In this study, glycemic index (GI) and glycemic load (GL) were positively associated with risk of type 2 diabetes in US black women. The authors used the data from the Black Women’s Health Study, a prospective cohort study of 59,000 US black women. During 8 years of follow-up, there were 1,938 incident cases of diabetes. The authors used Cox proportional hazard models to estimate incidence rate ratios for quintiles of dietary factors, while controlling for lifestyle and dietary factors. The authors suggest two possible mechanisms to explain their results. First, a high-GI food produces a relatively high blood glucose concentration and a high-insulin demand, which can result in loss of pancreatic function and eventually lead to glucose intolerance and diabetes. Second, high-GI foods can directly cause insulin resistance by increasing production of postprandial fatty acids. Since fibre intake has been shown to decrease postprandial glucose and insulin concentrations in individuals with and without diabetes, the authors examined the association between cereal fibre intake and the risk of diabetes in black women and found an inverse association. The authors conclude that black women can reduce their risk of diabetes by eating a diet that is high in cereal fibre and that their study has implications for primary prevention of a disease that has reached epidemic proportions among black women.
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