Associations of carbohydrates and carbohydrate-rich foods with incidence of type 2 diabetes

Olsson, Kjell; Ramne, Stina; González-Padilla, Esther; Ericson, Ulrika; Sonestedt, Emily

doi:10.1017/s0007114520005140

Cited by 10 publications

(10 citation statements)

References 34 publications

(54 reference statements)

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“…Several studies suggest that high consumption of SSBs may be positively associated with the risks of obesity and related complications ( 12 , 59–75 ), such as nonalcoholic fatty liver disease (NAFLD) ( 60 , 64 ), T2DM ( 61–63 , 65 , 72 , 76–80 ), stroke ( 71 ), coronary heart disease (CHD) ( 71 , 81 , 82 ), high blood pressure ( 15 , 70 , 73 ), and CVD mortality ( 83–85 ). However, in the prospective cohort study by Olsson et al ( 86 ), high intake of SSBs was not associated with an increased risk of T2DM. Other studies reported that high SSB consumption was associated with MetSyn in men but not women, which may be explained by differential hormone levels between males and females ( 81 , 82 , 87 ).…”

Section: Resultsmentioning

confidence: 84%

“…Several prospective cohort studies have shown that high sucrose or fructose consumption was not associated with the T2DM incidence or risks ( 86 , 91–96 ), nor was it even associated with a reduced risk of T2DM ( 78 , 91 , 97 , 98 ) ( Table 3 ). In contrast, Warfa et al ( 80 ) showed in a prospective cohort study that high sucrose consumption was associated with an increased risk of T2DM, and the study by Montonen et al ( 77 ) showed high fructose intake, but not sucrose intake, was associated with an increased T2DM incidence.…”

Section: Resultsmentioning

confidence: 99%

“…In contrast, Warfa et al ( 80 ) showed in a prospective cohort study that high sucrose consumption was associated with an increased risk of T2DM, and the study by Montonen et al ( 77 ) showed high fructose intake, but not sucrose intake, was associated with an increased T2DM incidence. For cardiometabolic health, studies ( 77 , 78 , 86 , 91 , 93 , 94 , 96 , 99–101 ) have shown that high intakes of both sucrose or fructose and total sugars were not associated with increased risks of total CVD, total CHD, or total stroke. Results were inconsistent for CVD or all-cause mortality, with some studies suggesting an adverse association between added sugar and mortality ( 79 , 102 ), while Tasevska et al ( 103 ) reported null findings in women or even a protective effect in men.…”

Section: Resultsmentioning

confidence: 99%

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Current WHO recommendation to reduce free sugar intake from all sources to below 10% of daily energy intake for supporting overall health is not well supported by available evidence

Yan

Chan

Louie

2022

The American Journal of Clinical Nutrition

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Sugar is widely consumed over the world. Although the mainstream view is that high added/free sugar consumption leads to obesity and related metabolic diseases, controversies exist. This narrative review aims to highlight important findings and identify major limitations and gaps in the current body of evidence in relation to the effect of high sugar intake on health. Previous animal studies have shown that high sucrose/fructose consumption causes insulin resistance in the liver, skeletal muscle and consequent hyperglycemia, mainly because of fructose-induced de novo hepatic lipogenesis. Evidence from human observational studies and clinical trials was however inconsistent, where most if not all studies linking high sugar intake to obesity focused on sugar-sweetened beverages (SSBs), and studies focusing on sugars from solid foods yielded null findings. In our opinion the substantial limitations in the current body of evidence such as short study duration, use of supraphysiological doses of sugar or fructose alone in animal studies, lack of direct comparison of the effects of solid vs. liquid sugars on health outcomes, as well as the lack of appropriate control seriously curtails the translatability of the findings to the real-world situation. It is quite possible that “high” sugar consumption at normal dietary doses (e.g., 25% daily energy intake) per se, i.e., the unique effect of sugar, especially in the solid form, may indeed not pose a health risk for individuals apart from the potential to reduce the overall dietary nutrient density, although newer evidence suggests “low” sugar intake (<5% daily energy intake) is just as likely to be associated with nutrient dilution. We argue the current public health recommendations to encourage the reduction of both solid and liquid forms of free sugars intake (e.g., sugar reformulation programs) should be revised due to the over-extrapolation of results from SSBs studies.

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Section: Resultsmentioning

confidence: 84%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Current WHO recommendation to reduce free sugar intake from all sources to below 10% of daily energy intake for supporting overall health is not well supported by available evidence

Yan

Chan

Louie

2022

The American Journal of Clinical Nutrition

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“…An inverse association between linoleic acid (which belongs to n-6 series of PUFA) intake and T2DM was reported by NHS, NHSII, and HPFS researches, particularly when linoleic acid replaced isocalorically SFA or carbohydrates [31]. Regarding carbohydrates, a study carried out in Sweden found inverse associations between intake of monosaccharides and fruits with T2DM, and positive associations for disaccharides and sweets [32]. Other studies have focused on glycemic index and glycemic load as the causal factors responsible for T2DM incidence [33,34], although it has also been suggested that glycemic index and glycemic load might be less useful tools to evaluate quality of carbohydrates than dietary fibre and whole-grain content [35].…”

Section: Discussionmentioning

confidence: 94%

Quality and Quantity of Protein Intake Influence Incidence of Type 2 Diabetes Mellitus in Coronary Heart Disease Patients: From the CORDIOPREV Study

et al. 2021

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Evidence suggests that enriching a diet with plant-based proteins could reduce the risk of developing type 2 diabetes mellitus. In the present work, we evaluated the association between the change in plant protein intake (adjusted by energy) and incidence of type 2 diabetes mellitus in patients with coronary heart disease from the CORDIOPREV (coronary diet intervention with olive oil and cardiovascular prevention) study. At baseline and during the follow-up, patients underwent medical examination and blood and oral glucose tolerance tests. Information on patient’s dietary intake was gathered by registered dietitians using a validated food frequency questionnaire. A total of 106 out of 436 nondiabetic patients at baseline developed type 2 diabetes mellitus after a median follow-up of 60 months. Cox regression analyses showed that patients who belonged to the group that increased plant protein intake exhibited a lower risk of developing the disease (HR = 0.64, (0.43–0.96)). Changes in plant protein intake were positively correlated with changes in carbohydrates, fibre, and legumes intake and negatively correlated with changes in saturated fatty acids intake. Results of the present study support the need of improving diet with plant-based proteins to prevent the onset of type 2 diabetes mellitus.

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“…During the literature research, the risk of type 2 diabetes is significantly increased with the long‐term consumption of high glycemic index (GI) foods (Eyinla et al., 2021). At the same time, the delay of glucose absorption and the reduction of blood sugar requirement would be obtained with low GI foods, which could enhance blood sugar control (Olsson et al., 2021). Thus, it is an effective and significant method for developing low GI functional food components to lighten or even cut the occurrence of diabetes (Eyinla et al., 2021).…”

Section: Introductionmentioning

confidence: 99%

Effect and mechanism of glycerol monostearate dimer (GMS‐D) and baking‐treatment on the structure, in vitro digestion of gelatinized potato starch‐GMS‐D

et al. 2022

Journal of Food Science

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With the increasing progress of society and in‐depth scientific research, dietary regulations, especially sustained glucose releases, are regarded as an effective and significant way to lighten or even cut the emergence of diabetes. In this research, the starch–lipid complex gelatinized potato starch‐glycerol monostearate dimer (GPS‐GMS‐D) was developed to provide a low‐glycemic index functional food component for type 2 diabetes. Briefly, the higher complexation index (CI, 71.02%), lower rapidly digestible starch (RDS, 35.57%), and lower estimated glycemic index (eGI, 52.34%) were referred to as GPS‐GMS‐D. It was assumed that the solid V‐type crystal structure, induced with the helix between GMS‐D and GPS due to high amylose, high saturation, and low steric hindrance, contributed to the lower digestibility. In addition, baking treatment for 5 min was systematically exerted to improve the flavor of GPS‐GMS‐D with a relatively high CI (59.98%) and low eGI (54.15%). It was believed that rapid dehydration and close interaction during baking treatment could slow down the decomposition of GPS‐GMS‐D and conversions of starch fractions. Therefore, these results suggested that the as‐developed GPS‐GMS‐D was a promising low GI functional dietary food component for diabetes mellitus, and a suitable baking post‐thermal treatment was successfully proposed to enhance the flavor of GPS‐GMS‐D. Practical Application The higher amylose and solid V‐type crystal structure in gelatinized potato starch‐glycerol monostearate dimer (GPS‐GMS‐D) would induce the formation of slowly digestive starch (SDS) and resistant starch (RS) to suppress enzymatic hydrolysis. Moreover, the flavor of GPS‐GMS‐D was enhanced with appropriate and moderate thermal processing (baking), which was likely to improve the quality of life of a person with diabetes. Thus, we believe that GPS‐GMS‐D is a promising functional food component for diabetes mellitus.

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Associations of carbohydrates and carbohydrate-rich foods with incidence of type 2 diabetes

Cited by 10 publications

References 34 publications

Current WHO recommendation to reduce free sugar intake from all sources to below 10% of daily energy intake for supporting overall health is not well supported by available evidence

Current WHO recommendation to reduce free sugar intake from all sources to below 10% of daily energy intake for supporting overall health is not well supported by available evidence

Quality and Quantity of Protein Intake Influence Incidence of Type 2 Diabetes Mellitus in Coronary Heart Disease Patients: From the CORDIOPREV Study

Effect and mechanism of glycerol monostearate dimer (GMS‐D) and baking‐treatment on the structure, in vitro digestion of gelatinized potato starch‐GMS‐D

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