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The glycemic index and cardiovascular disease risk

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Abstract

Postprandial hyperglycemia is increasingly recognized as an independent risk factor for cardiovascular disease. Glycemic “spikes” may adversely affect vascular structure and function via multiple mechanisms, including (acutely and/or chronically) oxidative stress, inflammation, low-density lipoprotein oxidation, protein glycation, and procoagulant activity. Postprandial glycemia can be reliably predicted by considering both the amount and type of carbohydrate. In particular, the glycemic index (GI), a measure of postprandial glycemic potency weight for weight of carbohydrate, has provided insights that knowledge of the sugar or starch content has not. In prospective observational studies, dietary GI and/or glycemic load independently predict cardiovascular disease, with relative risk ratios of 1.2 to 1.7 comparing highest and lowest quintiles. In randomized controlled trials in overweight subjects, diets based on low-GI carbohydrates have produced better cardiovascular-related outcomes than conventional low-fat diets. Taken together, the findings suggest that health professionals may be able to improve cardiovascular outcomes by recommending the judicious use of low-GI/glycemic load foods.

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Correspondence to Jennie Brand-Miller.

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Brand-Miller, J., Dickinson, S., Barclay, A. et al. The glycemic index and cardiovascular disease risk. Curr Atheroscler Rep 9, 479–485 (2007). https://doi.org/10.1007/s11883-007-0064-x

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