Prospective study of dietary carbohydrates, glycemic index, glycemic load, and incidence of type 2 diabetes mellitus in middle-aged Chinese women.

@article{citeulike:2330323, abstract = {BACKGROUND: Much uncertainty exists about the role of dietary glycemic index and glycemic load in the development of type 2 diabetes mellitus, especially in populations that traditionally subsist on a diet high in carbohydrates. METHODS: We observed a cohort of 64,227 Chinese women with no history of diabetes or other chronic disease at baseline for 4.6 years. In-person interviews were conducted to collect data on dietary habits, physical activity, and other relevant information using a validated questionnaire. Incident diabetes cases were identified via in-person follow-up. Associations between dietary carbohydrate intake, glycemic index, and glycemic load and diabetes incidence were evaluated using multivariable Cox proportional hazards models. RESULTS: We identified 1,608 incident cases of type 2 diabetes mellitus in 297,755 person-years of follow-up. Dietary carbohydrate intake and consumption of rice were positively associated with risk of developing type 2 diabetes mellitus. The multivariable-adjusted estimates of relative risk comparing the highest vs the lowest quintiles of intake were 1.28 (95\% confidence interval, 1.09-1.50) for carbohydrates and 1.78 (95\% confidence interval, 1.48-2.15) for rice. The relative risk for increasing quintiles of intake was 1.00, 1.04, 1.02, 1.09, and 1.21 (95\% confidence interval, 1.03-1.43) for dietary glycemic index and 1.00, 1.06, 0.97, 1.23, and 1.34 (95\% confidence interval, 1.13-1.58) for dietary glycemic load. CONCLUSION: High intake of foods with a high glycemic index and glycemic load, especially rice, the main carbohydrate-contributing food in this population, may increase the risk of type 2 diabetes mellitus in Chinese women.}, address = {Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, 2525 West End Ave, Ste 600, Nashville, TN 37203-1738, USA.}, author = {Villegas, R. and Liu, S. and Gao, Y. T. and Yang, G. and Li, H. and Zheng, W. and Shu, X. O. }, citeulike-article-id = {2330323}, comment = {Detractors to the glycemic index theory have always held Asians (Chinese) as an example of a culture with a rice-based (starch, high-glycemic index) diet who have no apparent adverse effects. This analysis of 64,227 Chinese women refutes that view. Those with the highest rice intake had the highest risk of DM. The risks were amplified (>200\% increased risk) in those who had >=300 g of rice per day and who had a waist-to-hip ratio >=0.85. Since a typical takout carton of rice contains ~400 g of rice in the U.S., Chinese food lovers should take notice of this nutritional hazard. In addition, rice contains no essential fatty or amino acids nor any critical micronutrients that cannot be obtained with a simple daily multivitamin. Like flour-based baked goods and pasta, rice is simply a filler with no nutritional value. With changes in lifestyle and greater availability of food, rice based diets are likely to be a pubic health disaster for the developing nations in Asia. Avoiding high-glycemic foods such as rice is one pillar of a healthy diet aimed to avoid DM and subsequent morbidity.--Peter A. McCullough, MD, MPH }, doi = {10.1001/archinte.167.21.2310}, issn = {0003-9926}, journal = {Arch Intern Med}, keywords = {diabetes, diet, risk}, month = {November}, number = {21}, pages = {2310--2316}, posted-at = {2008-02-04 18:47:53}, priority = {2}, title = {Prospective study of dietary carbohydrates, glycemic index, glycemic load, and incidence of type 2 diabetes mellitus in middle-aged Chinese women.}, url = {http://dx.doi.org/10.1001/archinte.167.21.2310}, volume = {167}, year = {2007} }

TY - JOUR ID - citeulike:2330323 L3 - citeulike-article-id:2330323 TI - Prospective study of dietary carbohydrates, glycemic index, glycemic load, and incidence of type 2 diabetes mellitus in middle-aged Chinese women. JF - Arch Intern Med VL - 167 IS - 21 SP - 2310 EP - 2316 AD - Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, 2525 West End Ave, Ste 600, Nashville, TN 37203-1738, USA. SN - 0003-9926 N2 - BACKGROUND: Much uncertainty exists about the role of dietary glycemic index and glycemic load in the development of type 2 diabetes mellitus, especially in populations that traditionally subsist on a diet high in carbohydrates. METHODS: We observed a cohort of 64,227 Chinese women with no history of diabetes or other chronic disease at baseline for 4.6 years. In-person interviews were conducted to collect data on dietary habits, physical activity, and other relevant information using a validated questionnaire. Incident diabetes cases were identified via in-person follow-up. Associations between dietary carbohydrate intake, glycemic index, and glycemic load and diabetes incidence were evaluated using multivariable Cox proportional hazards models. RESULTS: We identified 1,608 incident cases of type 2 diabetes mellitus in 297,755 person-years of follow-up. Dietary carbohydrate intake and consumption of rice were positively associated with risk of developing type 2 diabetes mellitus. The multivariable-adjusted estimates of relative risk comparing the highest vs the lowest quintiles of intake were 1.28 (95% confidence interval, 1.09-1.50) for carbohydrates and 1.78 (95% confidence interval, 1.48-2.15) for rice. The relative risk for increasing quintiles of intake was 1.00, 1.04, 1.02, 1.09, and 1.21 (95% confidence interval, 1.03-1.43) for dietary glycemic index and 1.00, 1.06, 0.97, 1.23, and 1.34 (95% confidence interval, 1.13-1.58) for dietary glycemic load. CONCLUSION: High intake of foods with a high glycemic index and glycemic load, especially rice, the main carbohydrate-contributing food in this population, may increase the risk of type 2 diabetes mellitus in Chinese women. KW - diabetes KW - diet KW - risk N1 - Detractors to the glycemic index theory have always held Asians (Chinese) as an example of a culture with a rice-based (starch, high-glycemic index) diet who have no apparent adverse effects. This analysis of 64,227 Chinese women refutes that view. Those with the highest rice intake had the highest risk of DM. The risks were amplified (>200% increased risk) in those who had >=300 g of rice per day and who had a waist-to-hip ratio >=0.85. Since a typical takout carton of rice contains ~400 g of rice in the U.S., Chinese food lovers should take notice of this nutritional hazard. In addition, rice contains no essential fatty or amino acids nor any critical micronutrients that cannot be obtained with a simple daily multivitamin. Like flour-based baked goods and pasta, rice is simply a filler with no nutritional value. With changes in lifestyle and greater availability of food, rice based diets are likely to be a pubic health disaster for the developing nations in Asia. Avoiding high-glycemic foods such as rice is one pillar of a healthy diet aimed to avoid DM and subsequent morbidity.--Peter A. McCullough, MD, MPH AU - Villegas, R AU - Liu, S AU - Gao, YT AU - Yang, G AU - Li, H AU - Zheng, W AU - Shu, XO PY - 2007/11/26/ UR - http://dx.doi.org/10.1001/archinte.167.21.2310 ER -