Low glycaemic index or low glycaemic load diets for overweight and obesity - PubMed (original) (raw)

Review

Low glycaemic index or low glycaemic load diets for overweight and obesity

D E Thomas et al. Cochrane Database Syst Rev. 2007.

Update in

Abstract

Background: Obesity is increasingly prevalent, yet the nutritional management remains contentious. It has been suggested that low glycaemic index or load diets may stimulate greater weight loss than higher glycaemic index or load diets or other weight reduction diets.

Objectives: To assess the effects of low glycaemic index or load diets for weight loss in overweight or obese people.

Search strategy: Trials were identified through The Cochrane Library, MEDLINE, EMBASE, CINAHL and manual searches of bibliographies.

Selection criteria: Randomised controlled trials comparing a low glycaemic index or load diet (LGI) with a higher glycaemic index or load diet or other diet (Cdiet) in overweight or obese people.

Data collection and analysis: Two authors independently selected trials, assessed quality and extracted data, including any information provided on adverse effects.

Main results: We identified six eligible randomised controlled trials (total of 202 participants). Interventions ranged from five weeks to six months duration with up to six months follow-up after the intervention ceased. The decrease in body mass (WMD -1.1 kg, 95% confidence interval (CI) -2.0 to -0.2, P < 0.05) (n = 163), total fat mass (WMD -1.1 kg, 95% CI -1.9 to -0.4, P < 0.05) (n =147) and body mass index (WMD -1.3, 95% CI -2.0 to -0.5, P < 0.05) (n = 48) was significantly greater in participants receiving LGI compared to Cdiets. The decrease in total cholesterol was significantly greater with LGI compared to Cdiets (WMD -0.22 mmol/L, 95% CI -0.43 to -0.02, P < 0.05), as was the change in LDL-cholesterol (WMD -0.24 mmol/L, 95% CI -0.44 to -0.05, P < 0.05). No study reported adverse effects, mortality or quality of life data.

Authors' conclusions: Overweight or obese people on LGI lost more weight and had more improvement in lipid profiles than those receiving Cdiets. Body mass, total fat mass, body mass index, total cholesterol and LDL-cholesterol all decreased significantly more in the LGI group. In studies comparing ad libitum LGI diets to conventional restricted energy low-fat diets, participants fared as well or better on th LGI diet, even though they could eat as much as desired. Lowering the glycaemic load of the diet appears to be an effective method of promoting weight loss and improving lipid profiles and can be simply incorporated into a person's lifestyle. Further research with longer term follow-up will determine whether improvement continues long-term and improves quality of life.

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Conflict of interest statement

None known.

Figures

1

1

Adapted QUOROM (quality of reporting of meta‐analyses) flow‐chart of study selection

1.1

1.1. Analysis

Comparison 1 Low glycaemic diet versus high glycaemic or other diet, Outcome 1 change in body mass (kg).

1.2

1.2. Analysis

Comparison 1 Low glycaemic diet versus high glycaemic or other diet, Outcome 2 change in total fat mass (DXA kg).

1.3

1.3. Analysis

Comparison 1 Low glycaemic diet versus high glycaemic or other diet, Outcome 3 change in body mass index (BMI units).

1.4

1.4. Analysis

Comparison 1 Low glycaemic diet versus high glycaemic or other diet, Outcome 4 change in total cholesterol concentration (mmol/L).

1.5

1.5. Analysis

Comparison 1 Low glycaemic diet versus high glycaemic or other diet, Outcome 5 change in LDL cholesterol concentration (mmol/L).

1.6

1.6. Analysis

Comparison 1 Low glycaemic diet versus high glycaemic or other diet, Outcome 6 change in HDL cholesterol concentration (mmol/L).

1.7

1.7. Analysis

Comparison 1 Low glycaemic diet versus high glycaemic or other diet, Outcome 7 change in triglycerides concentration (mmol/L) and % change (%).

1.8

1.8. Analysis

Comparison 1 Low glycaemic diet versus high glycaemic or other diet, Outcome 8 change in fat free mass (kg).

1.9

1.9. Analysis

Comparison 1 Low glycaemic diet versus high glycaemic or other diet, Outcome 9 fasting plasma glucose concentration: final concentrations (mmol/L) and change in concentration (mmol/L).

1.10

1.10. Analysis

Comparison 1 Low glycaemic diet versus high glycaemic or other diet, Outcome 10 fasting plasma insulin concentration: final concentrations (pmol/L) and change in concentration (pmol/L).

1.11

1.11. Analysis

Comparison 1 Low glycaemic diet versus high glycaemic or other diet, Outcome 11 free fatty acids: final concentrations (umol/L) and change in concentration (umol/L).

1.12

1.12. Analysis

Comparison 1 Low glycaemic diet versus high glycaemic or other diet, Outcome 12 systolic blood pressure: change (mmHg) and % change (%).

1.13

1.13. Analysis

Comparison 1 Low glycaemic diet versus high glycaemic or other diet, Outcome 13 diastolic blood pressure: change (mmHg) and % change (%).

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References

References to studies included in this review

Bouche 2002 {published data only}
    1. Bouche C, Rizkalla SW, Luo J, Vidal H, Veronese A, Pacher N, et al. Five‐week, low‐glycemic index diet decreases total fat mass and improves plasma lipid profile in moderately overweight nondiabetic men. Diabetes Care 2002;25(5):822‐8. - PubMed
Ebbeling 2003 {published data only}
    1. Ebbeling CB, Leidig MM, Sinclair KB, Hangen JP, Ludwig DS. A reduced‐glycemic load diet in the treatment of adolescent obesity. Archives of Pediatrics & Adolescent Medicine 2003;157(8):773‐9. - PubMed
Ebbeling 2005 {published data only}
    1. Ebbeling CB, Leidig MM, Sinclair KB, Seger‐Shippee LG, Feldman HA, Ludwig DS. Effects of an ad libitum low‐glycemic load diet on cardiovascular disease risk factors in obese young adults. American Journal of Clinical Nutrition 2005;81(5):976‐82. - PubMed
McMillan‐Price 2006 {published data only}
    1. McMillan‐Price J, Petocz P, Atkinson F, O'neill K, Samman S, Steinbeck K, et al. Comparison of 4 diets of varying glycemic load on weight loss and cardiovascular risk reduction in overweight and obese young adults: a randomized controlled trial. Archives of internal medicine 2007;166 (14):1466‐75. - PubMed
Slabber 1994 {published data only}
    1. Slabber M, Barnard HC, Kuyl JM, Dannhauser A, Schall R. Effects of a low‐insulin‐response, energy‐restricted diet on weight loss and plasma insulin concentrations in hyperinsulinemic obese females. American Journal of Clinical Nutrition 1994;60(1):48‐53. - PubMed
Sloth 2004 {published data only}
    1. Sloth B, Krog‐Mikkelsen I, Flint A, Tetens I, Bjorck I, Vinoy S, et al. No difference in body weight decrease between a low‐glycemic‐index and a high‐glycemic‐index diet but reduced LDL cholesterol after 10‐wk ad libitum intake of the low‐glycemic‐index diet. American Journal of Clinical Nutrition 2004;80(2):337‐47. - PubMed

References to studies excluded from this review

Agus 2000 {published data only}
    1. Agus MS, Swain JF, Larson CL, Eckert EA, Ludwig DS. Dietary composition and physiologic adaptations to energy restriction. American Journal of Clinical Nutrition 2000;71(4):901‐7. - PMC - PubMed
Ball 2003 {published data only}
    1. Ball SD, Keller KR, Moyer‐Mileur LJ, Ding Y‐W, Donaldson D, Jackson WD. Prolongation of satiety after low versus moderately high glycemic index meals in obese adolescents. Pediatrics 2003;111(3):488‐94. - PubMed
Clapp 1998 {published data only}
    1. Clapp J. Diet, exercise and feto‐placental growth. Archives of gynecology and obstetrics 1997;261:101‐7.
Dumesnil 2001 {published data only}
    1. Dumesnil JG, Turgeon J, Tremblay A, Poirier P, Gilbert M, Gagnon L, et al. Effect of a low‐glycaemic index‐‐low‐fat‐‐high protein diet on the atherogenic metabolic risk profile of abdominally obese men.[comment]. British Journal of Nutrition 2001;86(5):557‐68. - PubMed
Hanai 1997 {published data only}
    1. Hanai H, Ikuma M, Sato Y, Iida T, Hosoda Y, Matsushita I, et al. Long‐term effects of water‐soluble corn bran hemicellulose on glucose tolerance in obese and non‐obese patients: improved insulin sensitivity and glucose metabolism in obese subjects. Bioscience, Biotechnology & Biochemistry 1997;61(8):1358‐61. - PubMed
Jenkins 1985 {published data only}
    1. Jenkins DJ, Wolever TM, Kalmusky J, Giudici S, Giordano C, Wong GS, et al. Low glycemic index carbohydrate foods in the management of hyperlipidemia. American Journal of Clinical Nutrition 1985;42(4):604‐17. - PubMed
Jenkins 1987 {published data only}
    1. Jenkins DJ, Wolever TM, Collier GR, Ocana A, Rao AV, Buckley G, et al. Metabolic effects of a low‐glycemic‐index diet. American Journal of Clinical Nutrition 1987;46(6):968‐75. - PubMed
Pereira 2005 {published data only}
    1. Pereira MA, Swain J, Goldfine AB, Rifai N, Ludwig DS. Effects of a low‐glycemic load diet on resting energy expenditure and heart disease risk factors during weight loss. JAMA 2004;292(20):2482‐90. - PubMed
Piatti 1993 {published data only}
    1. Piatti PM, Pontiroli AE, Saibene A, Santambrogio G, Paroni R, Magni F et aö. Insulin sensitivity and lipid levels in obese subjects after slimming diets with different complex and simple carbohydrate content. International Journal of Obesity & Related Metabolic Disorders: Journal of the International Association for the Study of Obesity 1993;17(7):375‐81. - PubMed
Spieth 2000 {published data only}
    1. Spieth LE, Harnish JD, Lenders CM, Raezer LB, Perira MA, Hangen SJ, et al. A low‐glycemic index diet in the treatment of pediatric obesity. Archives of Pediatric Adolescent Medicine 2000 Sep;154(9):947‐51. - PubMed
Van Horn 1986 {published data only}
    1. Horn LV, Liu K, Parker D, Emidy L, Liao Y, Pan WH et aö. Serum lipid response to oat product intake with a fat‐modified diet. Journal of The American Dietetic Association 1986;86(6):759‐64. - PubMed
Wolever 1992 {published data only}
    1. Wolever TM, Jenkins DJ, Vuksan V, Jenkins AL, Wong GS, Josse RG. Beneficial effect of low‐glycemic index diet in overweight NIDDM subjects. Diabetes Care 1992;15(4):562‐4. - PubMed
Wolever 2002 {published data only}
    1. Wolever TM, Mehling C. High‐carbohydrate‐low‐glycaemic index dietary advice improves glucose disposition index in subjects with impaired glucose tolerance. British Journal of Nutrition 2002;87(5):477‐87. - PubMed
    1. Wolever TM, Mehling C. Long‐term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance. American Journal of Clinical Nutrition 2003;77(3):612‐21. - PubMed

Additional references

Brand‐Miller 2002
    1. Brand‐Miller JC, Holt SH, Pawlak DB, McMillan J. Glycemic index and obesity. American Journal of Clinical Nutrition 2002;76(1):281S‐5S. - PubMed
Bravata 2003
    1. Bravata ODM, Sanders L, Huang J, Krumholz H M, Olkin I, Gardner CD, et al. Efficacy and safety of low‐carbohydrate diets: a systematic review. JAMA 2003;289(14):1837‐50. - PubMed
Campbell 2002
    1. Campbell K, Waters E, O'Meara S, Kelly S, Summerbell C. Interventions for preventing obesity in children (Cochrane Review). Cochrane Database of Systematic Reviews 2002, Issue 2. [DOI: 10.1002/14651858] - DOI - PubMed
Cohen 1960
    1. Cohen J. A coefficient of agreement for nominal scales. Educational and Psychological Measurement 1960:37‐46.
Cooper 1994
    1. Cooper H, Hedges LV. The handbook of research synthesis. New York: Russell Safe Foundation, 1994.
Dietz 1998
    1. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998;101(3 Pt 2):518‐25. - PubMed
Fleiss 1981
    1. Fleiss. Statistical Methods for Rates and Proportions. 2nd Edition. Wiley, New York, 1981.
Higgins 2002
    1. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta‐analysis. Statistics in medicine 2002;21:1539‐58. - PubMed
Higgins 2003
    1. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analysis. BMJ 2003;327:557‐60. - PMC - PubMed
Higgins 2005
    1. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions 4.2.4. In: The Cochrane Library, Issue 2, 2005. Chichester, UK: John Wiley & Sons, Ltd, [updated March 2005].
Jadad 1996
    1. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Controlled Clinical Trials 1996;17(1):1‐12. - PubMed
Jenkins 1981
    1. Jenkins DJ, Wolever TM, Taylor RH, Barker H, Fielden H, Baldwin JM, et al. Glycemic index of foods: a physiological basis for carbohydrate exchange. American Journal of Clinical Nutrition 1981;34(3):362‐6. - PubMed
Kiens 1996
    1. Kiens B, Richter EA. Types of carbohydrate in an ordinary diet affect insulin action and muscle substrates in humans. American Journal of Clinical Nutrition 1996;63(1):47‐53. - PubMed
Moher 1999
    1. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta‐analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta‐analyses. Lancet 1999;354(9193):1896‐900. - PubMed
Mokdad 2001
    1. Mokdad OAH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, et al. Prevalence of obesity, diabetes, and obesity‐related health risk factors, 2001. JAMA 2003;289(1):76‐9. - PubMed
Parliament 2003
    1. Parliament (U.K.) Committee of Public Accounts. Tackling Obesity in England. www.publications.parliament.uk/pa/cm200102/cmselect/cmpubacc/421/42103.htm (accessed 16 June 2003).
Pawlak 2002
    1. Pawlak DB, Ebbeling CB, Ludwig DS. Should obese patients be counselled to follow a low‐glycaemic index diet? Yes. Obesity Reviews 2002;3(4):235‐43. - PubMed
Raben 2002
    1. Raben A. Should obese patients be counselled to follow a low‐glycaemic index diet? No. Obesity Reviews 2002;3(4):245‐56. - PubMed
Schulz 1995
    1. Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995;273(5):408‐12. - PubMed
    1. Silink M. Childhood diabetes: a global perspective. Hormone Research 2002;57 Suppl 1:1‐5. - PubMed
Strauss 2001
    1. Strauss RS, Pollack HA. Epidemic increase in childhood overweight, 1986‐1998. JAMA 2001;286(22):2845‐8. - PubMed
Summerbell 2003
    1. Summerbell C, Waters E, Edmunds. Interventions for treating obesity in children. Cochrane Database of Systematic Reviews 2003, Issue 1. [DOI: 10.1002/14651858.CD001872] - DOI - PubMed
Tang 2000
    1. Tang JL, Liu JL. Misleading funnel plot for detection of bias in meta‐analysis. Journal of Clinical Epidemiology 2000;53(5):477‐84. - PubMed
WHO 1997
    1. World Health Organization. Obesity, preventing and managing the global epidemic: Report of the WHO consultation of obesity. Geneva: World Health Organization, 1997. - PubMed

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