a1 Center for Research in Nutrition and Health Disparities and Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, 2718 Middleburg Drive, Columbia, SC 29 208 USA
a2 National Institutes of Health, National Institute of Diabetes, Digestive, and Kidney Diseases, Bethesda, MD 20817, USA
a3 German Institute of Human Nutrition Department of Epidemiology, Potsdam-Rehbruecke, Germany
Epidemiologic studies have applied the glycaemic index (GI) and glycaemic load (GL) to assessments of usual dietary intake. Results have been inconsistent particularly for the association of GI or GL with diabetes incidence. We aimed to advance understanding of the GI and GL as applied to food frequency questionnaires (FFQ) by evaluating GI and GL in relation to plasma measures of glycaemia. Included were 1255 adults at a baseline examination (1994–6) and 813 who returned for the 5-year follow-up examination. Usual diet, at both examinations, was assessed by a validated FFQ. GI and GL were evaluated in relation to average fasting glucose (two measures at each examination) and 2h post-75g glucose load plasma glucose (baseline and follow-up), and glycated haemoglobin (A1c; follow-up only); using generalized linear models. Correlation coefficients (r) for GI and GL related to measures of glycaemia, adjusted for total energy intake, ranged from −0·004 to 0·04 (all NS) for both examinations. Adjustment for potential confounders, for fasting glucose in models for 2h glucose (to model incremental glucose) and for average fasting glucose in models for A1c (to account, in part, for overnight endogenous glucose production) also did not materially alter findings, nor did inclusion of data from both examinations together in linear mixed models. The present results call into question the utility of GI and GL to reflect glycaemic response to food adequately, when used in the context of usual diet. Further work is needed to quantify usual dietary exposures relative to glucose excursion and associated chronic glycaemia and other metabolic parameters.
(Received June 08 2005)
(Revised September 19 2005)
(Accepted September 28 2005)