Low glycaemic index or low glycaemic load diets for people with overweight or obesity

• Published in: Cochrane database of systematic reviews 2023-06, Vol.6 (6), p.CD005105
• Main Authors: Chekima, Khadidja, Yan, See Wan, Lee, Shaun Wen Huey, Wong, Tziak Ze, Noor, Mohd Ismail, Ooi, Yasmin Bh, Metzendorf, Maria-Inti, Lai, Nai Ming
• Format: Article
• Language: English
• Subjects: Adult; Aged; Blood Glucose; Body Weight; Child; Complementary & alternative medicine; Diet; Endocrine & metabolic; Glycemic Index; Glycemic Load; Humans; Obesity; Overweight
• ISSN: 1469-493X; 1469-493X
• DOI: 10.1002/14651858.CD005105.pub3

The prevalence of obesity is increasing worldwide, yet nutritional management remains contentious. It has been suggested that low glycaemic index (GI) or low glycaemic load (GL) diets may stimulate greater weight loss than higher GI/GL diets or other weight reduction diets. The previous version of this review, published in 2007, found mainly short-term intervention studies. Since then, randomised controlled trials (RCTs) with longer-term follow-up have become available, warranting an update of this review. To assess the effects of low glycaemic index or low glycaemic load diets on weight loss in people with overweight or obesity. We searched CENTRAL, MEDLINE, one other database, and two clinical trials registers from their inception to 25 May 2022. We did not apply any language restrictions. We included RCTs with a minimum duration of eight weeks comparing low GI/GL diets to higher GI/GL diets or any other diets in people with overweight or obesity. We used standard Cochrane methods. We conducted two main comparisons: low GI/GL diets versus higher GI/GL diets and low GI/GL diets versus any other diet. Our main outcomes included change in body weight and body mass index, adverse events, health-related quality of life, and mortality. We used GRADE to assess the certainty of the evidence for each outcome. In this updated review, we included 10 studies (1210 participants); nine were newly-identified studies. We included only one study from the previous version of this review, following a revision of inclusion criteria. We listed five studies as 'awaiting classification' and one study as 'ongoing'. Of the 10 included studies, seven compared low GI/GL diets (233 participants) with higher GI/GL diets (222 participants) and three studies compared low GI/GL diets (379 participants) with any other diet (376 participants). One study included children (50 participants); one study included adults aged over 65 years (24 participants); the remaining studies included adults (1136 participants). The duration of the interventions varied from eight weeks to 18 months. All trials had an unclear or high risk of bias across several domains.  Low GI/GL diets versus higher GI/GL diets Low GI/GL diets probably result in little to no difference in change in body weight compared to higher GI/GL diets (mean difference (MD) -0.82 kg, 95% confidence interval (CI) -1.92 to 0.28; I = 52%; 7 studies, 403 participants; moderate-certainty evidence). Evidence from four studies reporting chan