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Macronutrient intake, glycaemic index and glycaemic load of older Australian subjects with and without diabetes: baseline data from the Blue Mountains Eye Study

Published online by Cambridge University Press:  08 March 2007

Alan W. Barclay*
Affiliation:
School of Molecular and Microbial Biosciences, University of Sydney, NSW, 2006, Australia
Jennie C. Brand-Miller
Affiliation:
School of Molecular and Microbial Biosciences, University of Sydney, NSW, 2006, Australia
Paul Mitchell*
Affiliation:
University of SydneyDepartment of Ophthalmology, Eye Clinic Westmead Hospital, Westmead, NSW, 2145Australia Centre for Vision Research, Department of Ophthalmology, University of Sydney, NSW, 2006, Australia
*
*Corresponding author: Professor Paul Mitchell, fax +61 2 9845 8345, email paul_mitchell@wmi.usyd.edu.au
*Corresponding author: Professor Paul Mitchell, fax +61 2 9845 8345, email paul_mitchell@wmi.usyd.edu.au
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Abstract

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Individuals with diabetes receive more nutrition advice than other population segments yet little is known about how well they comply or differ in nutrient intake from the rest of the population. The present study determined the mean macronutrient intake, glycaemic index (GI), and glycaemic load (GL) of a cohort of 3654 older Australians, with and without diabetes. Fasting pathology tests, including plasma glucose, were obtained for 88% of the 3654 residents, and a 145-item semi-quantitative food-frequency questionnaire was completed by 2900 residents (89%) between 1992 and 1994. In total, 6% of participants had diagnosed diabetes. Valid food-frequency data were available for 2736 without and 164 individuals with diabetes. The GI and GL were calculated from a customised database of Australian foods. Individuals with diabetes consumed significantly more protein (V=0·001) and less sugars (P≤0·001) than the general population. Only seven individuals with diabetes (4·3%) met all macronutrient recommendations and only four (2·4%) met fibre recommendations as well. Those with diabetes had a lower mean GI (55 (sd 5) V57 (sd 4); P=0·007, respectively) and GL (122 (sd 26) V 134 (sd 24); P<0·001, respectively) than the general population. In conclusion, older individuals with diabetes living in Australia in the 1990s chose a diet that had significantly more protein and less sugars than those without diabetes. This difference had little impact on the average GI, but it led to a moderate reduction in the average GL. Only a small percentage, however, was able to meet nutritional recommendations for optimal diabetes management.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2006

References

Amano, Y, Kawakubo, K, Lee, JS, Tang, AC, Sugiyama, M & Mori, KCorrelation between dietary glycemic index and cardiovascular disease risk factors among Japanese women. Eur J Clin Nutr (2004) 58, 14721478.Google Scholar
American Diabetes Association Diagnosis and classification of diabetes mellitus. Diabetes Care 27, Suppl (2004) 1, S5S10.Google Scholar
Anonymous Diet and day-to day variability in a sample of Spanish adults with IDDM or NIDDM (GSEDNu). Horm Metab Res (1997) 29, 450453.Google Scholar
Anonymous Recommendations for the nutritional management of patients with diabetes mellitus. Eur J Clin Nutr (2000) 54, 353355.Google Scholar
Attebo, K, Mitchell, P & Smith, WVisual acuity and the causes of visual loss in Australia. The Blue Mountains Eye Study. Ophthalmology (1996) 103, 357364.CrossRefGoogle ScholarPubMed
Banini, AE, Allen, JC, Allen, HG, Boyd, LC & Lartey, AFatty acids, diet, and body indices of type II diabetic American whites and blacks and Ghanaians. Nutrition (2003) 19, 722726.Google Scholar
Bolton-Smith, C & Woodward, MDietary composition and fat to sugar ratios in relation to obesity. Int J Obes Relat Metab Disord (1994) 18, 820828.Google Scholar
Brand-Miller, JCPostprandial glycemia, glycemic index, and the prevention of type 2 diabetes. Am J Clin Nutr (2004) 80, 243244.Google Scholar
Brand-Miller, JC, Holt, SH, Petocz, PReply to R Mendosa. Am J Clin Nutr (2003) 77, 994995.Google Scholar
Cameron, AJ, Welborn, TA, Zimmet, PZ, Dunstan, DW, Owen, N, Salmon, J, Dalton, M, Jolley, D, Shaw, JEOverweight and obesity in Australia: the 1999–2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Med J Aust (2003) 178, 427432.Google Scholar
Canadian Diabetes Association Clinical Guidelines Expert Committee Canadian Diabetes Association 2003 clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes (2003) 27, S1S152.Google Scholar
Ceriello, A, Hanefeld, M, Leiter, L, Monnier, L, Moses, A, Owens, D, Tajima, N & Tuomilehto, JPostprandial glucose regulation and diabetic complications. Arch Intern Med (2004) 164, 20902095.Google Scholar
Chan, JM, Rimm, EB, Colditz, GA, Stampfer, MJ & Willett, WCObesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care (1994) 17, 961969.CrossRefGoogle ScholarPubMed
Close, EJ, Wiles, PG, Lockton, JA, Walmsley, D, Oldham, J & Wales, JKDiabetic diets and nutritional recommendations: what happens in real life?". Diabet Med (1992) 9, 181188.Google Scholar
Connor, H, Annan, F, Bunn, E, Frost, G, McGough, N, Sarwar, T & Thomas, BThe implementation of nutritional advice for people with diabetes. Diabet Med (2003) 20, 786807.Google Scholar
Department of Community Services and Health NUTTAB 90 Nutrient Data Table for Use in Australia.Australian Government Publishing Service. 1990.Google Scholar
Diabetes Australia The Diabetes Epidemic: What Australia Should do About it. Canberra, Australia:. Diabetes Australia. 2004.Google Scholar
Diaz, EO, Galgani, JE, Aguirre, CA, Atwater, IJ & Burrows, REffect of glycemic index on whole-body substrate oxidation in obese women. Int J Obes (2005) 29, 108114.Google Scholar
Eeley, EA, Stratton, IM, Hadden, DR, Turner, RC & Holman, RRUKPDS 18, estimated dietary intake in type 2 diabetic patients randomly allocated to diet, sulphonylurea or insulin therapy. UK Prospective Diabetes Study Group. Diabet Med (1996) 13, 656662.Google Scholar
Foster-Powell, K, Holt, SH & Brand-Miller, JCInternational table of glycemic index and glycemic load values: 2002. Am J Clin Nutr (2002) 76, 556.Google Scholar
Franz, MJProtein and diabetes: much advice, little research. Curr Diab Rep (2002) 2, 457464.Google Scholar
Gibney, M, Sigman-Grant, M, Stanton, JL Jr & Keast, DRConsumption of sugars. Am J Clin Nutr (1995) 62, 178S193S.CrossRefGoogle ScholarPubMed
Gilbertson, HR, Brand-Miller, JC, Thorburn, AW, Evans, S, Chondros, P & Werther, GAThe effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes. Diabetes Care (2001) 24, 11371143.CrossRefGoogle ScholarPubMed
Gilbertson, HR, Thorburn, AW, Brand-Miller, JC, Chondros, P & Werther, GAEffect of low-glycemic-index dietary advice on dietary quality and food choice in children with type 1 diabetes. Am J Clin Nutr (2003) 77, 8390.Google Scholar
Holmes, MD, Liu, S, Hankinson, SE, Colditz, GA, Hunter, DJ & Willett, WCDietary carbohydrates, fiber, and breast cancer risk. Am J Epidemiol (2004) 159, 732739.CrossRefGoogle ScholarPubMed
Jenkins, DJ, Wolever, TM, Taylor, RH, Barker, H, Fielden, H, Baldwin, JM, Bowling, AC, Newman, HC, Jenkins, AL & Goff, DVGlycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr (1981) 34, 362366.CrossRefGoogle Scholar
Kopp, WHigh-insulinogenic nutrition – an etiologic factor for obesity and the metabolic syndrome?". Metabolism (2003) 52, 840844.CrossRefGoogle ScholarPubMed
Le Stunff, C & Bougneres, PEarly changes in postprandial insulin secretion, not in insulin sensitivity, characterize juvenile obesity. Diabetes (1994) 43, 696702.CrossRefGoogle Scholar
Ludwig, DSThe glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA (2002) 287, 24142423.Google Scholar
Meyer, KA, Kushi, LH, Jacobs, DR Jr, Slavin, J, Sellers, TA & Folsom, ARCarbohydrates, dietary fiber, and incident type 2 diabetes in older women. Am J Clin Nutr (2000) 71, 921930.Google Scholar
Mitchell, P, Smith, W, Wang, JJ, Cumming, RG, Leeder, SR & Burnett, LDiabetes in an older Australian population. Diabetes Res Clin Pract (1998) 41, 177184.Google Scholar
Rizkalla, SW, Taghrid, L, Laromiguiere, M, Huet, D, Boillot, J, Rigoir, A, Elgrably, F & Slama, GImproved plasma glucose control, whole-body glucose utilization, and lipid profile on a low-glycemic index diet in type 2 diabetic men: a randomized controlled trial. Diabetes Care (2004) 27, 18661872.CrossRefGoogle ScholarPubMed
Salmeron, J, Ascherio, A, Rimm, EB, Colditz, GA, Spiegelman, D, Jenkins, DJ, Stampfer, MJ, Wing, AL & Willett, WCDietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care (1997a) 20, 545550.CrossRefGoogle ScholarPubMed
Salmeron, J, Manson, JE, Stampfer, MJ, Colditz, GA, Wing, AL & Willett, WCDietary fiber, glycemic load, and risk of non-insulindependent diabetes mellitus in women. JAMA (1997b) 277, 472477.Google Scholar
Scheen, AJPathophysiology of type 2 diabetes. Acta Clin Belg (2003) 58, 335341.Google Scholar
Schulze, MB, Liu, S, Rimm, EB, Manson, JE, Willett, WC & Hu, FBGlycemicindex, glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women. Am J Clin Nutr (2004) 80, 348356.Google Scholar
Sheard, NF, Clark, NG, Brand-Miller, JC, Franz, MJ, Pi-Sunyer, FX, Mayer-Davis, E, Kulkarni, K & Geil, PDietary carbohydrate(amount and type) in the prevention and management of diabetes: a statement by the American Diabetes Association. Diabetes Care (2004) 27, 22662271.Google Scholar
Smith, W, Mitchell, P, Reay, EM, Webb, K & Harvey, PWValidity and reproducibility of a self-administered food frequency questionnaire in older people. Aust N Z J Public Health (1998) 22, 456463.Google Scholar
Stevens, J, Ahn, K, Juhaeri, , Houston, D, Steffan, L & Couper, DDietary fiber intake and glycemic index and incidence of diabetes in African-American and white adults: the ARIC study. Diabetes Care (2002) 25, 17151721.CrossRefGoogle ScholarPubMed
Thanopoulou, A, Karamanos, B, Angelico, F et al. ,. Nutritional habits of subjects with type 2 diabetes mellitus in the Mediterranean Basin: comparison with the non-diabetic population and the dietary recommendations. Multi-Centre Study of the Mediterranean Group for the Study of Diabetes (MGSD). Diabetologia (2004) 47, 367376.CrossRefGoogle Scholar
van Dam, RMThe epidemiology of lifestyle and risk for type 2 diabetes. Eur J Epidemiol (2003) 18, 11151125.Google Scholar
Wahlqvist, ML, Wilmshurst, EG & Richardson, ENThe effect of chain length on glucose absorption and the related metabolic response. Am J Clin Nutr (1978) 31, 19982001.Google Scholar
Willett, WNutritional Epidemiology Monographs in Epidemiology and Biostatistics, 2nd ed. (Kelsey, JL, Marmot, MG, Stolley, PD & Vessey, MP) New York:. Oxford University Press. vol 30, 1998.Google Scholar
Willett, W & Stampfer, MJTotal energy intake: implications for epidemiologic analyses. Am J Epidemiol (1986) 124, 1727.Google Scholar
Wolever, TM, Nguyen, PM, Chiasson, JL, Hunt, JA, Josse, RG, Palmason, C, Rodger, NW, Ross, SA, Ryan, EA & Tan, MHDeterminants of diet glycemic index calculated retrospectively from diet records of 342 individuals with non-insulin-dependent diabetes mellitus. Am J Clin Nutr (1994) 59, 12651269.Google Scholar