Carbohydrate quality, the prevalence of metabolic syndrome and glycaemic response in overweight clinical trial volunteers

摘要

Background: The quality of dietary carbohydrates (CHO) plays a pivotal role in the development of type 2 diabetes mellitus (T2DM). The predictive indicators of CHO quality on risk for T2DM may be informative for practice. Aim: To investigate the association between indicators of CHO quality (glycaemic load- GL, fibre, wholegrain) and metabolic syndrome (MetS) and glycaemic response in overweight and obese study volunteers. Methods: A secondary analysis using baseline diet history data from a 12-month weight-loss trial (the HealthTrack study) conducted during 2014-2015 in Wol-longong, Australia (n = 328, 25-54y). The association with CHO quality was examined using logistic regression for MetS (defined by the harmonised criteria), and multiple regression for HbA1c and fasting blood glucose, all stratified by gender. Results: The median GL was 83.49 (IQR: 62.47, 112.61) g/% for famales (n = 239) and 110.06 (IQR: 82.17, 142.74) g/% for males (n = 88). The prevalence of MetS in the HealthTrack study was 28.9% (n = 69) for females and 38.6% (n = 34) for males. GL was associated with MetS for females, chi~2 (8) = 36.42, P < 0.0005 and males, chi~2 (8) = 25.17, P = 0.001. Among females, GL predicted the level of HbAlc, F (8,230) = 4.067, P < 0.0005 and fasting blood glucose, F (8, 230) = 3.322, P = 0.001. Intake of insoluble fibre in females predicted fasting blood glucose, F (2, 236) = 3.364, P = 0.036. Conclusions: In this clinical sample, dietary GL appeared to be the best CHO quality indicator to target when addressing risk of T2DM. This was especially the case for overweight females.