Glycemic load and chronic disease

Nutr Rev. 2003 May;61(5 Pt 2):S49-55. doi: 10.1301/nr.2003.may.S49-S55.


The glycemic index (GI) has proven to be a useful nutritional concept, providing new insights into the relationship between foods and chronic disease. Observational studies suggest that diets with a high glycemic load (GI x carbohydrate content) are independently associated with increased risk of type 2 diabetes and cardiovascular disease. Postprandial hyperglycemia plays a direct pathogenic role in the disease process. Lower glucose and insulin levels are associated with improved risk profile, including high-density lipoprotein cholesterol, glycosylated proteins, oxidative status, hemostatic variables, and endothelial function. Limited evidence suggests that a low-GI diet may also protect against obesity, colon cancer, and breast cancer. Diets with a high glycemic load may affect health differently in insulin-resistant and insulin-sensitive individuals. Improvements in postprandial hyperglycemia can be brought about by manipulating either the type (i.e., GI) or amount of dietary carbohydrate, or both; at present, the GI appears to be more effective.

Publication types

  • Review

MeSH terms

  • Blood Glucose*
  • Cardiovascular Diseases / epidemiology
  • Chronic Disease*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Dietary Carbohydrates / administration & dosage*
  • Dietary Fiber / administration & dosage
  • Female
  • Food
  • Glycemic Index*
  • Humans
  • Hyperglycemia
  • Lipids / blood
  • Neoplasms / epidemiology
  • Obesity


  • Blood Glucose
  • Dietary Carbohydrates
  • Dietary Fiber
  • Lipids