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Dietary glycaemic index and glycaemic load in the European Prospective Investigation into Cancer and Nutrition

European Journal of Clinical Nutrition volume 63, pages S188–S205 (2009)Cite this article

Abstract

Objectives:

To describe dietary glycaemic index (GI) and glycaemic load (GL) values in the population participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study according to food groups, nutrients and lifestyle characteristics.

Methods:

Single 24-h dietary recalls (24-HDRs) from 33 566 subjects were used to calculate dietary GI and GL, and an ad hoc database was created as the main reference source. Mean GI and GL intakes were adjusted for age, total energy intake, height and weight, and were weighted by season and day of recall.

Results:

GI was the lowest in Spain and Germany, and highest in the Netherlands, United Kingdom and Denmark for both genders. In men, GL was the lowest in Spain and Germany and highest in Italy, whereas in women, it was the lowest in Spain and Greece and highest in the UK health-conscious cohort. Bread was the largest contributor to GL in all centres (15–45%), but it also showed the largest inter-individual variation. GL, but not GI, tended to be lower in the highest body mass index category in both genders. GI was positively correlated with starch and intakes of bread and potatoes, whereas it was correlated negatively with intakes of sugar, fruit and dairy products. GL was positively correlated with all carbohydrate components and intakes of cereals, whereas it was negatively correlated with fat and alcohol and with intakes of wine, with large variations across countries.

Conclusions:

GI means varied modestly across countries and genders, whereas GL means varied more, but it may possibly act as a surrogate of carbohydrate intake.

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Acknowledgements

The work described in this paper was carried out with the financial support of the European Commission: Public Health and Consumer Protection Directorate 1993–2004; Research Directorate-General 2005; Ligue contre le Cancer (France); Société 3M (France); Mutuelle Générale de l’Education Nationale; Institut National de la Santé et de la Recherche Médicale (INSERM); Institut Gustave Roussy; German Cancer Aid; German Cancer Research Center; German Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund (FIS) of the Spanish Ministry of Health; Spanish Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra and the Catalan Institute of Oncology; and ISCIII RETIC (RD06/0020), Spain; Cancer Research UK; Medical Research Council, UK; the Stroke Association, UK; British Heart Foundation; Department of Health, UK; Food Standards Agency, UK; the Wellcome Trust, UK; Greek Ministry of Health; Hellenic Health Foundation; Italian Association for Research on Cancer; Italian National Research Council, Regione Sicilia (Sicilian government); Associazione Iblea per la Ricerca Epidemiologica—ONLUS (Hyblean association for epidemiological research, NPO); Dutch Ministry of Health, Welfare and Sport; Dutch Prevention Funds; LK Research Funds; Dutch ZON (Zorg Onderzoek Nederland); World Cancer Research Fund (WCRF); Swedish Cancer Society; Swedish Research Council; Regional Government of Skane and the County Council of Vasterbotten, Sweden; Norwegian Cancer Society; the Norwegian Research Council and the Norwegian Foundation for Health and Rehabilitation. We thank Sarah Somerville, Nicole Suty and Karima Abdedayem for their assistance with editing and Kimberley Bouckaert and Heinz Freisling for technical assistance.

Author information

Author notes

  1. A A Welch

    Present address: 27Current address: School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK.,

  2. A E Cust

    Present address: 28Current address: Centre for MEGA Epidemiology, University of Melbourne, Melbourne, Australia.,

  3. P Ferrari

    Present address: 29Current address: Data Collection and Exposure Unit (DATEX), European Food Safety Authority, Parma, Italy.,

  4. M Schulze

    Present address: 30Current address: Public Health Nutrition Unit, Technische Universität München, Freising, Germany.,

  5. S Bingham: The author is deceased.

Authors and Affiliations

  1. Dietary Exposure Assessment Group, International Agency for Research on Cancer, Lyon, France

    M M E van Bakel, A E Cust, P Ferrari, C Biessy, S Rinaldi & N Slimani

  2. Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany

    R Kaaks & S Rohrmann

  3. Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands

    E J M Feskens

  4. Department of Public Health and Primary Care, MRC Centre for Nutritional Epidemiology in Cancer Prevention and Survival, University of Cambridge, Cambridge, UK

    A A Welch, M Lentjes & S Bingham

  5. Department of Preventive & Predictive Medicine, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy

    V Pala

  6. Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece

    K Avloniti, A Trichopoulou & T Psaltopoulou

  7. Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands

    Y T van der Schouw, J W Beulens & P H M Peeters

  8. National Institute for Public Health and the Environment (RIVM), Bilthoven, The, Netherlands

    D L van der A, H Du & H B Bueno-de-Mesquita

  9. Department of Human Biology, Nutrition and Toxicology Research Institute of Maastricht (NUTRIM), Maastricht University, Maastricht, The Netherlands

    H Du & A Tjønneland

  10. Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

    J Halkjær

  11. Epidemiology Department, Murcia Health Council, Murcia and CIBER en Epidemiología y Salud Pública (CIBERESP), Spain

    M J Tormo

  12. Department of Public Health, University of Parma, Parma, Italy

    F Brighenti

  13. Cancer Epidemiology Unit, University of Oxford, Oxford, UK

    E A Spencer

  14. Department of Clinical and Experimental Medicine, University of Naples, Federico II, Naples, Italy

    S Panico

  15. Molecular and Nutritional Epidemiology Unit, ISPO, Florence, Italy

    G Masala

  16. Inserm, ERI 20, Institut Gustave Roussy, Villejuif, France

    F Clavel-Chapelon & M Touvier

  17. AFSSA (French Food Safety Agency), DERNS/PASER, Maisons-Alfort, France

    M Touvier

  18. Institute of Community Medicine, University of Tromsø, Tromsø, Norway

    G Skeie

  19. Department of Clinical Sciences, Lund University, Malmö, Sweden

    E Sonestedt

  20. Department of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden

    I Johansson

  21. Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany

    M Schulze

  22. Institute of Public Health of Navarra, Pamplona and CIBER Epidemilogía y Salud Pública (CIBERESP), Spain

    E Ardanaz

  23. Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Barcelona, Spain

    G Buckland

  24. Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

    K Overvad

  25. Diet and Cancer Group, MRC Mitochondrial Biology Unit, Cambridge, UK

    S Bingham

  26. Department of Epidemiology, Public Health and Primary Care, Imperial College, London, UK

    E Riboli

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  1. M M E van Bakel
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  2. R Kaaks
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  18. M Lentjes
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  20. S Panico
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  27. M Touvier
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  28. G Skeie
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  33. E Ardanaz
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  34. G Buckland
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  35. A Tjønneland
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  36. K Overvad
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  37. S Bingham
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  38. E Riboli
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  39. N Slimani
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Corresponding author

Correspondence to N Slimani.

Additional information

Guarantor: MME van Bakel.

Contributors: MMEvB wrote the paper and prepared the tables and figures, taking into account comments from all co-authors. MMEvB and CB conducted the statistical analyses. NS was the overall coordinator of this project and was responsible for the EPIC nutritional databases. AEC, JH, JWB, YTvdS, EJMF, DvdA, HD, FB, VP, KA, MJT, PF, CB and NS were members of the ‘GI/GL working group’ and provided input on the statistical analyses, drafting of the paper and interpretation of results. The other co-authors were local EPIC collaborators involved in the collection of dietary and other data and in documenting and compiling the EPIC Nutrient Database (ENDB). ER is the overall coordinator of the EPIC study. All co-authors provided comments and suggestions on the paper and approved the final version.

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van Bakel, M., Kaaks, R., Feskens, E. et al. Dietary glycaemic index and glycaemic load in the European Prospective Investigation into Cancer and Nutrition. Eur J Clin Nutr 63 (Suppl 4), S188–S205 (2009). https://doi.org/10.1038/ejcn.2009.81

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