Dietary Glycemic Index and Glycemic Load Are Positively Associated with Risk of Developing Metabolic Syndrome in Middle‐Aged and Elderly Adults

Martí Juanola-Falgarona, Jordi Salas-Salvadó, Pilar Buil-Cosiales, Dolores Corella, Ramón Estruch, Emili Ros, Montserrat Fitó, Javier Recondo, Enrique Gómez-Gracia, Miquel Fiol, José Lapetra, Rosa M Lamuela-Raventós, Lluis Serra-Majem, Xavier Pintó, Miguel A Muñoz, Valentina Ruiz-Gutiérrez, José Alfredo Martínez, Itandehui Castro-Quezada, Mònica Bulló

To evaluate how glycemic index (GI) and glycemic load (GL) are associated with the metabolic syndrome (MetS) and its features in middle-aged and elderly adults at high cardiovascular risk. Prospective, longitudinal, population-based cohort. PREvención con DIeta MEDiterránea study. Men and women (N = 6,606) divided into three age groups (<65, 65-74, ≥75). Energy and nutrient intake was evaluated using a validated 137-item food frequency questionnaire. MetS and its features were defined in accordance with the criteria of the American Heart Association and National Heart, Lung, and Blood Institute. A positive association was observed between GI and MetS prevalence in the youngest and middle age groups for participants without diabetes mellitus, but no relationship was found for those with diabetes mellitus. During the median follow-up of 4.8 years, higher GI and GL were related to greater risk of MetS in the middle age group, independent of the presence of diabetes mellitus. Changes in dietary GI were associated with risk of developing the high fasting glucose component of the MetS in the oldest age category, and changes in dietary GL were associated with risk of developing abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, and high blood pressure in the youngest age category. Dietary GI and GL have a potential role in the development of MetS and associated clinical features, with particular age-dependent considerations.