Bahado-Singh, Perceval S.; Wheatley, Andrew O.; Osagie, A.U; Boyne, Michael; Morrison, Errol Y.St.A.; Asemota, Helen N.
Author Affiliation, Ana.
Low glycemic index foods: A nutritional approach for management of hyperglycemia and cardiovascular disease in type 2 diabetics
Date of Publication
Background: The global epidemic rise in type 2 diabetes (Barceló et al. 2003) has prompted the use of the glycemic index (GI) as a possible approach for optimizing the nutritional management of individuals diagnosed with type 2 diabetes (Brand-Miller et al. 2003). Although there is some level of debate surrounding the use of GI in diabetes management, diabetes prevention trials have shown that nutrition and lifestyle approaches with low GI diets may significantly improve the presence of an abnormally high concentration of glucose in the blood (Jarvi et al. 1999) and aid in the prevention of cardiovascular diseases (Ebbeling et al. 2005). Objective: To investigate the effect of the consumption diets of low GI indigenous Caribbean carbohydrate-rich foods on A1c, lipoprotein profile, homocystiene and C-reactive protein in type 2 diabetics. Research Design and Methods: A randomized control parallel trial compared two dietary treatments in adult type 2 diabetics (n = 65) over six months. The experimental treatment group (n =32) emphasized the consumption of low glycemic index foods, while subjects in the control group (n = 33) were not so advised. Attempts were made to ensure that both groups were isocaloric so as to avoid the confounding effect of the intervention group being relatively hypocaloric with 45-50% of energy from carbohydrates. Changes in study outcomes by multivariate and regression analysis were carried out and the results expressed as mean percentage change. Results After the 24 weeks study period subjects in the intervention group showed a significantly greater mean decrease in A1c concentration than subjects in the control group (-9.03% and -4.03% respectively). Mean homocystiene levels decreased significantly in the intervention and control groups (-17.53% and -6.98% respectively). A similar decrease in C-reactive protein concentration (-38.24% and -15.18 respectively) was also observed. The experimental diet group showed a sharper decline in plasma triglycerides than did the control diet group (-16.13% and -5.93% respectively; p<0.05). There were also significant changes in the HDL and LDL levels in both groups. Changes in total cholesterol concentrations, blood pressure, body weight and BMI did not differ significantly between the groups. Conclusion: The results from this study indicate that the consumption of low glycemic index indigenous carbohydrate-rich Caribbean foods may have a positive effect in glycaemic control and in the prevention of diabetes and its associated complications. This is seen in the improvement in glycaemic control and a decline in cardiovascular inflammatory biochemical markers. Consumption of low GI complex carbohydrates should prove useful and be promoted by health care professionals and dieticians in diabetes education.....