Comparison of Quality of Carbohydrate Metrics Related to Fasting Insulin, Glycosylated Hemoglobin and HOMA-IR in Brazilian Adolescents

Nutrients. 2022 Jun 19;14(12):2544. doi: 10.3390/nu14122544.

Abstract

Low glycemic index (GI) and glycemic load (GL) diets are effective for glycemic control (GC) associated with a carbohydrate-controlled meal plan. However, whether GI and GL peaks are related to GC is unknown. Objective: To compare the daily GI (DGI)/GL (DGL) and average GI (AvGI)/GL (AvGL) of meals (accounting for peaks) related to GC markers (GCM) in Brazilian adolescents. Methods: A representative national school-based (public/private) sample of students without diabetes, 12−17 years of age, was evaluated. Food intake was based on a 24 h recall. The models for complex cluster sampling were adjusted (sex, sexual maturation, age, and physical activity). Results: Of 35,737 students, 74% were from public schools, 60% girls, 17% overweight, and 8% obese. The minimum DGI and DGL were observed at lunch, with higher values at night. Fasting insulin was 1.5 times higher in overweight/obese (OW) girls, and 1.7 times higher in OW boys than in normal-weight (NW) girls. The same trend was observed for the homeostatic model assessment for insulin resistance (HOMA-IR) (OW = 2.82 vs. NW = 1.84 in girls; OW = 2.66 vs. NW = 1.54 in boys; p < 0.05). The daily and average metrics were greater for NW adolescents. Glycosylated hemoglobin was not associated with these metrics, except for AvGL. Insulin and HOMA-IR were associated with all metrics in NW adolescents, with greater coefficients associated with AvGL. Among overweight/obese adolescents, only GI metrics were associated (β = 0.23; AvGI and insulin) and appeared to have the best association with GCM. Conclusions: Among NW adolescents, GL is a better measure of carbohydrate quality, but for those with overweight/obesity, carbohydrate consumption is more associated with GC, probably because they eat/report small amounts of carbohydrates.

Keywords: adolescents; glycemic control; glycemic index; glycemic load; intake.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Benchmarking
  • Blood Glucose
  • Brazil
  • Child
  • Dietary Carbohydrates
  • Fasting
  • Female
  • Glycated Hemoglobin
  • Glycemic Index
  • Humans
  • Insulin
  • Insulin Resistance*
  • Male
  • Obesity
  • Overweight

Substances

  • Blood Glucose
  • Dietary Carbohydrates
  • Glycated Hemoglobin A
  • Insulin

Grants and funding

This work was supported by the Brazilian Department of Science and Technology at the Secretariat of Science and Technology and Strategic Inputs of the Ministry of Health (Departamento de Ciência e Tecnologia da Secretaria de Ciência e Tecnologia e Insumos Estratégicos do Ministério da Saúde -Decit/SCTIE/MS).