female. DGL was inversely related to impaired glucose tolerance and diabetes in male. In female, however, DGL was positively related to impaired glucose tolerance and diabetes. In particular, the risk of diabetes increased positively in level of DGL 260.5, and remained after multivariate adjustment (Q5 vs Q1:2.38, 0.87-6.48). When percent energy intakes from carbohydrates were more than 70%, the risk of impaired glucose tolerance and diabetes increased in both male and female. In particular, when percent energy intakes from carbohydrates were more than 69.9%, the risk of diabetes increased positively in male (Q4 vs Q1:2.34, 1.16-4.17). In conclusion, above 70% energy intakes from carbohydrates appeared to be a risk factor of diabetes. It seemed that the meal with high GI and GL value must be avoided it. And also, the macronutrients of the meal must be properly balanced. In particular, it may be said that it is a preventive way for treatment of the diabetes to avoid eating carbohydrates of much quantity.

Figures and Tables

Fig. 1
Distribution of diabetes and impaired glucose tolerance of subjects. *:Significantly different between two age groups at α = 0.05 by Chi-square test.
kjn-42-622-g001
Fig. 2
Dietary glycemic index and dietary glycemic load distribution according to blood glucose level. a, b:Significantly different between three groups at α = 0.05 by Bonferroni's multiple t-test.
kjn-42-622-g002
Table 1
General characteristics and macro-nutrient intake of subjects
kjn-42-622-i001

1) Impaired glucose tolerance, 2) Mean ± SE

a, b, c: Significantly different between three groups at α = 0.05 by Bonferroni's multiple t-test

Table 2
Odds ratios (and 95% confidence intervals) of diabetes and impaired glucose tolerance according to quintiles of dietary glycemic index
kjn-42-622-i002

1) Adjusted for age, education, income, region area, diabetes family history, smoking, drinking, exercise, energy intake

Table 3
Odds ratios (and 95% confidence intervals) of diabetes and impaired glucose tolerance according to quintiles of dietary glycemic load
kjn-42-622-i003

1) Adjusted for age, education, income, region area, diabetes family history, smoking, drinking, exercise, energy intake

Table 4
Odds ratios (and 95% confidence intervals) of diabetes and impaired glucose tolerance according to quintiles of % energy from carbohydrate intake
kjn-42-622-i004

1) Adjusted for age, education, income, region area, diabetes family history, smoking, drinking, exercise, energy intake

References

1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004. 27(5):1047–1053.
crossref
2. Korea Center for Disease Control and Prevention. Ministry for Health, Welfare and Family Affairs. National health & nutrition examination survey (KNHANES 4), Nutrition survey. 2007. Ministry for Health, Welfare and Family Affairs.
3. Korea National Statistical Office 2005. http://www.nso.go.kr.
4. Yang EJ, Kim WY. The Anthropometric characteristics of non-insulin dependent diabetes mellitus in Korea. Korean J Nutr. 1999. 32(4):401–406.
5. Franz MJ, Horton ES Sr, Bantle JP, Beebe CA, Brunzell JD, Coulston AM, Henry RR, Hoogwerf BJ, Stacpoole PW. Nutrition principles for the management of diabetes and related complications. Diabetes Care. 1994. 17(5):490–518.
crossref
6. Feskens EJ, Bowles CH, Kromhout D. Carbohydrate intake and body mass index in relation to the risk of glucose intolerance in an elderly population. Am J Clin Nutr. 1991. 54:136–140.
crossref
7. Yang EJ. A study on dietary factors related to the incidence of diabetes mellitus in Korea. Department of food and nutrition [dissertation]. 1997. Seoul: Ewha Womans University.
8. Jenkins DA, Thomad MS, Alexandra LJ. Starchy foods and glycemic index. Diabetes Care. 1988. 11:149–159.
crossref
9. Chai HJ, Hong HO, Kim HS, Lee JS, Yu CH. Relationship between food intakes, glycemic index, glycemic load, and body weight among high school boys in Seoul. Korean J Nutr. 2008. 41(7):645–657.
10. Murakami K, Sasaki S, Takahashi Y, Okubo H, Hosoi Y, Horiguchi H, Oguma E, Kayama F. Dietary glycemic index and load in relation to metabolic risk factors in Japanese female farmers with traditional dietary habits. Am J Clin Nutr. 2006. 83:1161–1169.
crossref
11. Schulze MB, Liu S, Rimm EB, Manson JE, Willett WC, Hu FB. Glycemic index, glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women. Am J Clin Nutr. 2004. 80:348–359.
crossref
12. Du H, van der A DL, van Bakel MM, van der Kallen CJ, Blaak EE, van Greevenbroek MM, Jansen EH, Nijpels G, Stehouwer CD, Dekker JM, Feskens EJ. Glycemic index and glycemic load in relation to food and nutrient intake and metabolic risk factors in a Dutch population. Am J Clin Nutr. 2008. 87:655–661.
crossref
13. Foster-Powell K, Holt SH, Brand-Miller JC. International table of glycemic index and glycemic load value. Am J Clin Nutr. 2002. 76:5–56.
16. Sung YA, Oh JY, Kim DJ, Kim SH, Kim SK, Moon SD, Lee EJ, Jung CH, Hong YS. Standard of diagnosis and classification of diabetes. Korean Diabetes J. 2007. 8(1):23–24.
17. Kim CS, Jeong EK, Park JN, Cho MH, Nam JS, Kim HJ, Kong JH, Park JS, Nam JY, Kim DM, Ahn CW, Cha BS, Lim SK, Kim KR, Lee HC, Nam CM. Prevalence of diabetes mellitus (fasting plasma glucose by the ADA criteria) and impaired fasting glucose according to anthropometric characteristics and dietary habits-1998 National Health and Nutrition Survey. Korean Diabetes J. 2005. 29(2):151–166.
18. Kim WY, Cho MS, Jang YA, Won HS, Lee HS, Yang EJ. Clinical Nutrition. 2004. Seoul: Shinkwang.
19. Cho NH. Epidemic characteristic and risk factor analysis of diabetes-Korean National Health and Nutrition Examination Survey 1998. 2000. Korean Society of Lipidology and Atherosclerosis;11–16.
20. Ryu JS, Kim SD, Park JS, Lee JS. Risk factors of impaired fasting glucose and type 2 diabetes mellitus -using datamining. Korean J Epidemiol. 2006. 28(2):138–151.
21. Bennett PH, Knowler WC, Baird HR, Bulter WJ, Pettitt DJ. Diet and development of NIDDM: an epidemiological perspective. Diet, Diabetes and atherosclerosis. 1984. New York: Raven Press;109–119.
22. Sahyoun NR, Anderson AL, Tylavsky FA, Lee JS, Sellmeyer DE, Harris TB. Health, Aging, and Body Composition Study. Dietary glycemic index and glycemic load and the risk of type 2 diabetes in older adults. Am J Clin Nutr. 2008. 87(1):126–131.
crossref
23. Barclay AW, Petocz P, McMillan-Price J, Flood VM, Prvan T, Mitchell P, Brand-Miller JC. Glycemic index, glycemic load, and chronic disease risk-a meta-analysis of observational studies. Am J Clin Nutr. 2008. 87(3):627–637.
crossref
24. Hodge AM, English DR, O'Dea K, Giles GG. Glycemic index and dietary fiber and the risk of type 2 diabetes. Diabetes Care. 2004. 27(11):2701–2706.
crossref
25. Riccardi G, Rivellese AA, Giacco R. Role of glycemic index and glycemic load in the healthy state, in prediabetes, and in diabetes. Am J Clin Nutr. 2008. 87:suppl. 269S–274S.
crossref
26. Asp NG. Classification and methodology of food carbohydrates as related to nutritional effects. Am J Clin Nutr. 1995. 61:suppl. 930S–937S.
crossref
27. Montonen J, Knekt P, Jarvinen R, Aromaa A, Reunanen A. Whole-grain and fiber intake and the incidence of type 2 diabetes. Am J Clin Nutr. 2003. 77:622–629.
crossref
28. Meyer KA, Kushi LH, Jacobs DR Jr, Slavin J, Sellers TA, Folsom AR. Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. Am J Clin Nutr. 2000. 71:921–930.
crossref
29. Jenkins DJ, Kendall CW, Marchie A, Jenkins AL, Augustin LS, Ludwig DS, Barnard ND, Anderson JW. Type 2 diabetes and the vegetarian diet. Am J Clin Nutr. 2003. 78:suppl. 610S–616S.
crossref
TOOLS
Similar articles