Review| Volume 23, ISSUE 1, P1-10, January 2013

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Low glycaemic index diets and blood lipids: A systematic review and meta-analysis of randomised controlled trials

  • L.M. Goff
    Corresponding author. King's College London, Division of Diabetes & Nutritional Sciences, Franklin-Wilkins Building, Room 4.10, Stamford Street, London SE1 9NH, UK. Tel.: +44(0)20 7848 4380; fax: +44(0)20 7848 4171.
    King's College London, School of Medicine, Division of Diabetes and Nutritional Sciences, Franklin-Wilkins Building, London SE1 9NH, UK
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  • D.E. Cowland
    King's College London, School of Medicine, Division of Diabetes and Nutritional Sciences, Franklin-Wilkins Building, London SE1 9NH, UK
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  • L. Hooper
    University of East Anglia, Norwich Medical School, Norwich NR4 7TJ, UK
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  • G.S. Frost
    Imperial College London, School of Medicine, Division of Endocrinology and Metabolism, Nutrition and Dietetic Research Group Investigative Medicine, Hammersmith Campus, London W12 0NN, UK
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      Low glycaemic index (GI) diets are beneficial in the management of hyperglycemia. Cardiovascular diseases are the major cause of mortality in diabetes therefore it is important to understand the effects of GI on blood lipids. The aim was to systematically review randomised controlled trials (RCTs) of low GI diets on blood lipids.

      Data synthesis

      We searched OVID Medline, Embase and Cochrane library to March 2012. Random effects meta-analyses were performed on twenty-eight RCTs comparing low- with high GI diets over at least 4 weeks (1272 participants; studies ranged from 6 to 155 participants); one was powered on blood lipids, 3 had adequate allocation concealment. Low GI diets significantly reduced total (−0.13 mmol/l, 95%CI −0.22 to −0.04, P = 0.004, 27 trials, 1441 participants, I2 = 0%) and LDL-cholesterol (−0.16 mmol/l, 95%CI −0.24 to −0.08, P < 0.0001, 23 trials, 1281 participants, I2 = 0%) compared with high GI diets and independently of weight loss. Subgroup analyses suggest that reductions in LDL-C are greatest in studies of shortest duration and greatest magnitude of GI reduction. Furthermore, lipid improvements appear greatest and most reliable when the low GI intervention is accompanied by an increase in dietary fibre. Sensitivity analyses, removing studies without adequate allocation concealment, lost statistical significance but retained suggested mean falls of ∼0.10 mmol/l in both. There were no effects on HDL-cholesterol (MD −0.03 mmol/l, 95%CI −0.06 to 0.00, I2 = 0%), or triglycerides (MD 0.01 mmol/l, 95%CI −0.06 to 0.08, I2 = 0%).


      This meta-analysis provides consistent evidence that low GI diets reduce total and LDL-cholesterol and have no effect on HDL-cholesterol or triglycerides.



      CVD (cardiovascular disease), GI (glycaemic index), MetS (metabolic syndrome), RCT (randomised controlled trial), T2DM (type 2 diabetes mellitus)
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