Effects on cardiovascular risk factors of a low- vs high-glycemic index Mediterranean diet in high cardiometabolic risk individuals: the MEDGI-Carb study
Journal article, 2024

Background: The role of dietary Glycemic Index (GI), independently of fiber intake, in modulating cardiovascular disease (CVD) risk among non-diabetic individuals has not been fully elucidated.
Objective: To evaluate the effects of a low- versus a high-GI diet, based on a Mediterranean dietary pattern, on cardiometabolic risk factors in individuals at high CVD risk, participating in the MEDGI-Carb intervention study.
Subjects and methods: 160 individuals, aged 30–69 years, BMI 25–37 kg/m2, with a waist circumference >102 cm (males) or >88 cm (females) and one feature of the metabolic syndrome, participated in a multi-national (Italy, Sweden, USA) randomized controlled parallel group trial. Participants were assigned to a low GI (< 55) or high-GI MedDiet (> 70) for 12 weeks. The diets were isoenergetic and similar for available carbohydrate (270 g/d) and fiber (35 g/d) content. Fasting metabolic parameters were evaluated in the whole cohort, while an 8-h triglyceride profile (after standard breakfast and lunch) was evaluated only in the Italian cohort.
Results: Blood pressure and most fasting metabolic parameters improved at the end of the dietary intervention (time effect, p < 0.05 for all); however, no differences were observed between the low- and the high-GI MedDiet groups (time x group effect; p > 0.05 for all). Conversely, the low-GI diet, compared with high-GI diet, significantly reduced the 8-h triglyceride profile (p < 0.017, time*group effect) that was measured only in the Italian cohort. However, it induced a reduction of plasma triglycerides after lunch (tAUC) that was of only borderline statistically significance (p = 0.065).
Conclusions: Consuming a low-GI in comparison with a high-GI MedDiet does not differentially affect the major cardiometabolic risk factors at fasting in individuals at increased cardiometabolic risk. Conversely, it could reduce postprandial plasma triglycerides. Clinical trial registry number: NCT03410719, (https://clinicaltrials.gov).


Giuseppina Costabile

University of Naples Federico II

Robert E. Bergia

College of Health and Human Sciences

Marilena Vitale

University of Naples Federico II

Thérése Hjorth

Chalmers, Life Sciences, Food and Nutrition Science

Wayne Campbell

College of Health and Human Sciences

Rikard Landberg

Chalmers, Life Sciences, Food and Nutrition Science

Gabriele Riccardi

University of Naples Federico II

Rosalba Giacco

Consiglo Nazionale Delle Richerche

European Journal of Clinical Nutrition

0954-3007 (ISSN) 14765640 (eISSN)

Vol. 78 5 384-390

Subject Categories

Cardiac and Cardiovascular Systems

Public Health, Global Health, Social Medicine and Epidemiology

Nutrition and Dietetics





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