Original Article
European Journal of Clinical Nutrition advance online publication 16 September 2009; doi: 10.1038/ejcn.2009.115
Glycaemic load is associated with insulin resistance in older Australian women
Contributors: SO'N was involved in conception and design of the LAW study, and acquisition of data on insulin resistance and potential confounding variables. PLW and TO'S were involved in study conception and design. TO'S was involved in acquisition of dietary data and drafting of the paper. TO'S and AB analysed the data, and, together with PLW, were involved in interpretation of the data. All authors were involved in review of the paper.
T A O'Sullivan1, A P Bremner2, S O'Neill3 and P Lyons-Wall4
- 1Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- 2School of Population Health, University of Western Australia, Crawley, Western Australia, Australia
- 3Betty Byrne Henderson Research Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- 4School of Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
Correspondence: Dr TA O'Sullivan, Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, PO Box 855, West Perth, Western Australia 6872, Australia. E-mail: tosullivan@ichr.uwa.edu.au
Received 7 April 2009; Revised 3 August 2009; Accepted 5 August 2009; Published online 16 September 2009.
Abstract
Background/Objectives:
Diets with a high postprandial glycaemic response may contribute to the long-term development of insulin resistance and diabetes; however, earlier epidemiological studies are conflicting on whether glycaemic index (GI) or glycaemic load (GL) are dietary factors associated with the progression. Our objectives were to estimate GI and GL in a group of older women, and evaluate cross-sectional associations with insulin resistance.
Subjects/Methods:
The subjects were 329 Australian women aged 42–81 years participating in year 3 of the Longitudinal Assessment of Ageing in Women study. Dietary intakes were assessed by diet history interviews and analysed using a customized GI database. Insulin resistance was defined as a homeostasis model assessment value of >3.99, based on fasting blood glucose and insulin concentrations.
Results:
GL was significantly higher in the 26 subjects who were classified as insulin resistant compared with subjects who were not (134
33 versus 11424, P<0.001). In a logistic regression model, an increment of 15 GL units increased the odds of insulin resistance by 2.09 (95% confidence interval (1.55, 2.80), P<0.001) independently of potential confounding variables. No significant associations were found when insulin resistance was assessed as a continuous variable.
Conclusions:
The results of this cross-sectional study support the concept that diets with a higher GL are associated with an increased risk of insulin resistance. Further studies are required to determine whether reducing the glycaemic intake, either by consuming lower GI foods or through smaller serves of carbohydrate, can contribute to a reduction in development of insulin resistance and long-term risk of type II diabetes.
Keywords:
glycaemic index, glycaemic load, carbohydrate, insulin resistance, women, LAW study
