Association between dietary glycemic index and excess weight in pregnant women in the first trimester of pregnancy / Associação entre o índice glicêmico dietético e o excesso de peso em gestantes no primeiro trimestre de gestação

Abstract Objective To assess the association between dietary glycemic index (GI) and excess weight in pregnant women in the first trimester of pregnancy. Methods A cross-sectional study in a sample of 217 pregnant women was conducted at the maternal-fetal outpatient clinic of the Hospital Geral de Fortaleza, Fortaleza, state of Ceará, Brazil, for routine ultrasound examinations in the period between 11 and 13 weeks + 6 days of gestation.Weight and height were measured and the gestational body mass index (BMI) was calculated. The women were questioned about their usual body weight prior to the gestation, considering the prepregnancy weight. The dietary GI and the glycemic load (GL) of their diets were calculated and split into tertiles. Analysis of variance (ANOVA) or Kruskal-Walls and chi-squared (χ2) statistical tests were employed. A crude logistic regression model and a model adjusted for confounding variables known to influence biological outcomes were constructed. A p-value < 0.05 was considered significant for all tests employed. Results The sample group presented a high percentage of prepregnancy and gestational overweight (39.7% and 40.1%, respectively). InthetertilewiththehigherGIvalue, therewasa lower dietary intake of total fibers (p = 0.005) and of soluble fibers (p = 0.008). In the third tertile, the dietary GI was associated with overweight in pregnant women in the first trimester of gestation, both in the crude model and in the model adjusted for age, total energy intake, and saturated fatty acids. However, this association was not observed in relation to the GL. Conclusion A high dietary GI was associated with excess weight in women in the first trimester of pregnancy.

Resumo Objetivo Avaliar a associação entre índice glicêmico (IG) dietético e presença de excesso de peso em gestantes no primeiro trimestre de gestação. Métodos Estudo transversal realizado com 217 gestantes atendidas no Ambulatório de Medicina Materno-Fetal do Hospital Geral de Fortaleza, Fortaleza, CE, para realização de exames ultrassonográficos de rotina no período entre 11 e 13 semanas e 6 dias de gestação. Peso e altura foram obtidos para o cálculo do índice de massa corporal (IMC) gestacional. As mulheres foram questionadas quanto ao peso corporal habitual anterior à gestação, considerado o peso pré-gestacional. O IG e a carga glicêmica (CG) das suas dietas foram calculados e divididos em tercis. As associações foram investigadas por análise de variância (ANOVA, na sigla em inglês) ou pelos testes Kruskal-Walls e qui-quadrado (χ2). Resultados O grupo tinha alto percentual de excesso de peso pré-gestacional (39,7%) e gestacional (40,1%). Houve menor consumo de fibras totais (p = 0,005) e fibras insolúveis (p = 0,008) no tercil de maior valor de IG. No terceiro tercil, o IG da dieta foi associado ao excesso de peso dasmulheres no primeiro trimestre de gestação, tanto no modelo bruto como no modelo ajustado para idade, consumo total de energia e de ácidos graxos saturados. No entanto, não se observou esta associação emrelação à CG. Conclusão O alto IG da dieta consumida foi associado ao excesso de peso das mulheres no primeiro trimestre da gestação.

Determinação do índice glicêmico e da carga glicêmica de dietas hospitalares servidas para diabéticos / Determination of glycemic index and glycemic load of hospital diets served for diabetics

OBJETIVOS: Determinar o índice glicêmico e a carga glicêmica de dietas habitualmente oferecidas nos hospitais para pacientes com diabetes mellitus. MÉTODOS: Um estudo transversal avaliou cardápios servidos para pacientes diabéticos internados em hospitais da cidade de Curitiba, Paraná, Brasil. Analisando os cardápios, determinou-se teor energético, de macronutrientes, índice glicêmico e carga glicêmica das refeições ofertadas aos pacientes. RESULTADOS: Participaram do estudo cinco hospitais gerais da cidade e foram avaliados 10 cardápios de dieta para diabetes. A estrutura dos cardápios diferenciou-se principalmente na oferta quantitativa de frutas e leite. As dietas variaram entre 1317,6 a 2013,2 kcal, com 18,9 a 27,6% de proteínas, 21,9 a 29,4% de lipídios, 48,2 a 53,3% de carboidratos e 24,7 a 33,6 g de fibras. O índice glicêmico diário variou de 47 a 57% e a carga glicêmica diária entre 81 e 109%. CONCLUSÕES: Todas as dietas ofertadas foram hiperproteicas, normolipídicas e normoglicídicas. ntretanto, observaram-se níveis inadequados de carga glicêmica em todos os cardápios avaliados, embora com níveis adequados de índice glicêmico. Faz-se necessária a revisão dos planos alimentares elaborados para diabéticos, visando o melhor tratamento dietoterápico a essa população.

AIMS: To determine the glycemic index and the glycemic load of diets usually offered by hospitals to patients with diabetes mellitus. METHODS: A cross-sectional study evaluated menus served to diabetic inpatients of hospitals in the city of Curitiba, Parana, Brazil. Analyzing the menus, we determined the energy content, macronutrients, glycemic index and glycemic load of the meals offered to the patients. RESULTS: Five general hospitals of the city participated in the study and 10 menus for diabetes were evaluated. The structure of the menus was different mainly in the quantitative supply of fruits and milk. Diets ranged from 1317.6 to 2013.2 kcal, with 18.9 to 27.6% of proteins, 21.9 to 29.4% of lipids, 48.2 to 53.3% of carbohydrates and 24.7 to 33.6 g of fibers. Daily glycemic index ranged from 47 to 57% and daily glycemic load from 81 to 109%. CONCLUSIONS: All offered diets were hyperproteic, normolipid and normoglicidic. However, inadequate levels of glycemic load were observed in all the evaluated menus, although with adequate levels of glycemic index. It is necessary to review the diet plans elaborated for diabetics, aiming at the best dietary treatment for this population

Asociación entre la carga glicémica de la ingesta alimentaria y el síndrome metabólico en niños y adolescentes obesos / Association between dietary glycemic load and metabolic syndrome in obese children and adolescents

Objetivo. Evaluar la asociación entre síndrome metabólico (SM) y carga glicémica (CG) de la ingesta alimentaria en niños y adolescentes obesos atendidos en consulta endocrinológica de un hospital de referencia pediátrica en Lima, Perú. Población y método. Estudio transversal en niños y adolescentes obesos (índice de masa corporal ≥ percentil 95) de 10 a 15 años. Se clasificó como SM según los criterios de la International Diabetes Federation. Se aplicó un recordatorio de 24 horas y se calculó la CG total y por comida. Se evaluó la asociación entre los terciles de CG (comparación con el inferior) y SM usando razones de prevalencia ajustadas (RPa) por variables demográficas, antecedentes familiares, de actividad física y consumo total de carbohidratos en modelos de regresión de Poisson con varianza robusta. Resultados. De 273 niños y adolescentes obesos, 52,4% fueron varones y 94,9% fueron físicamente inactivos. La mediana de CG fue de 213 (164,8287,4) y la de ingesta calórica diaria fue 2275 (1851-3024) kcal, dada principalmente por carbohidratos (62%). La prevalencia de SM fue de 22,3%; los componentes con mayor prevalencia fueron la obesidad abdominal (81,7%) y los valores de lipoproteínas de alta densidad (HDL, del inglés high density lipoprotein) bajos (63,7%). Por último, se encontró una asociación entre el consumo elevado de CG y el riesgo de presentar SM (RPa 4,5; IC 95%: 1,3-15,3). Conclusiones. Existe una asociación entre el alto consumo de CG y la presencia de SM en niños y adolescentes con obesidad.

Objective. To study the association between the metabolic syndrome (MS) and the glycemic load (GL) of food intake among obese children and adolescents seen in consultation by the endocrinology team in a pediatric referral hospital in Lima, Peru. Population and Method. Cross-sectional study among obese children and adolescents (body mass index ≥ 95 percentile), 10-15 years old. The MS was classified according to criteria of the International Diabetes Federation. A 24 hour reminder was used, and the overall and per meal GL was calculated. The association between the GL tertiles (comparison with the lower tertile) and the MS was assessed using prevalence ratios adjusted by demographic outcome measures, family history, physical activity and total carbohydrate consumption in Poisson regression models with a robust variance. Results. Out of 273 obese children and adolescents, 52.4% were male and 94.9% did not engage in any physical activity. Glycemic load median value was 213 (164.8-287.4) and the daily calorie intake value was 2275 (1851-3024) kcal, consisting mainly of carbohydrates (62%). MS prevalence was 22.3%; the most prevalent components were abdominal obesity (81.7%) and low values of high density lipoprotein (HDL) (63.7%). Lastly, an association was observed between a high consumption of GL and the risk of developing MS (aRP 4.5; 95% CI: 1.3-15.3). Conclusions. There is an association between a high consumption of GL and the presence of MS among obese children and adolescents.

Índice, carga glicémica y fibra dietética de los alimentos y su asociación con resistencia a la insulina en adultos chilenos / Glycemic index, glycemic load and dietary fiber of foods and its association with insulin resistance in Chilean adults

El Índice y Carga Glicémica (IG y CG) categorizan los alimentos según su capacidad de incrementar la glicemia, considerando cantidad y calidad de hidratos de carbono consumidos. Diferentes estudios han postulado que una dieta con IG y CG altos y bajo consumo de fibra incrementan la glicemia e insulinemia, aunque con resultados heterogéneos.El objetivo de este estudio fue analizar la asociación entre IG, CG e ingesta de fibra y valores HOMA-IR en adultos jóvenes. En una muestra representativa de 738 personas que tenían entre 32 y 38 años, nacidos en el Hospital de Limache, Región de Valparaíso, Chile, se recogió información socioeconómica, de salud, se determinó estado nutricional, glicemia, insulina basal y HOMA, y con la encuesta de frecuencia de consumo se estimó IG, CG e ingesta de fibra. Se construyeron modelos de regresión múltiple, controlando efectos de confusión e interacción. En modelos ajustados, se observó que por cada 10 unidades que aumenta el IG y CG de la dieta en individuos con exceso de peso, aumenta el HOMA-IR en 0,31 (p=0,042) y 0,03 (p=0,012), respectivamente y por cada 10 gramos que aumenta la fibra total y soluble, disminuye el HOMA-IR en 0,10 (p=0,04) y 0,62 (p=0,034) respectivamente. En personas sin exceso de peso no hubo estos efectos. Existe una asociación directa entre el aumento de IG y CG de los alimentos y el incremento de HOMA-IR sólo en individuos con exceso de peso y una asociación inversa entre ingesta de fibra dietética total y soluble y HOMA-IR(AU)

Glycemic index, glycemic load and dietary fiber of foods and its association with insulin resistance in Chilean adults. Glycemic index and glycemic load (GI and GL) categorize foods according to their ability to increase blood sugar levels, considering quantity and quality of carbohydrates consumed. Different studies have postulated that a high GI and GL diet and low fiber intake increased glycemia and insulinemia, although with heterogeneous results. The aim of this study was to analyze the association between GI, GL and fiber intake and HOMA-IR values in young adults. In a representative sample of 738 people aged between 32 and 38 years old, born in the Limache’s Hospital, Valparaiso, Chile, socioeconomic and health information, nutritional status, basal glycemia, insulin and HOMA were collected. With a food frequency questionnaire, GI, GL and fiber intake were estimated. Multiple regression models were constructed, controlling confounding and interaction effects. In adjusted models, it was found that for every 10 units that increases diet GI and GL in overweight individuals, HOMA- IR increases in 0.31 (p = 0.042) and 0.03 (p = 0.012) respectively, and for every 10 grams that increases total and soluble fiber intake, HOMA-IR reduces in 0.10 (p = 0.04) and 0.62 (p = 0.034) respectively. In people without overweight such effects were not observed. There was a direct association bet- ween increased GI and GL foods and increased HOMA-IR only in individuals with overweight and an inverse association between total and soluble fiber intake and HOMA-IR(AU)

Associação entre o índice glicêmico e a carga glicêmica da dieta de frequentadores de clínicas estéticas privadas de Porto Alegre - RS e indicadoresde adiposidade corporal / Association between glycemic index and glycemic load in the diet of clients of private esthetics clinics in Porto Alegre and body fat indicators

Objective: To evaluate the possible association between dietary glycemic index (GI) and glycemic load (GL) and anthropometric indicators of adiposity in clients of private esthetics clinics of Porto Alegre, Rio Grande do Sul state, Brazil. Methods:Observational, cross-section study in which all participants underwent anthropometric (measurement of weight, height, BMI, and waist circumference) and dietary (24-hour recall) assessments. The dietary GI and GL were calculated as proposed by the Food and Agriculture Organization ? FAO, considering the values of the International Table of GlycemicIndex (2008). Dietary analysis was performed using DietWin® software and statistical analysis using SPPS 16.0 Package®. Results: One hundred nineteen clients of three private cosmetic clinics of Porto Alegre were Included in the current study. The following data were collected from the study subjects: 39.12 ± 13.55 years old, BMI equals to 26.21 ± 5.10kg/m², and waist circumference equal to 80.5 ± 11.3 cm for women and 99.7 ± 13.7 cm for men. The daily GL was equal to 89.9 ± 38.7 grams and the GI was equal to 54.4 ± 7.5%. The daily GL differed between participants categorized byBMI, considering the cutoff of the World Health Organization (WHO): higher GL was observed among overweight and obese participants in comparison to participants with underweight and normal weight (89.9 ± 38.7 g vs 89.9 ± 38.7 grams, p = 0.02). The GL explained approximately 26% of the variability in waist circumference values (p <0.001). Conclusion: Clients of private cosmetic clinics of Porto Alegre included in the current study presented overweight in a high proportion; it could be related to a high dietary GL. This aspect should be considered in the nutrition counseling ofthis group of patients regarding carbohydrate intake

Objetivo: Avaliar a possível associação entre o índice glicêmico (IG) e a carga glicêmica (CG) da dieta de frequentadores de clínicas estéticas privadas de Porto Alegre/RS e indicadores antropométricos de adiposidade corporal. Métodos: Estudo observacional transversal em que os participantes foram submetidos à avaliação antropométrica [peso, estatura, índice de massa corporal (IMC) e circunferência da cintura (CC)] e do consumo alimentar (recordatório de 24 horas). O IG e a CG das dietas foram calculados conforme padrão proposto pela FAO, a partir dos valores de IG da Tabela internacional (2008). A análise dietética dos dados foi realizada no software DietWin® e as análises estatísticas no Pacote SPPS 16.0®. Resultados: Foram avaliados 119 frequentadores de três clínicas estéticas privadas de Porto Alegre com idade média de 39,12 ± 13,55 anos, IMC de 26,21 ± 5,10Kg/m² e CC de 80,5 ± 11,3cm (para mulheres) e de 99,7 ± 13,7cm (para homens). A CG diária foi igual a 89,9 ± 38,7g e o IG igual a 54,4 ± 7,5%. A CG diária diferiu entre os grupos quando categorizados pelo IMC, considerando-se os pontos de corte da Organização Mundial de Saúde (OMS): maior CG diária entre os participantes com sobrepeso e obesidade em comparação àqueles com baixo peso e eutrofia (89,9 ± 38,7g vs. 89,9 ± 38,7g, P=0,02). A CG da dieta explicou cerca de 26% da variabilidade nos valores de CC dos participantes (P<0.001). Conclusão: Elevada prevalência de excesso de peso corporal foi observada na amostra de frequentadoresde clínicas estéticas privadas avaliada, o que foi relacionado ao consumo de dieta com elevada CG. A orientação nutricional desse grupo específico de indivíduos deve ponderar para esse aspecto quando da escolha de alimentos-fonte de carboidrato.

Respuesta glicémica al consumo de una barra de cereales-leguminosa (Phaseolus vulgaris) en individuos sanos / Glycemic response to consumption of a cereals and legume (Phaseolus vulgaris) bar on healthy individuals

El objetivo de la presente investigación fue formular una barra de cereales y leguminosa (Phaseolus vulgaris) y evaluar su impacto sobre la respuesta glicémica de individuos sanos, a fin de contribuir con la oferta de alimentos beneficiosos para la salud del consumidor. Para esto se formuló una barra con una mezcla de cereales (maíz y avena) y dos porcentajes (20% y 30%) de Phaseolus vulgaris. Adicionalmente, se preparó una barra de cereales sin leguminosa (barra control). Mediante evaluación sensorial, se seleccionó la barra con 30% de Phaseolus vulgaris, por ser evaluada con mejor sabor y textura, además esa combinación de cereales y leguminosas favorece la complementación aminoacídica y los criterios de formulación previamente establecidos. La caracterización química indicó un contenido de proteínas mayor en la barra con 30% de Phaseolus vulgaris (13,55%), en relación a la barra control (8,5%). Los contenidos de grasa, cenizas y fibra dietética no presentaron diferencias (p>0,05) entre ambas barras evaluadas. Sin embargo, el contenido de fibra soluble y de almidón resistente de la barra seleccionada resultó un 32,05% y 18,67% mayor, respectivamente, que en la barra control, con lo cual se podría contribuir con la disminución de la velocidad de absorción de la glucosa. La barra seleccionada presentó un índice glicémico bajo (49) y carga glicémica intermedia (12,0) en voluntarios sanos, lo que podría traducirse en una posible reducción de la tasa de absorción de glucosa al torrente sanguíneo, asociada a un contenido de carbohidratos de absorción lenta. La barra formulada representa una propuesta de merienda saludable para el consumidor.

The objective of this work was to formulate a cereals and legume (Phaseolus vulgaris) bar and assess its impact on the glycemic response of healthy individuals, in order to contribute to the healthy food supply beneficial to consumers. A mixture of cereals (corn and oats) and different percentages (20 and 30%) of Phaseolus vulgaris was used to formulate the bar. Additionally, a legume cereal bar without legumes (bar control) was prepared. The bar with 30% of Phaseolus vulgaris was selected through sensory evaluation, being scored with better flavor and texture. This combination of cereals and legumes aminoacid improves complementation and reaches the formulation criteria previously established. Chemical characterization indicated a higher protein content in the bar with 30% of Phaseolus vulgaris (13,55%) relative to the bar control (8,5%). The contents of fat, ash and dietary fiber did not differ between the two bars evaluated. However, the soluble fiber and resistant starch of the selected bar was a 32,05% and 18,67%, respectively, than in the control bar; this may contribute to decreasing the rate of glucose uptake. The selected bar presented a low glycemic index (49) and intermediate glycemic load (12,0) in healthy volunteers, which could lead to a possible reduction in the rate of absorption of glucose into the bloodstream, associated with a carbohydrate content of slow absorption. This bar represents a proposal of a healthy snack for the consumer.

Chemical composition and functional properties of chocolate cakes formulated with yacon tube roots (Smallanthus sonchifolius)

This present work aimed at developing a cake using yacon flour (20% and 40%), for replacing partially thew heat flour. The products were characterized on the nutritional composition, glycemic index, glycemic charge and in vitro prebiotic effect. The physico chemical analyses showed a high fiber concentration in the experimental cakes, in compliance with the legislation in force, being 7.49g% for the cake A (yacon 20%)and 10.75g% for the cake B (yacon 40%). Low concentrations of available carbohydrates of 11.22g% and 9.35g% were found in both cake A and B, respectively. Glicemic index lower than 55 and glycemic chargelo wer than 10 were detected. The prebiotic effect was observed by keeping the lactic bacteria above 106UFC/g of substrate. On that account, cakes containing high fiber concentrations were achieved. Regard lessof the added amounts of yacon flour to the experimental cakes, they were classified as of low glycemic index and glycemic charges products, besides their in vitro prebiotic effect.

Relación del consumo de alimentos de alto índice glicémico en la dieta y los niveles de HbA1c en individuos Diabéticos Tipo 2 en tratamiento con dieta y/o Metformina

En la actualidad aún no existe consenso acerca de recomendaciones claras sobre el uso de IG (índice glicémico) de los alimentos para el control dietético de la DM2 (diabetes mellitus 2). Distintas entidades proponen el uso de conteo de CHO (hidratos de carbono), pues no se cuenta con evidencia suficiente para la planificación dietética en base al IG. El objetivo de este estudio fue relacionar el consumo de alimentos de alto IG con el control glicémico de pacientes DM 2 del programa de salud cardiovascular de tres CESFAM (centro de salud familiar) de la comuna de Santiago, Chile. Se seleccionaron 40 sujetos a quienes se les realizó evaluación antropométrica y una encuesta de frecuencia de consumo alimentaria de 30 dias modificada. Se obtuvieron IG, CG (carga glicémica), número de porciones de alto IG consumidas/dia y cantidad de CHO totales consumidos/día. Éstos se correlacionaron con valores de HbA1c (hemoglobina glicosilada) de los últimos 3 meses obtenidos de la ficha clínica. La edad promedio total fue 58.6 ± 9.5 años. El porcentaje de obesidad fue 62,5% y el promedio IMC de 32.5. El valor promedio de HbA1c fue 7.08 ± 1.6, para HbA1c <7% fue 57.5%. La cantidad total de CHO ingerida/dia fue de 403.8 g. El promedio de IG y CG fue de 78.5 y 317.5 g respectivamente. El número total de porciones de alimentos con IG alto consumido al día fue 21.8. Se obtuvo correlación estadísticamente significativa entre HbA1c y número de porciones de alto IG (r= 0.56 p=0.002). Para el resto de las variables no se encontró correlación con significancia estadística (p>0.05). Por cada porción extra de alimentos con alto IG se observó un aumento de la HbA1c en un 0,9%. En nuestra población estudiada la cantidad de alimentos con alto IG consumidos/dia se correlacionó signicativamante con los valores de HbA1c.

Relationship of consumption of high glycemic index food in the diet and levels of HbA1c in type 2 diabetic patients treated with diet and / or Metformin. At present there is still no clear consensus on recommendations on the use of GI of foods for the dietary management of T2DM. Rather different entities propose the use of carbohydrate counting, because there is not even enough evidence for dietary planning based on this index. The aim of this study was to relate consumption of high GI food with glycemic control of type 2 diabetes patients from the cardiovascular health program of 3 CESFAM (Family Health Centers) in Santiago, Chile. Forty individuals were selected, anthropometric measurements were conducted as well as a modified poll of frequency of food consumption of 30 days. Data from GI, GL, number of servings with high GI consumed per day and total amount of CARB consumed per day. Correlations were determined with values of HbA1c of the last 3 month obtained from the medical record. The average age was 58.6 ± 9.5 years. The percentage of obesity was 62,5% and the average BMI was 32,5. The average HbA1c value was 7.08 ± 1.6, for HbA1c <7% it was 57,5%. The total amount of CARB ingested/day was 403,8 g. The average of GI and GL was 78.5 and 317.5 respectively. The total number of servings of food with high GI ingested per day was 21,8. There was a statistically significant correlation between HbA1c and number of servings with high GI (r= 0.56 p=0.002). For the remaining variables there was no statistically significant correlation (p>0.05). For each extra serving of high GI food there was an increase of 0.9% of HbA1c. In our research population the amount of food with high GI ingested per day was significantly correlated with values of HbA1c.

Papel do índice glicêmico e da carga glicêmica na prevenção e no controle metabólico de pacientes com diabetes melito tipo 2: [revisão] / Glycemic index and glycemic load in the prevention and treatment of type 2 diabetes mellitus: [review]

O controle glicêmico intensificado pode prevenir e/ou retardar o aparecimento das complicações crônicas do diabetes melito (DM). O carboidrato da dieta é o principal determinante da glicemia pós-prandial, sendo o índice glicêmico (IG) e a carga glicêmica úteis para prever a resposta glicêmica aos alimentos. O objetivo deste manuscrito foi revisar criticamente o papel das dietas de baixo IG na prevenção e controle metabólico do diabetes melito tipo 2 (DMT2). O risco para desenvolvimento de DMT2 com dietas de alto IG variou de 1,21 a 1,59. A redução de 12 a 32 unidades no IG da dieta diminuiu em 0,39 a 0,50 pontos percentuais a HbA1c. Os efeitos dessas dietas no perfil lipídico e peso corporal no DMT2 permanecem controversos. Em conclusão, as evidências atuais indicam que a incorporação do IG no planejamento dietético de pacientes com DMT2 contribui para a melhora do controle glicêmico.

The tight glycemic control can prevent and/or delay the development of chronic complications of diabetes mellitus (DM). Dietary carbohydrates are the main determinant of postprandial blood glucose and glycemic index (GI) and glycemic load are used to predict blood glucose response to foods. The aim of this paper was to critically review the role of low GI diets in type 2 diabetes mellitus (T2DM) prevention and metabolic control. The risk for development of T2DM with high GI diets ranged from 1.21 to 1.59.The reduction from 12-32 units in the GI of diets decreased 0.39-0.50 percent in HbA1c values. However, the effects of these diets on lipid profile and body weight in patients with T2DM remain controversial. In conclusion, the current evidence indicates that the inclusion of GI in the dietary planning for patients with T2DM contributes to the improvement of glycemic control.

Índice glicêmico e carga glicêmica de dietas consumidas por indivíduos obesos / Glycemic index and glycemic load of diets consumed by obese individuals

OBJETIVO: Avaliar o índice glicêmico e a carga glicêmica de dietas de indivíduos obesos. MÉTODOS: Trata-se de estudo retrospectivo, que analisou as fichas clínicas de 80 adultos obesos, acompanhados em um serviço privado localizado em Fortaleza, Ceará. Determinaram-se o índice glicêmico e a carga glicêmica da dieta. Para verificação da associação entre índice glicêmico e carga glicêmica, e dessas variáveis com a ingestão energética diária e com o índice de massa corporal dos indivíduos, utilizou-se o teste de correlação de Pearson. O teste "t" de Student foi utilizado para verificar diferenças entre os dois índices e o sexo. Em ambos os testes adotou-se p<0,05 como nível de significância. RESULTADOS: Verificou-se predomínio de índice glicêmico inadequado (moderado ou alto) no desjejum (82,9 por cento), no lanche vespertino (60,0 por cento) e no jantar (64,6 por cento). O índice glicêmico diário foi inadequado para 78,7 por cento do grupo e predominantemente moderado conforme a média encontrada (59,23), porém menos inadequado que a carga glicêmica diária, que foi alta (143,8), e pior, no sexo masculino. O índice de massa corporal do grupo, em geral e segundo o sexo, não foi associado com quaisquer dos dois índices. A ingestão energética diária associou-se apenas com a carga glicêmica, seja em geral ou considerando o sexo. CONCLUSÃO: Os resultados apontam para uma maior importância da carga glicêmica na avaliação dietética desta clientela, sugerindo a inclusão de sua determinação na rotina de atendimento.

OBJECTIVE: To evaluate the glycemic index and glycemic load of diets of obese individuals. METHODS: This is a retrospective study that analyzed the medical records of 80 obese adults attending a private health care service in Fortaleza, Ceará. The glycemic index and load of their diet was determined. The Pearson correlation test was used to verify if there was an association between glycemic index and glycemic load and of these variables with their daily energy intake and body mass index. The Student's "t" test was used to verify the differences between the two indexes and gender. A significance level of p<0.05 was adopted for both tests. RESULTS: Inadequate (moderate or high) glycemic index prevailed at breakfast (82.9 percent), afternoon snack (60.0 percent) and dinner (64.6 percent). The daily glycemic index was inadequate for 78.7 percent of the group and predominantly moderate according to the mean found (59.23), however it was less inadequate than the daily glycemic load which was high (143.8) and worse among males. The body mass index of the group, in general and according to gender, was not associated with any of the indices. Daily energy intake was associated only with glycemic load, both generally and taking gender into account. CONCLUSION: The results point toward a higher glycemic load in the dietary assessment of obese individuals, suggesting that glycemic load should be routinely determined in this population.

Índice glicêmico e carga glicêmica no manejo do diabetes melito / Glycemic index and glycemic load in the management of diabetes mellitus

O diabetes melito (DM) é uma doença crônica, caracterizada por um estado dehiperglicemia e associada a complicações micro e macrovasculares. O controle da glicemia éo principal objetivo no tratamento do DM. Os conceitos de índice glicêmico (IG) e cargaglicêmica (CG) têm sido investigados como potenciais ferramentas para auxiliar no manejodietoterápico destes pacientes. Ademais, seu papel já está sendo reconhecido por algumasassociações de DM no mundo. O IG compara quantidades iguais de carboidrato; enquantoque a CG leva em consideração a quantidade e a qualidade do carboidrato consumido. Ambossão influenciados por fatores intrínsecos e extrínsecos ao alimento. Dietas com baixo IG podem,teoricamente, beneficiar o controle metabólico do DM por diminuírem a hiperglicemia pósprandialprecoce e o risco de hipoglicemia no estado pós-absortivo. A relação entre IG, CG eo desenvolvimento de DM ainda não é um achado unânime na literatura. Em contrapartida,observa-se uma melhora no controle glicêmico dos pacientes diabéticos que seguiram dietasde baixo IG. Tais dietas são de fácil aplicação prática e não restringem a variedade de alimentos.Portanto, o IG e a CG poderiam ser utilizados como ferramentas adicionais no manejodietoterápico do DM.

Diabetes mellitus (DM) is a chronic disease characterized by hyperglycemia andassociated with micro- and macrovascular complications. Good glycemic control is a maingoal. The concepts of glycemic index (GI) and glycemic load (GL) have been subject ofinvestigation as potential tools to help in the dietary management of diabetic patients. Moreover,their role has been already acknowledged by some diabetic associations all over the world. GIcompares the quality of carbohydrate intake, whereas GL takes into consideration both thequantity and quality of carbohydrate intake. They are both influenced by intrinsic and extrinsicfactors of food. Diets with low GI can theoretically benefit metabolic control in DM becausethey decrease early postprandial hyperglycemia and the risk of hypoglycemia during thepostabsorptive state. The association of a high GI and GL with the development of DM is not auniform finding in the literature. Conversely, improvement of glycemic control in diabetic patientswho follow low GI diets has been consistently observed. These diets are easily implementedand do not restrict variety of food choices. Therefore, GI and GL may be useful as additionaltools in the dietary management of DM.