Preliminary report: the effect of a 6-month dietary glycemic index manipulation in addition to healthy eating advice and weight loss on arterial compliance and 24-hour ambulatory blood pressure in men: a pilot study


      We aimed to determine whether altering dietary glycemic index (GI) in addition to healthy eating and weight loss advice affects arterial compliance and 24-hour blood pressure (BP), both coronary heart disease (CHD) risk factors. Middle-aged men with at least 1 CHD risk were randomized to a 6-month low-GI (LGI) or high-GI (HGI) diet. All were advised on healthy eating and weight loss. They were seen monthly to assess dietary compliance and anthropometrics. Carotid-femoral pulse wave velocity (PWV), fasting blood lipid profile, and glucose and insulin concentrations were measured at baseline and at months 3 and 6. Six-hour postprandial glucose and insulin responses and 24-hour ambulatory BP were also assessed at baseline and month 6. Thirty-eight subjects (HGI group, n = 16; LGI group, n = 22) completed the study. At month 6, groups differed in dietary GI, glycemic load, and carbohydrate intake (P < .001). Fasting insulin concentration and insulin resistance (calculated by homeostatic model assessment) were lower in the LGI than the HGI group (P < .01). The reduction in total cholesterol and 24-hour BP was bigger in the LGI than the HGI group (P < .05); and only the LGI group had significant reductions (P < .05) in PWV, low-density lipoprotein cholesterol, and triacylglycerol concentration. There were no differences in postprandial glucose or insulin responses between the groups. The results suggest that an LGI diet may be more beneficial in reducing CHD risk, including PWV and 24-hour BP, even in the setting of healthy eating and weight loss; and thus, further study is warranted.
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        • Willum-Hansen T.
        • Staessen J.A.
        • Torp-Pedersen C.
        • et al.
        Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population.
        Circulation. 2006; 113: 664-670
        • O'Rourke M.F.
        Arterial stiffness, systolic blood pressure and the logical treatment of arterial hypertension.
        Hypertens Dallas. 1990; 15: 339-347
        • Eckel R.H.
        • Wassef M.
        • Chait A.
        • et al.
        Prevention conference VI: diabetes and cardiovascular disease: writing group II: pathogenesis of atherosclerosis in diabetes.
        Circulation. 2002; 105: 138-143
        • Balcher J.
        • Guerin A.P.
        • Pannier B.
        Impact of aortic stiffness on survival in end-stage renal disease.
        Circulation. 1999; 99: 2434-2439
        • Cohn J.N.
        Arterial stiffness, vascular disease, and risk of cardiovascular events.
        Circulation. 2006; 113: 601-603
        • Jenkins D.J.
        • Wolever T.M.
        • Taylor R.H.
        • et al.
        Glycaemic index of foods: a physiological basis for carbohydrate exchange.
        Am J Clin Nutr. 1981; 34: 362-366
        • Barclay A.W.
        • Petocz P.
        • McMillan-Price J.
        • et al.
        Glycaemic index, glycaemic load, and chronic disease risk—a meta-analysis of observational studies.
        Am J Clin Nutr. 2008; 87: 627-637
        • Kim H.
        • Leeb S.J.
        • Kanga E.S.
        • et al.
        Effects of lifestyle modification on metabolic parameters and carotid intima-media thickness in patients with type 2 diabetes mellitus.
        Metab Clin Exp. 2006; 55: 1053-1059
        • Wood D.
        • Wray R.
        • Poulter N.
        • et al.
        JBS 2: Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice.
        Heart. 2005; 91: v1-v52
        • Frost G.
        • Lyons F.
        • Bovill-Taylor C.
        • et al.
        Intensive lifestyle intervention combined with the choice of pharmacotherapy improves weight loss and cardiac risk factors in the obese.
        J Hum Nutr Diet. 2002; 15: 287-295
        • Wolever T.M.
        • Jenkins D.J.
        Application of glycaemic index to mixed meals.
        Lancet. 1985; 2: 944
        • Foster-Powell K.
        • Holt S.H.
        • Brand-Miller J.C.
        International table of glycaemic index and glycaemic load values: 2002.
        Am J Clin Nutr. 2002; 76: 5-56
        • Henry C.J.
        • Lightowler H.J.
        • Strik C.M.
        • et al.
        Glycaemic index and glycaemic load values of commercially available products in the UK.
        Br J Nutr. 2005; 94: 922-930
        • University of Sydney
        University of Sydney Web site on glycaemic index.
        • Wolever T.M.
        • Jenkins D.J.
        The use of the glycaemic index in predicting the blood glucose response to mixed meals.
        Am J Clin Nutr. 1986; 43: 167-172
        • The Oxford Centre for Diabetes
        E. &. M. HOMA calculator.
        (Accessed: 1-6-2007)
        • Asmar R.
        • Benetos A.
        • Topouchian J.
        • et al.
        Assessment of arterial distensibility by automatic pulse wave velocity measurement. Validation and clinical application studies.
        Hypertension. 1995; 26: 485-490
        • Asmar R.
        Pulse wave velocity. Principles and measurement.
        in: Asmar R. Arterial stiffness and pulse wave velocity clinical applications. Elsevier SAS, Paris1999: 25-55
        • Gosse P.
        • Laforge A.
        • Ansoborto P.
        • et al.
        Clinical evaluation of the DIASYS Integra blood pressure recorder.
        J Hypertens. 1997; 15: 18S
        • O'Brien E.
        • Waeber B.
        • Parati G.
        • et al.
        Blood pressure measuring devices: recommendations of the European Society of Hypertension.
        BMJ. 2001; 322: 531-536
        • Brand-Miller J.C.
        • Holt S.H.
        • Pawlak D.B.
        • McMillan J.
        Glycemic index and obesity.
        Am J Clin Nutr. 2002; 76: 281S-285S
        • Kelly S.
        • Frost G.
        • Whittaker V.
        • Summerbell C.
        Low glycaemic index diets for coronary heart disease.
        Cochrane Database Syst Rev. 2004; 4: CD004467
        • Harbis A.
        • Defoort C.
        • Narbonne H.
        • et al.
        Acute hyperinsulinism modulates plasma apolipoprotein B-48 triglyceride-rich lipoproteins in healthy subjects during the postprandial period.
        Diabetes. 2001; 50: 462-469
        • Frost G.
        • Leeds A.
        • Trew G.
        • et al.
        Insulin sensitivity in women at risk of coronary heart disease and the effect of a low glycaemic diet.
        Metabolism. 1998; 47: 1245-1251
        • Laaksonen D.E.
        • Toppinen L.K.
        • Jantunen K.S.
        • et al.
        Dietary carbohydrate modification enhances insulin secretion in persons with the metabolic syndrome.
        Am J Clin Nutr. 2005; 82: 1218-1227
        • Wolever T.M.
        • Mehling C.
        High-carbohydrate–low-glycaemic index dietary advice improves glucose disposition index in subjects with impaired glucose tolerance.
        Br J Nutr. 2002; 87: 477-487
        • Wildman R.P.
        • Farhat G.N.
        • Patel A.S.
        • et al.
        Weight change is associated with change in arterial stiffness among healthy young adults.
        Hypertension. 2005; 45: 187-192
        • Tanaka H.
        • Safar M.E.
        Influence of lifestyle modification on arterial stiffness and wave reflections.
        Am J Hypertens. 2005; 18: 137-144