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Abstract: S1-5 DIETARY CARBOHYDRATE (GLYCEMIC INDEX)
- Pre-meeting symposia - Nutrition, Lifestyle, and Atherosclerosis Abstract: S1-5 Citation: Atherosclerosis Supplement 2009, Vol. 10, Issue 2
DIETARY CARBOHYDRATE (GLYCEMIC INDEX) T Wolever1,2 1
Nutritional Sciences, University of Toronto; 2St. Michael's Hospital, Toronto, On
That high postprandial plasma glucose (PPG) causes cardiovascular disease (CVD) is demonstrated by studies showing: 1) consistent, dose-response relationships between high PPG and increased risk for CVD; 2) reducing PPG with acarbose reduced the development of CVD; and 3) increased oxidative stress and inflammation as plausible mechanisms. The main dietary determinants of acute PPG are the amount and source of available carbohydrate (avCHO). The effect of avCHO source is quantified by glycemic index (GI), defined as the incremental area under the glucose curve after 50g avCHO from a food expressed as % of that after 50g glucose. Since GI is independent of the amount of avCHO consumed, it does not indicate what PPG after a meal will be. Glycemic load (GL) is a quantitative index of PPG defined as GL=g×GI/100 where g = grams avCHO. Although GL predicts acute PPG, it does not predict health outcomes because it can be changed either by altering the amount of avCHO, or GI (or both), maneuvers which have different effects; also, the effect of reducing avCHO intake depends on what replaces the avCHO in the diet. We compared the effect of reducing diet GL by reducing GI with that of reducing avCHO intake (replaced with monounsaturated fat), in subjects with type 2 diabetes. Reducing diet GI for 1-year significantly reduced PPG after a lowGI breakfast, reduced inflammation as measured by c-reactive protein (CRP), and increased ȕcell function. By contrast after 1-year of reduced avCHO intake, there was no change in PPG and CRP, and a reduction in ȕ-cell function. It is concluded, therefore, that reducing GL by reducing diet GI, but not by reducing avCHO intake, favorably affects pathophysiological events responsible for CVD, and may, therefore, reduce CVD risk. Canadian Institutes of Health Research
DIETARY CARBOHYDRATE (GLYCEMIC INDEX) T Wolever1,2 1
Nutritional Sciences, University of Toronto; 2St. Michael's Hospital, Toronto, On
That high postprandial plasma glucose (PPG) causes cardiovascular disease (CVD) is demonstrated by studies showing: 1) consistent, dose-response relationships between high PPG and increased risk for CVD; 2) reducing PPG with acarbose reduced the development of CVD; and 3) increased oxidative stress and inflammation as plausible mechanisms. The main dietary determinants of acute PPG are the amount and source of available carbohydrate (avCHO). The effect of avCHO source is quantified by glycemic index (GI), defined as the incremental area under the glucose curve after 50g avCHO from a food expressed as % of that after 50g glucose. Since GI is independent of the amount of avCHO consumed, it does not indicate what PPG after a meal will be. Glycemic load (GL) is a quantitative index of PPG defined as GL=g×GI/100 where g = grams avCHO. Although GL predicts acute PPG, it does not predict health outcomes because it can be changed either by altering the amount of avCHO, or GI (or both), maneuvers which have different effects; also, the effect of reducing avCHO intake depends on what replaces the avCHO in the diet. We compared the effect of reducing diet GL by reducing GI with that of reducing avCHO intake (replaced with monounsaturated fat), in subjects with type 2 diabetes. Reducing diet GI for 1-year significantly reduced PPG after a lowGI breakfast, reduced inflammation as measured by c-reactive protein (CRP), and increased ȕcell function. By contrast after 1-year of reduced avCHO intake, there was no change in PPG and CRP, and a reduction in ȕ-cell function. It is concluded, therefore, that reducing GL by reducing diet GI, but not by reducing avCHO intake, favorably affects pathophysiological events responsible for CVD, and may, therefore, reduce CVD risk. Canadian Institutes of Health Research