Meta-analysis of the health effects of using the glycaemic index in meal-planning

Opperman, A.M., Venter, C.S., Oosthuizen, W., Thompson, R.L. and Vorster, H.H. (2004) Meta-analysis of the health effects of using the glycaemic index in meal-planning. British Journal of Nutrition, 92 (3), 367-381. (doi:10.1079/BJN20041203).

Abstract

Diabetes mellitus and CVD are some of the leading causes of mortality and morbidity. Accumulating data indicate that a diet characterised by low-glycaemic index (GI) foods may improve the management of diabetes or lipid profiles. The objective of the present meta-analysis was to critically analyse the scientific evidence that low-GI diets have beneficial effects on carbohydrate and lipid metabolism compared with high-GI diets. We searched for randomised controlled trials with a crossover or parallel design published in English between 1981 and 2003, investigating the effect of low-GI v. high-GI diets on markers for carbohydrate and lipid metabolism. Unstandardised differences in mean values were examined using the random effects model. The main outcomes were fructosamine, glycated Hb (HbA1c), HDL-cholesterol, LDL-cholesterol, total cholesterol and triacylglycerol. Literature searches identified sixteen studies that met the strict inclusion criteria. Low-GI diets significantly reduced fructosamine by -0·1 (95 % CI -0·20, 0·00) mmol/l (P=0·05), HbA1c by 0·27 (95 % CI -0·5, -0·03) % (P=0·03), total cholesterol by -0·33 (95 % CI -0·47, -0·18) mmol/l (P<0·0001) and tended to reduce LDL-cholesterol in type 2 diabetic subjects by -0·15 (95 % CI -0·31, -0·00) mmol/l (P=0·06) compared with high-GI diets. No changes were observed in HDL-cholesterol and triacylglycerol concentrations. No substantial heterogeneity was detected, suggesting that the effects of low-GI diets in these studies were uniform. Results of the present meta-analysis support the use of the GI as a scientifically based tool to enable selection of carbohydrate-containing foods to reduce total cholesterol and to improve overall metabolic control of diabetes.

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