Association between glycemic index, glycemic load, and fructose with insulin resistance: the CDC of the Canary Islands study

• Published in: European journal of nutrition Vol. 49; no. 8; pp. 505 - 512
• Main Authors: DOMINGUEZ COELLO, Santiago, DE LEON, Antonio Cabrera, RODRIGUEZ PEREZ, María C, BORGES ALAMO, Carlos, CARRILLO FERNANDEZ, Lourdes, GONZALEZ, Delia Almeida, GARCIA YANES, Jezabel, GONZALEZ HERNANDEZ, Ana, BRITO DIAZ, Buenaventura, AGUIRRE-JAIME, Armando
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Berlin/Heidelberg : Springer-Verlag 01.12.2010; Springer-Verlag; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Blood Glucose - metabolism; Body Mass Index; Chemistry; Chemistry and Materials Science; Cross-Sectional Studies; Diabetes Mellitus - etiology; Diet - statistics & numerical data; Dietary Carbohydrates - administration & dosage; Dietary Carbohydrates - classification; Dietary Carbohydrates - metabolism; dietary fiber; Dietary Fiber - administration & dosage; Dietary Fiber - metabolism; Dietary Proteins - administration & dosage; Dietary Proteins - metabolism; Energy Intake; Feeding. Feeding behavior; Female; fructose; Fructose - administration & dosage; Fructose - metabolism; Fundamental and applied biological sciences. Psychology; Glycemic Index; Glycemic load; Humans; Insulin - blood; Insulin Resistance; Male; Middle Aged; Multivariate Analysis; Nutrition; Original Contribution; Spain; Surveys and Questionnaires; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Waist Circumference; Young Adult; Atlantic Ocean Islands; Canary Islands; Energy intake; Insulin resistance; Glycemic index; Dietary fiber; Glycemic load; Fructose; Endocrinopathy; Target tissue resistance; Association; Energy; Nutrition; Metabolic diseases
• ISSN: 1436-6207; 1436-6215
• DOI: 10.1007/s00394-010-0110-2

Background The involvement of carbohydrates in triggering insulin resistance (IR) remains a source of controversy. Aim of the study To study the relation between glycemic index (GI), glycemic load (GL), and fructose with insulin resistance in a predominantly rural population in the Canary Islands. Methods Cross-sectional study carried out in 668 nondiabetic people aged 18-75. IR was estimated with serum glucose and C-peptide (HOMA2-IR). Nutrient intakes were obtained from a validated food frequency questionnaire. ANOVA was used to analyze nutrient distribution across quartiles of HOMA2-IR. Four multivariate nutrient density models (dependent variable: log-transformed HOMA2-IR) which differed only in the kinds of carbohydrates included were tested (Model 1: carbohydrates; Model 2: GI and then GL; Model 3: free fructose, other simple sugars and starch; Model 4: total fructose, remaining sugars and starch). Results There was no association between GI and IR. There was a direct association between GL (P < 0.001), fructose (free [P = 0.001], total [P = 0.013]), energy intake (P < 0.001), fruit fiber (<0.001), and glucose (P = 0.003) with IR. There was an inverse association between cereal (P = 0.008) and vegetable fiber (P < 0.001) and IR. Multivariate models corroborated the association of carbohydrates, GL, fructose, vegetable fiber, and energy intake with IR. The association between GL and IR disappeared when Model 2 was adjusted by total fructose intake. Conclusions There was a direct association between fructose intake and IR. There was no relationship between GI and IR. Although a direct association of GL with IR was detected, it was attributable to the consumption of fructose.