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There is no good evidence of benefit when NSP or other
components of wholegrains, fruits, vegetables and
legumes are added to functional and manufactured foods.
Low glycaemic index foods may confer benefits in terms
of lowering total cholesterol and improving glycaemic
control in people with diabetes. However, it is not clear
whether these benefits are independent of the effects of
dietary fibre or the fact that low glycaemic index foods
tend to have intact plant cell walls. Furthermore, it is
uncertain whether functional and manufactured foods
with a low glycaemic index confer the same long-term
benefits as low glycaemic index predominantly plantbased
foods.
A low dietary glycaemic load may reduce the risk of type II
diabetes and cardiovascular disease. The same caveats as
those described above for the therapeutic role of low GI
foods apply.
Limitations to the use of the glycaemic index and
glycaemic load concepts in the clinical setting are further
described in the accompanying paper in this series.
Acknowledgements
I thank Professor Kjeld Hermansen, Dr Andrew Neil, Dr
Gabriele Riccardi, Dr Angela Rivellese, Dr Monika Toeller,
Professor A Stewart Truswell, Dr Rob M van Dam and Dr HH
Vorster for the valuable comments they provided on the
earlier paper.
Conflict of interest
During the preparation and peer-review of this paper in
2006, the author and peer-reviewers declared the following
interests.
Author
Professor Jim Mann: none declared.
Peer-reviewers
Professor Kjeld Hermansen: none declared.
Dr Andrew Neil: none declared.
Dr Gabriele Riccardi: none declared.
Dr Angela Rivellese: none declared.
Dr Monika Toeller: none declared.
Professor A Stewart Truswell: none declared.
Dr Rob M van Dam: none declared.
Dr HH Vorster: member and director of the Africa Unit for
Transdisciplinary health Research (AUTHeR), Research grant
from the South African Sugar association.
References
Ahrens E, Hirsch J, Oette K, Farquhar J, Stein Y (1961). Carbohydrateinduced
and fat-induced lipemia. Trans Assoc Am Physicians 74,
134–146.
Cardiovascular disease and diabetes
J Mann
Anderson JW (2002). Whole-grains intake and risk for coronary heart
disease. In: Marquart L, Slavin JL, Fulcher RD (eds). Whole-grain
Foods in Health and Disease. American Association of Cereal Chemists.
St Paul: Minnesota, USA. pp 187–200.
Anderson JW (2003). Whole grains protect against atherosclerotic
cardiovascular disease. Proc Nutr Soc 62, 135–142.
Anderson JW, Hanna TJ, Peng X et al. (2000). Whole grain foods and
heart disease risk. J Am Coll Nutr 19, 291S–299S.
Antonis A, Bersohn I (1961). The influence of diet on serum-triglycerides
in South African White and Bantu prisoners. Lancet 7, 39.
Appel LJ, Moore TJ, Obarzanek E et al. (1997). For the DASH
Collaborative Research Group. A clinical trial of the effects of
dietary patterns on blood pressure. N Engl J Med 336, 1117–1124.
Baghurst KI, Record SJ, Baghurst PA (1991). The relationship between
refined sugar and micronutrient intakes. Proc Nutr Soc Australia
16, 33.
Basu A, Devaraj S, Jialal I (2006). Dietary factors that promote or
retard inflammation. Arterioscler Thromb Vasc Biol 26, 995–1001.
Bazzano LA, He J, Ogden LG, Loria C, Vupputuri S, Myers L et al.
(2001). Legume consumption and risk of coronary heart disease in
US men and women: NHANES 1 Epidemiologic Follow-up Study.
Arch Intern Med 161, 2573–2578.
Brand-Miller J, Hayne S, Petocz P et al. (2003). Low-glycemic index
diets in the management of diabetes: a meta-analysis of randomized
controlled trials. Diabetes Care 26, 2261–2267.
Brunner EJ, Thorogood M, Rees K, Hewitt G (2005). Dietary advice
for reducing cardiovascular risk. Cochrane Database of Systematic
Reviews 4, Art. No: CD002128.DOl: 10.1002/.
Burr ML, Fehily AM, Gilbert JF, Rogers S, Holliday RM, Sweetnam PM
et al. (1989). Effects of changes in fat, fish and fibre intakes on
death and myocardial reinfarction: diet and reinfarction trial
(DART). Lancet ii, 757–761.
Chandalia M, Garg A, Lutjohann D, von Bergmann K, Grundy SM,
Brinkley LJ (2000). Beneficial effects of high dietary fiber intake
in patients with type 2 diabetes mellitus. N Engl J Med 342,
1392–1398.
Colditz GA, Manson JF, Stampfer MJ, Rosner B, Willett WC, Speizer
FF (1992). Diet and risk of clinical diabetes in women. Am J Clin
Nutr 55, 1018–1023.
Daly M (2003). Sugars, insulin sensitivity, and the postprandial state.
Am J Clin Nutr 78, 865S–872S.
de Lorgeril M, Renaud S, Mamelle N, Salen P, Martin J, Monjaud I
et al. (1994). Mediterranean alpha-linolenic acid-rich diet in
secondary prevention of coronary heart disease. Lancet 343,
1454–1459.
DiMeglio DP, Mattes RD (2000). Liquid versus solid carbohydrate:
effects on food intake and body weight. Int J Obes Relat Metab
Disord 24, 794–800.
Elliott SS, Keim NS, Stern JS, Teff K, Havel PJ (2002). Fructose,
weight gain, and the insulin resistance syndrome. Am J Clin Nutr
76, 911–922.
Esmaillzadeh A, Mirmiran P, Azizi F (2005). Whole-grain consumption
and the metabolic syndrome: a favorable association in
Tehranian adults. Eur J Clin Nutr 59, 353–362.
Flight I, Clifton P (2006). Cereal grains and legumes in the
prevention of coronary heart disease and stroke: a review of the
literature. Eur J Clin Nutr 60, 1145–1159.
Fried SK, Rao SP (2003). Sugars, hypertriglyceridemia, and cardiovascular
disease. Am J Clin Nutr 78 (Suppl 8), 73S–80S.
Fung TT, Hu FB, Pereira MA et al. (2002). Whole-grain intake and the
risk of type 2 diabetes: a prospective study in men. Am J Clin Nutr
76, 535–540.
Fung TT, Rimm EB, Spiegelman D, Rifai N, Tofler GH, Willett WC
et al. (2001a). Association between dietary patterns and plasma
biomarkers of obesity and cardiovascular disease risk. Am J Clin
Nutr 73, 61–67.
Fung TT, Willett WC, Stampfer MJ, Manon JE, Fu FB (2001b). Dietary
patterns and risk of coronary heart disease in women. Arch Intern
Med 161, 1857–1862.
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