Glycemic response and health—a systematic review and meta-analysis: the database, study characteristics, and macronutrient intakes

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Abstract
Background: Reduction of dietary glycemic response has been proposed as a means of reducing the risk of diabetes and coronary heart disease. Its role in health maintenance and management, alongside unavailable carbohydrate (eg, fiber), is incompletely understood. Objective: We aimed to assess the evidence relating the glycemic impact of foods to a role in health maintenance and management of disease. Design: We searched the literature for relevant controlled dietary intervention trials on glycemic index (GI) according to inclusion and exclusion criteria, extracted the data to a database, and synthesized the evidence via meta-analyses and meta-regression models. Results: Among literature to January 2005, 45 relevant publications were identified involving 972 subjects with good health or metabolic disease. With small reductions in GI (Conclusions: Among GI studies, observed reductions in glycemic load are most often not solely due to substitution of high for low glycemic carbohydrate foods. Available carbohydrate intake is a confounding factor. The role of unavailable carbohydrate remains to be accounted for.