厦门市城区居民膳食血糖负荷和膳食胰岛素负荷的 现况调查

摘要:目的　了解厦门市城区居民碳水化合物消费情况及膳食血糖负荷及膳食胰岛素负荷的现状,调查膳食血糖负荷及膳食胰岛素负荷与生化指标。方法　根据全国营养调查方案,2010年10-12月对厦门市城区的6个社区居委会成年居民进行调查,采用连续3 d 24 h回顾法对其中的291人进行膳食调查、身体测量及生化指标测量;根据膳食血糖生成指数（GI）和碳水化合物摄入量计算膳食血糖负荷（GL）;根据膳食胰岛素指数（II）和能量及食用频率计算膳食胰岛素负荷（IL）。结果　被调查的厦门市城区成年居民的平均膳食血糖指数为75.2;平均膳食血糖负荷为179.1;平均膳食胰岛素指数为30.4,平均膳食胰岛素负荷为247.2。粮谷类对膳食GL、IL的贡献达92.0%、83.1%。不同GL、IL水平的被调查人群的身体测量及生化指标间的差异无统计学意义;通过多元线性回归分析并未发现膳食GI、GL、II、IL与糖尿病的患病风险有明显的相关性。结论　粮谷类食物是厦门市城区居民膳食GL、IL的主要来源,低膳食GL的人群粮谷类消费低,脂肪消费高,膳食结构不合理;并未发现膳食GL、IL与身体测量及生化指标之间的联系。     

Glycemic index and glycemic load are not associated with brain lesions in the elderly

Objective  The goal of this study was to determine if brain lesion volume was correlated with dietary glycemic index and glycemic load in elderly individuals. Design and Setting  This cross-sectional study was performed at an academic medical center as part of a clinical study of late-life depression. Participants  Subjects (n=137) were age 60 or over, and were participating as non-depressed comparison subjects. Measurements  Food intake was assessed using the Block 1998 food frequency questionnaire. Glycemic index and glycemic load measures were derived from reported food intake. Brain lesion volumes were calculated from magnetic resonance imaging (MRI). Results  No significant associations were found between glycemic index or glycemic load, and brain lesion volume. Conclusion  Dietary glycemic measures may be unrelated to brain lesions or may be related to brain lesions only in individuals with impaired glycemic control or other vascular risk factors. Further studies are needed to confirm this finding and to determine if glycemic control moderates this association. (work was completed as part of the Master of Science in Clinical Research program)     

低血糖生成负荷饮食对糖尿病病人的疗效观察

目的:探讨低血糖生成负荷(LGL)饮食对2型糖尿病病人的影响. 方法:将90例2型糖尿病人随机分为试验组和对照组,每组各45例.试验组病人采用临床治疗配合正规糖尿病饮食以及少量多餐的低血糖负荷饮食;对照组采用临床治疗配合正规糖尿病饮食治疗.分别观察两组病人的体重指数(BMI)、空腹血糖(FPG)、餐后2h血糖(2 hPG)、糖化血红蛋白(HbAlc)、住院时间和住院费用等指标. 结果:试验组病人治疗后HbAlc明显改善,低血糖发生人数少于对照组,住院时间缩短,住院费用也低于对照组. 结论:LGL饮食干预能改善2型糖尿病病人HbAlc,减少低血糖发生率.     

The association between dietary glycemic index,glycemic load and diet quality indices in Iranian adults: results from Isfahan Healthy Heart Program

To assess the association between dietary glycemic index (GI), glycemic load (GL) and dietary quality indices in Iranian adults. This cross section was conducted among 1571 Iranian adults aged ≥19 years. GI, GL and diet quality indices were estimated by 24-h recall and DDS was calculated using a validated 48-item food frequency questionnaire. Participants who were in the top tertile of GI had lower healthy eating index (HEI) (57.2?±?7.8 versus 55.6?±?8.7; p?p?2. Individuals in the lowest tertile of GL had lower HEI, MAR and NARs for Zn, vitamin B₂, B₃, B₆, B₁₂, vitamin D. Both GI and GL were positively related to dietary diversity score (DED) (p?相似文献   

Dietary carbohydrate, glycemic index, and glycemic load in relation to risk of colorectal cancer in women

Diets with a high glycemic index and glycemic load have been hypothesized to be implicated in the etiology of colorectal cancer owing to their potential to increase postprandial glucose and insulin levels. Prospective data on glycemic index and glycemic load in relation to colorectal cancer risk are limited and inconsistent. Therefore, the authors prospectively investigated the associations of dietary carbohydrate, glycemic index, and glycemic load with the incidence of colorectal cancer among 61,433 Swedish women who were free of cancer in 1987-1990 and completed a 67-item food frequency questionnaire. During follow-up through June 2005, 870 incident cases of colorectal adenocarcinoma were diagnosed. Carbohydrate intake, glycemic index, and glycemic load were not associated with risk of colorectal cancer, colon cancer, or rectal cancer. The multivariate hazard ratios for colorectal cancer comparing the highest with the lowest quintile were 1.10 (95% confidence interval: 0.85, 1.44) for carbohydrate intake, 1.00 (95% confidence interval: 0.75, 1.33) for glycemic index, and 1.06 (95% confidence interval: 0.81, 1.39) for glycemic load. Results did not vary by body mass index. The findings from this prospective study do not support the hypothesis that a high carbohydrate intake, a high glycemic index, and a high glycemic load increase the risk of colorectal cancer.     

Dietary glycemic index and load in relation to metabolic risk factors in Japanese female farmers with traditional dietary habits

BACKGROUND: Little is known about the relation of dietary glycemic index (GI) and glycemic load (GL) to metabolic risk factors, particularly in non-Western populations. OBJECTIVE: We examined the cross-sectional associations between dietary GI and GL and several metabolic risk factors in healthy Japanese women with traditional dietary habits. DESIGN: The subjects were 1354 Japanese female farmers aged 20-78 y from 5 regions of Japan. Dietary GI and GL were assessed with a self-administered diet-history questionnaire. Body mass index (BMI) was calculated as weight (kg) divided by the square of height (m). Fasting blood samples were collected for biochemical measurements. RESULTS: The mean dietary GI was 67, and the mean dietary GL (/1000 kcal) was 88 (GI for glucose = 100). White rice (GI = 77) was the major contributor to dietary GI and GL (58.5%). After adjustment for potential dietary and nondietary confounding factors, dietary GI was positively correlated with BMI (n = 1354; P for trend = 0.017), fasting triacylglycerol (n = 1349; P for trend = 0.001), fasting glucose (n = 764; P for trend = 0.022), and glycated hemoglobin (n = 845; P for trend = 0.038). Dietary GL was independently negatively correlated with HDL cholesterol (n = 1354; P for trend = 0.004) and positively correlated with fasting triacylglycerol (P for trend = 0.047) and fasting glucose (P for trend = 0.012). CONCLUSIONS: Both dietary GI and GL are independently correlated with several metabolic risk factors in subjects whose dietary GI and GL were primarily determined on the basis of the GI of white rice.     

低血糖负荷食物交换份法结合移动饮食管理对2型糖尿病患者血糖改善的效果探索

目的 探索低血糖负荷（glycemic load,GL）食物交换份法结合移动饮食管理对2型糖尿病患者血糖的影响。方法 在医院招募2型糖尿病患者58例,随机分为参考主食（reference staple food,RF）组和自选食物（self-choice,SC）组,RF组26例,SC组32例。对两组研究对象进行统一的糖尿病医学营养教育,之后分别对两组对象进行连续42天的低GL食物交换份法干预, RF组由研究者提供低GL主食,SC组自选每日全部食物。全体研究对象每日在移动饮食管理平台记录食物摄入情况,研究者每日对其饮食GL和能量摄入进行计算、监测和核查分析比较两组对象平均每日饮食GL及能量摄入情况,在干预前和干预后的第14、28、42天检测并比较两组的体重、体脂率、身体质量指数（body mass index ,BMI）、腰围、空腹血糖（fasting blood glucose ,FBG）、2小时餐后血糖（postprandial 2h blood glucose ,2hPBG）、空腹胰岛素（fasting insulin ,Ins）、空腹C肽（fasting C-peptide ,C-P）和糖化血红蛋白（glycosylated hemoglobin ,HbA1c）。结果 干预期间,两组研究对象的平均每日饮食GL和能量摄入均低于干预前（P＜0.05）,且基本达到预期目标。与干预前相比,干预后两组FBG、HbA1c、体重、BMI和腰围均出现明显降低（P＜0.05）,其中RF组干预前FBG、HbA1c平均值分别为7.33 μmmol/L、7.02%,干预后分别为6.31 μmmol/L、6.33%（t=4.28,P＜0.001;t=5.43,P＜0.001）,SC组干预前FBG、HbA1c平均值分别为7.83 μmmol/L、7.27%,干预后分别为7.27 μmmol/L、6.81%（t=2.89,P=0.007;t=5.11,P＜0.001）。结论 低GL食物交换份法结合移动饮食管理对2型糖尿病患者的血糖、体重具有较好的改善效果,两种方法的结合可成为2型糖尿病防治更科学、可行、合理、精准的饮食管理方案。     

Dietary glycemic index, dietary glycemic load, and cardiovascular disease in middle-aged and older Swedish men

BACKGROUND: In women, dietary glycemic index (GI) and dietary glycemic load (GL) have been associated with cardiovascular disease; in men, however, the evidence for an association is weaker. OBJECTIVE: We tested the hypothesis that men consuming diets high in GI or GL have a greater risk of cardiovascular disease. DESIGN: At baseline, we assessed dietary GI and dietary GL by using food-frequency questionnaires in 36 246 Swedish men aged 45-79 y without diabetes or prior cardiovascular disease. Participants were followed through inpatient, cause-of-death, and death registries from 1 January 1998 until 31 December 2003 for myocardial infarction, ischemic stroke, hemorrhagic stroke, and cardiovascular mortality and until 31 December 2005 for all-cause mortality. We used Cox models with age as the time scale to estimate relative risks adjusted for cigarette smoking, body mass index, physical activity, demographic characteristics, and nutritional factors. RESULTS: Dietary GI and dietary GL were not associated with myocardial infarction (n = 1324), ischemic stroke (n = 692), cardiovascular mortality (n = 785), or all-cause mortality (n = 2959). Dietary GL was associated with hemorrhagic stroke [n = 165; relative risk = 1.44 comparing extreme quartiles (95% CI: 0.91, 2.27); P for trend = 0.047]. CONCLUSIONS: Dietary GI and dietary GL were not associated with ischemic cardiovascular disease or mortality, but dietary GL was associated with a greater risk of hemorrhagic stroke. Discrepancies between these findings and those of previous studies may be due to variations in the associations by sex or to differences in dietary contributions to GI and GL.     

2型糖尿病患者踝肱指数与心血管疾病危险因素的相关性分析

目的分析2型糖尿病患者踝肱指数（ABI）与心血管疾病（CVD）危险因素的关系。方法采用病例对照研究设计,将238名2型糖尿病患者分成ABI低值组（ABI〈0.9）和对照组（ABI〉0.9）,观察两组代谢指标的控制情况以及临床心血管疾病发病率,并分析ABI与CVD危险因素的关系。结果与对照组相比,ABI低值组血糖、血脂水平较高,高血压、CVD发病率较高（P〈0.05）;有吸烟史者在ABI低值组较多。结论 ABI降低与高血压、吸烟、CVD史、高血糖等心血管疾病危险因素具有相关性。     

Glycemic index and glycemic load in relation to food and nutrient intake and metabolic risk factors in a Dutch population

BACKGROUND: Previous studies on the glycemic index (GI) and glycemic load (GL) reported inconsistent findings on their association with metabolic risk factors. This may partly have been due to differences in underlying dietary patterns. OBJECTIVE: We aimed to examine the association of GI and GL with food and nutrient intake and with metabolic risk factors including blood glucose, insulin, lipids, and high-sensitivity C-reactive protein (CRP). DESIGN: The study entailed cross-sectional analyses of data from 2 joint observational studies, the CoDAM Study and the Hoorn Study. RESULTS: In total, 974 subjects aged 42-87 y were included in the study. The mean (+/-SD) GI was 57 +/- 4 and the mean GL was 130 +/- 39. Dairy products, potatoes and other tubers, cereal products, and fruit were the main predictive food groups for GI. GL was closely correlated with intake of total carbohydrates (r(s) = 0.97), which explained >95% of the variation in GL. After adjustment for potential confounders, GI was significantly inversely associated with HDL cholesterol and positively associated with fasting insulin, the homeostasis model assessment index of insulin resistance, the ratio of total to HDL cholesterol, and CRP. No association was observed between GL and any of the metabolic risk factors, except for a borderline significant positive association with CRP. CONCLUSIONS: In this population, a low-GI diet, which is high in dairy and fruit but low in potatoes and cereals, is associated with improved insulin sensitivity and lipid metabolism and reduced chronic inflammation. GL is highly correlated with carbohydrate intake and is not clearly associated with the investigated metabolic risk factors.     

Compiling glycemic index and glycemic load values for addition to a food composition database

The glycemic index (GI) provides an indication of a food's carbohydrate quality by measuring the blood glucose response to consuming the food. The glycemic load (GL) is calculated as the GI times the available carbohydrate in a fixed amount of the food. GI and GL are currently of interest for the study of associations of diet and chronic disease including diabetes, cardiovascular disease, cancer and obesity. An international table of GI values is available and provides a compilation of currently available data. The purpose of this project was to use these data, as well as other available references, to expand the Cancer Research Center of Hawaii Food Composition Table (FCT) to include GI and GL values. All of the individual foods in the FCT (n=1592) were assigned GI values as a direct match (n=181), imputation (n=948), calculated value (n=208), or assigned a zero value (n=255). GL per 100 g was then calculated using the assigned GI and available carbohydrate per 100 g of food. The addition of GI and GL values to the FCT will allow researchers to estimate the effect of dietary carbohydrate quality on various health outcomes.     

Association between dietary carbohydrate,glycemic index,glycemic load,and the prevalence of obesity in Korean men and women

Intake of high–glycemic index (GI) food has been postulated to reduce satiety, resulting in an increased total energy intake and reduced access to body fat as fuel. Thus, we hypothesize that high dietary GI and glycemic load (GL) are associated with an increased prevalence of obesity in the Korean population. Dietary GI and GL were calculated for 933 Korean men and women based on dietary intake assessed by food frequency questionnaires and using a GI table developed from published GI databases in a cross-sectional design. Mean differences in dietary GL and carbohydrate intake between obese and nonobese men were statistically significant after adjusting for covariates (P = .027 and .021, respectively). High dietary GL and carbohydrate intake were negatively associated with the prevalence of obesity among men in a multivariate-adjusted logistic regression model (P for trend = .026 and .036, respectively). Statistically significant effects of dietary GI and GL on the prevalence of obesity among women were observed in a generalized linear model (P = .002 and .042, respectively) and a logistic regression model (P for trend < .001 and = .007, respectively), after adjusting for covariates. Women with higher dietary GI and GL were more likely to be obese, a result consistent with our hypothesis. However, an inverse association for dietary GL and carbohydrate and prevalence of obesity was found in men, suggesting that mechanisms contributing to the prevalence of obesity between sexes may be different.     

Dietary glycemic index in relation to metabolic risk factors and incidence of coronary heart disease: the Zutphen Elderly Study

OBJECTIVE: To examine whether a high dietary glycemic index is associated with hyperinsulinemia, hyperglycemia, dyslipidemia and coronary heart disease (CHD) risk in elderly men. DESIGN: Prospective study of incidence of major CHD (non-fatal myocardial infarction or death due to CHD) between 1985 and 1995 in 646 men, and a cross-sectional analysis of metabolic risk factors in 1990 in 394 men. SETTING: Population based study in the Dutch town Zutphen. SUBJECTS: Men aged 64-84 y in 1985 without a history of CHD or diabetes, whose diet was assessed with the cross-check dietary history method. RESULTS: The dietary glycemic index was positively correlated with consumption (g carbohydrate) of wheat bread (r=0.47) and sugar products (r=0.41) and inversely with fruit (r=-0.37) and milk (r=-0.40) consumption. During 4527 person-years of follow-up, 94 cases of CHD were documented. The risk ratio for CHD was 1.11 (95% CI, 0.66-1.87) for the highest as compared to the lowest tertile of glycemic index after correction for age, body mass index, physical activity, cigarette smoking, and dietary factors (P (trend)=0.70). Furthermore, the glycemic index was not appreciably associated with blood concentrations of total cholesterol, HDL-cholesterol, triacylglycerols or (fasting or postload) insulin or glucose. CONCLUSIONS: Our findings do not support the hypothesis that a high-glycemic-index diet unfavorably affects metabolic risk factors or increases risk for CHD in elderly men without a history of diabetes or CHD.     

Dietary glycemic index is associated with decreased premenstrual symptoms in young Japanese women

OBJECTIVES: High glycemic index (GI) carbohydrates may increase brain serotonin, which in turn acts to alleviate premenstrual symptoms, because, although the main determinant of brain serotonin concentration is a high plasma ratio of tryptophan to other large neutral amino acids, a high-GI diet has been shown to increase this ratio. In this observational cross-sectional study, we investigated associations between dietary GI and other dietary carbohydrates and premenstrual symptoms. METHODS: Subjects were 640 female Japanese dietetic students 18-22 y of age. Dietary carbohydrates were assessed using a validated, self-administered, comprehensive diet history questionnaire. Menstrual cycle symptoms were assessed using the retrospective version of the Moos Menstrual Distress Questionnaire (MDQ). Independent associations of dietary GI and glycemic load and intake of available carbohydrate and dietary fiber with the MDQ total score and subscale scores (pain, concentration, behavioral change, autonomic reactions, water retention, and negative affect) in the premenstrual phase (expressed as percentages relative to those in the intermenstrual phase) were examined. RESULTS: Dietary GI was independently inversely associated with total MDQ score in the premenstrual phase (P for trend = 0.02). Dietary GI also showed independent and inverse associations with several MDQ subscale scores in the premenstrual phase, including concentration, autonomic reactions, and water retention (P for trend < 0.05). Conversely, dietary glycemic load and intake of available carbohydrate and dietary fiber were not associated with any of the MDQ scores in the premenstrual phase. CONCLUSION: Dietary GI was independently associated with decreased premenstrual symptoms in a group of young Japanese women.     

Potato consumption and cardiovascular disease risk factors among Iranian population

Background: Previous studies investigated the effects of dietary glycaemic index and glycaemic load on cardiovascular risk factors. Little evidence is available regarding the association between potato intake and cardiovascular risk factors in Iran. Objective: This cross-sectional study was conducted in the first stage of Isfahan Healthy Heart Programme. Methods: A total of 4774 subjects were included in the present study. Dietary intake was assessed with a 49-item food frequency questionnaire. Biochemical assessments were done according to the standard protocol. Results: There were significant associations between potato consumption and diabetes mellitus (odds ratio (OR): 1.38; 95% CI: 1.14–1.67; p < 0.001), high fasting blood sugar level (OR: 1.40; 95% CI: 1.17–1.68; p < 0.001) and low serum high density lipoprotein level (OR: 1.10; 95% CI: 1.01–1.20; p = 0.02) remained after adjustments for possible confounding factors. Conclusion: We found a positive relation between potato consumption, high fasting blood glucose level and diabetes mellitus.     

Higher glycemic index and glycemic load diet is associated with increased risk of esophageal squamous cell carcinoma: a case-control study

Several studies have indicated the association between intake of foods high in dietary glycemic index (GI) and glycemic load (GL) with an increased risk of digestive tract cancers. We hypothesized that GI and GL may be associated with risk of esophageal squamous cell carcinoma (ESCC) in a high-risk population in Iran. In total, we interviewed 47 cases with incident of ESCC and 96 frequency-matched hospital controls, then calculated the average dietary GI and GL via a validated food frequency questionnaire. Dietary GL was calculated as a function of GI, carbohydrate content, and frequency of intake of certain foods. Dietary GI and GL levels were significantly higher among the ESCC cases compared with the controls (P < .05). After adjustment for potential confounders, those in the highest tertile of dietary GI had 2.95 times higher risk of ESCC compared with those in the lowest (95% confidence interval, 1.68-3.35; P for trend = .002). In addition, being in the highest tertile of dietary GL was positively associated with an ESCC risk (odds ratio, 3.49; 95% confidence interval, 2.98-4.41; P for trend = .001). Findings of the present study indicate that diets with high GI and GL might have potentially unfavorable effects on ESCC risk and suggest a possible role for excess circulating insulin and related insulin-like growth factor 1 in esophageal cancer development.