In plain English, eating a diet that is low in refined sugar and high in fiber minimizes the rise in blood glucose level, thus subsequently decreasing chances of having a heart attack or other major cardiovascular event.
Typically, demographic diet studies are performed in high-income Western populations. By contrast, the NEJM study compared 137,851 participants from five continents on a multitude of diets using the glycemic index (GI) as a common denominator. The GI measures the increase in blood glucose level after consuming 50 grams of carbohydrates. Three slices of bread, three potatoes, a cup of rice, or a cup of pasta—each are about equal to 50 grams of carbohydrates.
“Foods high in refined carbs and sugar are digested more quickly and often have a high GI, while foods high in protein, fat, or fiber typically have a low GI. Foods that contain no carbs are not assigned a GI and include meat, fish, poultry, nuts, seeds, herbs, spices, and oils,” according to a recent
Healthline piece.
People from China, followed by Africa and South Asia, consumed high GI diets. A compounding negative effect across all participants was obesity. Namely, people who were overweight and/or obese had an increased risk of high GI foods causing cardiovascular disease and premature death.
Lower GI foods include green vegetables, beans, legumes, and whole grains. Fruits contain fiber, which mitigates some of their glycemic properties. An earlier published study in
Lancet showed three or four servings of fruit, vegetables, and legumes were associated with a lower risk of both non-cardiovascular and cardiovascular mortality.
Including participants from diverse socio-economic regions across the globe is unusual. Interestingly, as the world shrinks with increased connectivity, travel, and most recently contagion, diet choices also can be shared. Understanding the adverse effects of high GI foods is the first step to change behavior and avoid the dire consequences of excess sugar in any form.
What you eat matters.