Carbohydrates and Health

Type 2 diabetes mellitus
7.6 Eight cohort studies were identified that presented evidence on total starch intake
and the incidence of type 2 diabetes mellitus, four of which were included in a
meta-analysis (Meyer et al., 2000; Hodge et al., 2004; Barclay et al., 2007; Schulze
et al., 2008). Four studies could not be included in a meta-analysis as they did not
report the necessary data (Feskens et al., 1995; Monterrosa et al., 1995; Leonetti et
al., 1996; Janket et al., 2003). One cohort study was subsequently identified in the
update search (Sluijs et al., 2010) (Cardio-metabolic review; Update search).
7.7 No association was found between total starch intake and type 2 diabetes mellitus
(RR 1.00, 95% CI 0.84, 1.19 for each 50g/day increase; p=0.96). The studies that are
not included in the meta-analysis do not observe an association between starch
intakes and risk of type 2 diabetes mellitus. The study identified in the update
search observed that a higher starch intake is associated with a greater incidence
of type 2 diabetes mellitus (Sluijs et al., 2010).
Starch (g/day) and type 2 diabetes mellitus
• No association
• Moderate evidence
Starch-rich foods
Refined grains
Cardiovascular disease events
7.8 Three cohort studies were identified that presented evidence on the intake of
refined grains and combined incidence of stroke and coronary events, all of which
were included in the meta-analysis (Liu et al., 2000b; Steffen et al., 2003; Jacobs,
Jr. et al., 2007). No further cohort studies were identified in the update search
(Cardio-metabolic review, cardiovascular disease chapter).
7.9 No association was found between refined grains intake and the combined
incidence of stroke and coronary events, referred to as cardiovascular events,
(RR 1.00, 95% CI 0.98, 1.01 for each half serving/day increase; p=0.5).
Refined grains (serving/day) and cardiovascular disease events
• No association
• Moderate evidence
Type 2 diabetes mellitus
7.10 Four cohort studies were identified that presented evidence on refined grains
intake and incidence of type 2 diabetes mellitus, all of which were included in a
meta-analysis (Meyer et al., 2000; Liu et al., 2000a; Fung et al., 2002; Montonen
et al., 2003). One cohort study was identified in the update search (Yu et al., 2011)
(Cardio-metabolic review, diabetes chapter; Update search).
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