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Association between glycemic index, glycemic load, and fructose with insulin resistance: the CDC of the Canary Islands study

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Abstract

Background

The involvement of carbohydrates in triggering insulin resistance (IR) remains a source of controversy.

Aim of the study

To study the relation between glycemic index (GI), glycemic load (GL), and fructose with insulin resistance in a predominantly rural population in the Canary Islands.

Methods

Cross-sectional study carried out in 668 nondiabetic people aged 18–75. IR was estimated with serum glucose and C-peptide (HOMA2-IR). Nutrient intakes were obtained from a validated food frequency questionnaire. ANOVA was used to analyze nutrient distribution across quartiles of HOMA2-IR. Four multivariate nutrient density models (dependent variable: log-transformed HOMA2-IR) which differed only in the kinds of carbohydrates included were tested (Model 1: carbohydrates; Model 2: GI and then GL; Model 3: free fructose, other simple sugars and starch; Model 4: total fructose, remaining sugars and starch).

Results

There was no association between GI and IR. There was a direct association between GL (P < 0.001), fructose (free [P = 0.001], total [P = 0.013]), energy intake (P < 0.001), fruit fiber (<0.001), and glucose (P = 0.003) with IR. There was an inverse association between cereal (P = 0.008) and vegetable fiber (P < 0.001) and IR. Multivariate models corroborated the association of carbohydrates, GL, fructose, vegetable fiber, and energy intake with IR. The association between GL and IR disappeared when Model 2 was adjusted by total fructose intake.

Conclusions

There was a direct association between fructose intake and IR. There was no relationship between GI and IR. Although a direct association of GL with IR was detected, it was attributable to the consumption of fructose.

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Acknowledgments

This study was supported by Grant 070934 from the Health Research Fund (FIS in Spanish) and by the Science and Health Foundation (FUNCIS in Spanish). We thank K. Shashok for translating the manuscript into English.

Conflict of interest statement

The authors state that they have no conflict of interest.

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Authors and Affiliations

  1. Primary Health Care Research Unit, La Candelaria University Hospital, Santa Cruz de Tenerife, Canary Islands, Spain

    Santiago Domínguez Coello, Antonio Cabrera de León, María C. Rodríguez Pérez, Carlos Borges Álamo, Lourdes Carrillo Fernández, Delia Almeida González, Jezabel García Yanes, Ana González Hernández, Buenaventura Brito Díaz & Armando Aguirre-Jaime

  2. Preventive Medicine and Public Health Area, School of Medicine, University of La Laguna, Tenerife, Canary Islands, Spain

    Antonio Cabrera de León

  3. La Victoria Primary Health Centre, C/Domingo Salazar 21, Centro de Salud La Victoria, 38380, Santa Cruz de Tenerife, Canary Islands, Spain

    Santiago Domínguez Coello

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  1. Santiago Domínguez Coello
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  2. Antonio Cabrera de León
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Correspondence to Santiago Domínguez Coello.

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Domínguez Coello, S., Cabrera de León, A., Rodríguez Pérez, M.C. et al. Association between glycemic index, glycemic load, and fructose with insulin resistance: the CDC of the Canary Islands study. Eur J Nutr 49, 505–512 (2010). https://doi.org/10.1007/s00394-010-0110-2

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  • DOI: https://doi.org/10.1007/s00394-010-0110-2

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