Dietary glycemic index and load and the risk of type 2 diabetes: Assessment of causal relations

Geoffrey Livesey; Richard Taylor; Helen F Livesey; Anette E Buyken; David J A Jenkins; Livia S A Augustin; John L Sievenpiper; Alan W Barclay; Simin Liu; Thomas M S Wolever; Walter C Willett; Furio Brighenti; Jordi Salas-Salvadó; Inger Björck; Salwa W Rizkalla; Gabriele Riccardi; Carlo La Vecchia; Antonio Ceriello; Antonia Trichopoulou; Andrea Poli; Arne Astrup; Cyril W C Kendall; Marie-Ann Ha; Sara Baer-Sinnott; Jennie Brand-Miller

doi:10.3390/nu11061436

Dietary glycemic index and load and the risk of type 2 diabetes: Assessment of causal relations

Geoffrey Livesey^*, Richard Taylor, Helen F Livesey, Anette E Buyken, David J A Jenkins, Livia S A Augustin, John L Sievenpiper, Alan W Barclay, Simin Liu, Thomas M S Wolever, Walter C Willett, Furio Brighenti, Jordi Salas-Salvadó, Inger Björck, Salwa W Rizkalla, Gabriele Riccardi, Carlo La Vecchia, Antonio Ceriello, Antonia Trichopoulou, Andrea PoliArne Astrup, Cyril W C Kendall, Marie-Ann Ha, Sara Baer-Sinnott, Jennie Brand-Miller

^*Corresponding author af dette arbejde

Institut for Idræt og Ernæring - Fedmeforskning

26 Citationer (Scopus)

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Abstract

While dietary factors are important modifiable risk factors for type 2 diabetes (T2D), the causal role of carbohydrate quality in nutrition remains controversial. Dietary glycemic index (GI) and glycemic load (GL) have been examined in relation to the risk of T2D in multiple prospective cohort studies. Previous meta-analyses indicate significant relations but consideration of causality has been minimal. Here, the results of our recent meta-analyses of prospective cohort studies of 4 to 26-y follow-up are interpreted in the context of the nine Bradford-Hill criteria for causality, that is: (1) Strength of Association, (2) Consistency, (3) Specificity, (4) Temporality, (5) Biological Gradient, (6) Plausibility, (7) Experimental evidence, (8) Analogy, and (9) Coherence. These criteria necessitated referral to a body of literature wider than prospective cohort studies alone, especially in criteria 6 to 9. In this analysis, all nine of the Hill’s criteria were met for GI and GL indicating that we can be confident of a role for GI and GL as causal factors contributing to incident T2D. In addition, neither dietary fiber nor cereal fiber nor wholegrain were found to be reliable or effective surrogate measures of GI or GL. Finally, our cost–benefit analysis suggests food and nutrition advice favors lower GI or GL and would produce significant potential cost savings in national healthcare budgets. The high confidence in causal associations for incident T2D is sufficient to consider inclusion of GI and GL in food and nutrient-based recommendations.

Originalsprog	Engelsk
Artikelnummer	1436
Tidsskrift	Nutrients
Vol/bind	11
Udgave nummer	6
Antal sider	34
ISSN	2072-6643
DOI	https://doi.org/10.3390/nu11061436
Status	Udgivet - jun. 2019

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Livesey, G., Taylor, R., Livesey, H. F., Buyken, A. E., Jenkins, D. J. A., Augustin, L. S. A., Sievenpiper, J. L., Barclay, A. W., Liu, S., Wolever, T. M. S., Willett, W. C., Brighenti, F., Salas-Salvadó, J., Björck, I., Rizkalla, S. W., Riccardi, G., La Vecchia, C., Ceriello, A., Trichopoulou, A., ... Brand-Miller, J. (2019). Dietary glycemic index and load and the risk of type 2 diabetes: Assessment of causal relations. Nutrients, 11(6), [1436]. https://doi.org/10.3390/nu11061436

Livesey, G, Taylor, R, Livesey, HF, Buyken, AE, Jenkins, DJA, Augustin, LSA, Sievenpiper, JL, Barclay, AW, Liu, S, Wolever, TMS, Willett, WC, Brighenti, F, Salas-Salvadó, J, Björck, I, Rizkalla, SW, Riccardi, G, La Vecchia, C, Ceriello, A, Trichopoulou, A, Poli, A, Astrup, A, Kendall, CWC, Ha, M-A, Baer-Sinnott, S & Brand-Miller, J 2019, 'Dietary glycemic index and load and the risk of type 2 diabetes: Assessment of causal relations', Nutrients, bind 11, nr. 6, 1436. https://doi.org/10.3390/nu11061436

@article{9b80e5c5b9c74882a84417b7cd5f4f83,

title = "Dietary glycemic index and load and the risk of type 2 diabetes: Assessment of causal relations",

abstract = "While dietary factors are important modifiable risk factors for type 2 diabetes (T2D), the causal role of carbohydrate quality in nutrition remains controversial. Dietary glycemic index (GI) and glycemic load (GL) have been examined in relation to the risk of T2D in multiple prospective cohort studies. Previous meta-analyses indicate significant relations but consideration of causality has been minimal. Here, the results of our recent meta-analyses of prospective cohort studies of 4 to 26-y follow-up are interpreted in the context of the nine Bradford-Hill criteria for causality, that is: (1) Strength of Association, (2) Consistency, (3) Specificity, (4) Temporality, (5) Biological Gradient, (6) Plausibility, (7) Experimental evidence, (8) Analogy, and (9) Coherence. These criteria necessitated referral to a body of literature wider than prospective cohort studies alone, especially in criteria 6 to 9. In this analysis, all nine of the Hill{\textquoteright}s criteria were met for GI and GL indicating that we can be confident of a role for GI and GL as causal factors contributing to incident T2D. In addition, neither dietary fiber nor cereal fiber nor wholegrain were found to be reliable or effective surrogate measures of GI or GL. Finally, our cost–benefit analysis suggests food and nutrition advice favors lower GI or GL and would produce significant potential cost savings in national healthcare budgets. The high confidence in causal associations for incident T2D is sufficient to consider inclusion of GI and GL in food and nutrient-based recommendations.",

keywords = "Faculty of Science, Causation, Diabetes, Glycemic index, Glycemic load, Dietary fiber, Alcohol, Cohort studies, Epidemiology, Meta-analysis, Public health",

author = "Geoffrey Livesey and Richard Taylor and Livesey, {Helen F} and Buyken, {Anette E} and Jenkins, {David J A} and Augustin, {Livia S A} and Sievenpiper, {John L} and Barclay, {Alan W} and Simin Liu and Wolever, {Thomas M S} and Willett, {Walter C} and Furio Brighenti and Jordi Salas-Salvad{\'o} and Inger Bj{\"o}rck and Rizkalla, {Salwa W} and Gabriele Riccardi and {La Vecchia}, Carlo and Antonio Ceriello and Antonia Trichopoulou and Andrea Poli and Arne Astrup and Kendall, {Cyril W C} and Marie-Ann Ha and Sara Baer-Sinnott and Jennie Brand-Miller",

note = "CURIS 2019 NEXS 222",

year = "2019",

month = jun,

doi = "10.3390/nu11061436",

language = "English",

volume = "11",

journal = "Nutrients",

issn = "2072-6643",

publisher = "M D P I AG",

number = "6",

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TY - JOUR

T1 - Dietary glycemic index and load and the risk of type 2 diabetes: Assessment of causal relations

AU - Livesey, Geoffrey

AU - Taylor, Richard

AU - Livesey, Helen F

AU - Buyken, Anette E

AU - Jenkins, David J A

AU - Augustin, Livia S A

AU - Sievenpiper, John L

AU - Barclay, Alan W

AU - Liu, Simin

AU - Wolever, Thomas M S

AU - Willett, Walter C

AU - Brighenti, Furio

AU - Salas-Salvadó, Jordi

AU - Björck, Inger

AU - Rizkalla, Salwa W

AU - Riccardi, Gabriele

AU - La Vecchia, Carlo

AU - Ceriello, Antonio

AU - Trichopoulou, Antonia

AU - Poli, Andrea

AU - Astrup, Arne

AU - Kendall, Cyril W C

AU - Ha, Marie-Ann

AU - Baer-Sinnott, Sara

AU - Brand-Miller, Jennie

N1 - CURIS 2019 NEXS 222

PY - 2019/6

Y1 - 2019/6

N2 - While dietary factors are important modifiable risk factors for type 2 diabetes (T2D), the causal role of carbohydrate quality in nutrition remains controversial. Dietary glycemic index (GI) and glycemic load (GL) have been examined in relation to the risk of T2D in multiple prospective cohort studies. Previous meta-analyses indicate significant relations but consideration of causality has been minimal. Here, the results of our recent meta-analyses of prospective cohort studies of 4 to 26-y follow-up are interpreted in the context of the nine Bradford-Hill criteria for causality, that is: (1) Strength of Association, (2) Consistency, (3) Specificity, (4) Temporality, (5) Biological Gradient, (6) Plausibility, (7) Experimental evidence, (8) Analogy, and (9) Coherence. These criteria necessitated referral to a body of literature wider than prospective cohort studies alone, especially in criteria 6 to 9. In this analysis, all nine of the Hill’s criteria were met for GI and GL indicating that we can be confident of a role for GI and GL as causal factors contributing to incident T2D. In addition, neither dietary fiber nor cereal fiber nor wholegrain were found to be reliable or effective surrogate measures of GI or GL. Finally, our cost–benefit analysis suggests food and nutrition advice favors lower GI or GL and would produce significant potential cost savings in national healthcare budgets. The high confidence in causal associations for incident T2D is sufficient to consider inclusion of GI and GL in food and nutrient-based recommendations.

AB - While dietary factors are important modifiable risk factors for type 2 diabetes (T2D), the causal role of carbohydrate quality in nutrition remains controversial. Dietary glycemic index (GI) and glycemic load (GL) have been examined in relation to the risk of T2D in multiple prospective cohort studies. Previous meta-analyses indicate significant relations but consideration of causality has been minimal. Here, the results of our recent meta-analyses of prospective cohort studies of 4 to 26-y follow-up are interpreted in the context of the nine Bradford-Hill criteria for causality, that is: (1) Strength of Association, (2) Consistency, (3) Specificity, (4) Temporality, (5) Biological Gradient, (6) Plausibility, (7) Experimental evidence, (8) Analogy, and (9) Coherence. These criteria necessitated referral to a body of literature wider than prospective cohort studies alone, especially in criteria 6 to 9. In this analysis, all nine of the Hill’s criteria were met for GI and GL indicating that we can be confident of a role for GI and GL as causal factors contributing to incident T2D. In addition, neither dietary fiber nor cereal fiber nor wholegrain were found to be reliable or effective surrogate measures of GI or GL. Finally, our cost–benefit analysis suggests food and nutrition advice favors lower GI or GL and would produce significant potential cost savings in national healthcare budgets. The high confidence in causal associations for incident T2D is sufficient to consider inclusion of GI and GL in food and nutrient-based recommendations.

KW - Faculty of Science

KW - Causation

KW - Diabetes

KW - Glycemic index

KW - Glycemic load

KW - Dietary fiber

KW - Alcohol

KW - Cohort studies

KW - Epidemiology

KW - Meta-analysis

KW - Public health

U2 - 10.3390/nu11061436

DO - 10.3390/nu11061436

M3 - Review

C2 - 31242690

SN - 2072-6643

VL - 11

JO - Nutrients

JF - Nutrients

IS - 6

M1 - 1436

ER -

Dietary glycemic index and load and the risk of type 2 diabetes: Assessment of causal relations

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