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Medical Forum / General / Nutrition / November 2004

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dietary influences on triglycerides, including Asians

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Susan - 03 Nov 2004 15:01 GMT
It's impossible to find any high carb studies that don't find a carb and/or
GI/GL influence on triglycerides, which go up inevitably based upon carb
consumption.

: Eur J Clin Nutr. 2004 Nov;58(11):1472-8. Related Articles, Links  

 
Correlation between dietary glycemic index and cardiovascular disease risk
factors among Japanese women.

Amano Y, Kawakubo K, Lee JS, Tang AC, Sugiyama M, Mori K.

1Department of Health Promotion Sciences, Division of Health Sciences and
Nursing, Graduate School of Medicine, The University of Tokyo, Japan.

OBJECTIVE:: To examine the correlation between dietary glycemic index (GI) and
cardiovascular disease (CVD) risk factors among subjects who consume white rice
as a staple food. DESIGN:: A cross-sectional study was conducted to explore the
associations between dietary GI, dietary glycemic load (GL) and dietary
intakes, and CVD risk factors. Dietary GI and GL were calculated from a 3-day
(including two consecutive weekdays and one holiday) dietary records. SETTING::
A weight-reduction program at a municipal health center in Tokyo, Japan.
SUBJECTS:: A total of 32 women aged 52.5+/-7.2 y participated in the
weight-reduction program. RESULT:: The GI food list made for the current study
calculated for 91% of carbohydrate intakes measured. The mean dietary GI was
64+/-6, and the mean dietary GL was 150+/-37. Individuals in the highest
tertile of GI consumed more carbohydrate, mostly from white rice (P<0.001), and
less fat (P<0.01). Individuals in all three groups by tertile of GL showed
similar tendencies. In the lowest GI tertile, the highest concentration of
HDL-cholesterol and lowest concentration of triacylglycerol and immunoreactive
insulin were observed (P<0.01). In the lowest GL tertile, the highest
concentration of HDL-cholesterol and the lowest concentration of
triacylglycerol were observed (P<0.05). CONCLUSION:: Calculated dietary GI and
GL were positively associated with CVD risk factors among the Japanese women
who consumed white rice as a staple food.European Journal of Clinical Nutrition
(2004) 58, 1472-1478. doi:10.1038/sj.ejcn.1601992 Published online 5 May 2004.

PMID: 15127092 [PubMed - in process]

Asia Pac J Clin Nutr. 2004;13(Suppl):S3. Related Articles, Links  

Glycemic index in relation to coronary disease.

Brand-Miller JC.

Human Nutrition Unit, University of Sydney, NSW, 2006, Australia.

In cardiovascular disease, dietary fat and blood lipids have attracted the
lion's share of attention. But carbohydrate, the macronutrient that increases
when fats are restricted, may not be the totally desirable nutrient that we
believe. The findings of the Lyon Heart Study, one of the most important
nutrition studies ever carried out, emphasise that the 'prudent' high
carbohydrate western diet is not the best choice for reducing cardiovascular
events. One explanation is the potential to increase postprandial
hyperglycemia, an under-recognised risk factor for cardiovascular and total
mortality in the non-diabetic population. In the DECODE study and a host of
other large prospective cohort studies, high post-challenge blood glucose was
associated with 1.8 to 3 times greater relative risk of death. The glycemic
potential of carbohydrates is therefore relevant to both prevention and
management of coronary disease. Diets based on high glycemic index (GI)
carbohydrate foods have been shown to 1) increase day-long blood glucose and
insulin levels 2) exacerbate insulin resistance in predisposed individuals 3)
adversely affect markers of the metabolic syndrome (triglycerides and
HDL-cholesterol) in intervention studies and 4) increase the risk of coronary
disease in a healthy population. How does high blood glucose increase the risk
of CVD? Laboratory studies have shown that high glucose levels even within the
normal range adversely affect endothelial function via a multitude of
mechanisms including oxidative stress, inflammatory factors, protein glycation,
LDL oxidation, pro-coagulatory and anti-fibrinolytic activity. In intervention
studies of men with hyperlipidemia, Jenkins et al showed that a low GI diet was
associated with lower TG and LDL cholesterol levels compared with an otherwise
equivalent diet based on high GI carbohydrates. In women with a family history
of CVD following a low GI diet for 4 weeks, Frost et al found increased insulin
sensitivity after a glucose challenge and increased glucose uptake in isolated
adipocytes. Even in lean young adults, a low GI diet reduced muscle
triglycerides, a marker of insulin resistance, despite no effect on
insulin-stimulated glucose uptake. Epidemiological studies provide further
support. In the Nurses Health Study, those in the highest quintile of GI and
glycemic load (GI x carbohydrate) had nearly double the relative risk of
coronary infarct, compared to those in the lowest quintile, after adjustment
for known risk factors, including fibre. In several observational studies of
healthy men and women, high GI diets have been consistently associated with
lower HDL levels. In post-menopausal women, high GI diets were associated with
higher C-reactive protein levels (a marker of low grade chronic inflammation),
high triglycerides and lower HDL levels, all of which increase the risk of CVD.
Low GI diets may also reduce visceral fat deposition. In recent studies, we
compared 4 weight loss diets of differing glycemic load (GL). Compared to the
conventional low fat diet with a high GL, the reduced GL diets produced greater
rates of weight loss but only the low GI diet was associated with significant
reductions in LDL-cholesterol (unpublished data). Finally, the STOP-NIDDM study
using Acarbose (a drug which slows brush border digestion of carbohydrates)
provides direct evidence that reducing the rate of carbohydrate absorption per
se halves the risk of cardiovascular events and hypertension. The use of
naturally-occurring 'slow-release' or low glycemic index (GI) carbohydrates to
achieve the same end remains controversial.

PMID: 15294465 [PubMed - in process]

Susan
markd@toad-net.com - 03 Nov 2004 22:34 GMT
While your observation is correct as far as it goes the most important
point is weight and excess energy intake, those in the study were going to
a weight clinic.  The standard e. asia diet is 70 percent carbs and
highish carbs at that.  The key is that if one doesn't consume more energy
in any form then is required for daily life there is no problem.  The trig
level goes up indeed and is very soon used as an energy source when an
energy balance is maintained, that is the way it is supposed to work.  The
e. asia food tradition area did not have excess energy intake related
problems until recently when lifestyles changed.  Using standard measures
of health and lifespan, the e. asian food area has been among the highest
observed.

>It's impossible to find any high carb studies that don't find a carb and/or
>GI/GL influence on triglycerides, which go up inevitably based upon carb
[quoted text clipped - 94 lines]
>
>Susan
markd@toad-net.com - 04 Nov 2004 17:03 GMT
I have read the below before, the key to the e. asia diet and it's good
health/lifespan outcomes is in the part you snipped,ie. a high carb/gi/gl
diet when combined with a lifestyle which doesn't promote excess energy
does fine.  The glucose and trig. blood levels are a normal energy pool
that is consumed during daily activity, it is not stored as fat.  The
below study mentions the greater risk of a high gi/gl diet for cvd risk,
true, but also not a factor with regard to energy balance.  One measure of
the e. asia diet as to health is cvd rate, which is quite low and has only
worsened recently when lifestyles has had an impact on energy balance.  
Their good cvd outcomes come with consuming 70 percent of diet in highish
gi/gl carbs, rice and noodles.

> ...snip......
>
[quoted text clipped - 103 lines]
>>>
>>>Susan
 
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