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Selected Works of Rasha Khatib, Ph.D, MHS
Article
Associations of the glycaemic index and the glycaemic load with risk of type 2 diabetes in 127 594 people from 20 countries (PURE): A prospective cohort study
The lancet. Diabetes & endocrinology
  • Victoria Miller, Population Health Research Institute, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada. Electronic address: victoria.miller@phri.ca.
  • David A Jenkins, Department of Nutritional Sciences and Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada; Clinical Nutrition Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada; Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, ON, Canada.
  • Mahshid Dehghan, Population Health Research Institute, McMaster University, Hamilton, ON, Canada.
  • Kristie Srichaikul, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.
  • Sumathy Rangarajan, Population Health Research Institute, McMaster University, Hamilton, ON, Canada.
  • Andrew Mente, Population Health Research Institute, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Viswanathan Mohan, Department of Diabetology, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialties Centre, Chennai, India.
  • Sumathi Swaminathan, St John's Research Institute, St John's National Academy of Health Sciences, Bangalore, India.
  • Rosnah Ismail, Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan, Kuala Lumpur, Malaysia.
  • Maria Luz Diaz, Estudios Clinicos Latino America, Rosario, Argentina.
  • Rekha M Ravindran, Department of Health Sciences, Government of Kerala, Kerala, India; Health Action by People, Trivandrum, Kerala, India.
  • Katarzyna Zatonska, Social Department of Wroclaw Medical University, Wroclaw, Poland.
  • Ahmad Bahonar, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
  • Yuksel Altuntas, University of Health Sciences Turkey, Faculty of Medicine, Istanbul Sisli Hamidiye Etfal Health Training Research Hospital, Clinic of Endocrinology and Metabolism, Sisli/Istabul, Türkiye.
  • Rasha Khatib, Advocate Health - Midwest
  • Patricio Lopez-Jaramillo, Masira Research Institute, Medical School, Universidad de Santander, Bucaramanga, Colombia.
  • Afzalhussein Yusufali, Tamani Foundation, Matemwe, Zanzibar, Tanzania.
  • Karen Yeates, Division of Nephrology, Department of Medicine, Queen's University, Kingston, ON, Canada.
  • Jephat Chifamba, Department of Biomedical Sciences, University of Zimbabwe, Harare, Zimbabwe.
  • Romaina Iqbal, Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
  • Rita Yusuf, Center for Health, Population and Development, Independent University, Dhaka, Bangladesh.
  • Elizabeth Catherina Swart, Department of Dietetics and Nutrition, University of the Western Cape, Bellville, South Africa.
  • Hu Bo, Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
  • Guoliang Han, Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
  • Xiaocong Li, Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
  • Khalid F Alhabib, Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University Medical City, King Saud University, Riyaadh, Saudi Arabia.
  • Annika Rosengren, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, and Sahlgrenska University Hospital, Gothenburg, Sweden.
  • Alvaro Avezum, International Research Center, Hospital Alemão-Oswaldo Cruz & UNISA, São Paulo, SP Brazil.
  • Fernando Lanas, Universidad de la Frontera, Temuco, Chile.
  • Salim Yusuf, Population Health Research Institute, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.
Link
Scholarly Activity Date
5-1-2024
Abstract

Background: The association between the glycaemic index and the glycaemic load with type 2 diabetes incidence is controversial. We aimed to evaluate this association in an international cohort with diverse glycaemic index and glycaemic load diets.

Methods: The PURE study is a prospective cohort study of 127 594 adults aged 35-70 years from 20 high-income, middle-income, and low-income countries. Diet was assessed at baseline using country-specific validated food frequency questionnaires. The glycaemic index and the glycaemic load were estimated on the basis of the intake of seven categories of carbohydrate-containing foods. Participants were categorised into quintiles of glycaemic index and glycaemic load. The primary outcome was incident type 2 diabetes. Multivariable Cox Frailty models with random intercepts for study centre were used to calculate hazard ratios (HRs).

Findings: During a median follow-up of 11·8 years (IQR 9·0-13·0), 7326 (5·7%) incident cases of type 2 diabetes occurred. In multivariable adjusted analyses, a diet with a higher glycaemic index was significantly associated with a higher risk of diabetes (quintile 5 vs quintile 1; HR 1·15 [95% CI 1·03-1·29]). Participants in the highest quintile of the glycaemic load had a higher risk of incident type 2 diabetes compared with those in the lowest quintile (HR 1·21, 95% CI 1·06-1·37). The glycaemic index was more strongly associated with diabetes among individuals with a higher BMI (quintile 5 vs quintile 1; HR 1·23 [95% CI 1·08-1·41]) than those with a lower BMI (quintile 5 vs quintile 1; 1·10 [0·87-1·39]; p interaction=0·030).

Interpretation: Diets with a high glycaemic index and a high glycaemic load were associated with a higher risk of incident type 2 diabetes in a multinational cohort spanning five continents. Our findings suggest that consuming low glycaemic index and low glycaemic load diets might prevent the development of type 2 diabetes.

Document Type
Article
PubMed ID
38588684
Citation Information
Miller V, Jenkins DA, Dehghan M, et al. Associations of the glycaemic index and the glycaemic load with risk of type 2 diabetes in 127 594 people from 20 countries (PURE): a prospective cohort study. Lancet Diabetes Endocrinol. 2024;12(5):330-338. doi:10.1016/S2213-8587(24)00069-X