GI News Briefs

Carbohydrate quality counts in preventing heart disease
Carbohydrate quality counts in reducing risk of heart disease according to the findings of a study of 15,714 Dutch women on the effect of GI and GL on heart disease risk. The study draws attention to Australia’s GI Symbol Program showing how food labelling can play a role in helping consumers reduce the GI of their diet.

In commenting on the study in an editorial in the Journal of the American College of Cardiology, Frank B. Hu MD, PhD writes: ‘It’s time to shift the diet-heart paradigm away from restricted fat intake and towards reduced GL.’ We know that GI News readers get confused about GI and GL and what should they do. This study makes it clear that reducing total carbohydrate intake is not helpful. Reducing the GI of your diet (choosing the smart carbs), not increasing fat and protein is the solution to reducing GL.

Discussing their findings the study’s authors clearly state that it was the quality of the carbohydrate in the diet that made the difference (the GI) not the quantity. Here’s what they say:
‘… the concept of glycemic load and glycemic index is criticized for limited applicability in daily practice, also given recent results from large-scale diet interventions. However, the concept is currently implemented in nutrition guidelines in Australia through labeling of foods with a symbol and their glycemic index value, suggesting that it is applicable in public health recommendations.’
– JACC Vol 50, No 1, 2007

Diabetes doubles stroke risk
Canadian researchers writing in the American Heart Association’s journal Stroke report that ‘the risk of stroke within 5 years of treatment for type 2 diabetes is more than double the rate for the general population.’ And they found that the risk is substantially greater for younger than older people. The findings stem from a study involving 12,272 adults with type 2 diabetes. While the over-75s have a 1.8-fold increased risk for stroke compared to those of similar age in the general population; the 30–44-year-olds have a 5.6-fold increase in stroke risk. The researchers believe there’s an urgent need for ‘early aggressive cardiovascular risk management for type 2 diabetes’ – that means controlling hypertension (high blood pressure), quitting smoking, and dealing with elevated cholesterol.
– Stroke, June 2007

Pre-diabetes has a deadly impact on the heart
People with pre-diabetes are more than twice as likely to die of cardiovascular disease compared with those with normal glucose tolerance according to researchers at the International Diabetes Institute. The finding comes from research involving 10,429 Australians (average age of 51–63) taking part in the AusDiab study. Diabetes and pre-diabetes accounted for 65 per cent of all heart disease deaths in the group they report. ‘The five-year risk of cardiac mortality was 2.6 times higher among people who had diabetes and was 2.5 times higher in those with impaired fasting glucose,’ writes lead author and epidemiologist Elizabeth Barr.
– Circulation 2007, doi:10.1161/CIRCULATIONAHA.106.685628

Kids and diabetes – which type?
‘In the past, when a child was diagnosed with diabetes, the typical symptoms of weight loss, dehydration and thirst made it easy to classify as type 1, juvenile onset or insulin-dependent diabetes,’ write Prof Jennie Brand-Miller and her co-authors in The New Glucose Revolution for Diabetes. ‘In recent years a new picture has emerged: instead of being thin this child is overweight (or close), and
instead of their body not making insulin, their body is making lots of insulin. For example, in Australia, nearly 1 in 10 young people with diabetes now has type 2. Twenty years ago it was almost unheard of in this age group.’

Whether type 1 or 2, diabetes is for life, which is why getting the numbers right is vital so that health services have the plans, services and budgets in place to provide appropriate care for children and young adults with diabetes and its complications. In June 2007, the SEARCH for Diabetes in Youth Study Group reported its data on the incidence diabetes among young people in the US. They found that the vast majority of all new cases of diabetes in children younger than 10 regardless of race/ethnicity was type 1. Even among children over 10, type 1 is still the most common form of diabetes. Although type 2 is relatively infrequent in kids overall, it becomes more common after the age of 10, especially among US minority populations.

Here are the figures for those who want more detail:

• The incidence of type 1 diabetes (per 100 000 person-years) was 24.3.
• The highest rates of type 1 were observed in non-Hispanic white youth (18.6, 28.1, and 32.9 for age groups 0–4, 5–9, and 10–14 years, respectively).
• Overall, type 2 was still relatively infrequent, but the highest rates (17.0 to 49.4 per 100 000 person-years) were documented among 15-to 19-year-old minority groups.

– JAMA. 2007;297:2716-2724 www.jama.com