Vol.:(0123456789) 1 3 Eur J Nutr DOI 10.1007/s00394-017-1402-6 ORIGINAL CONTRIBUTION The relationship between carbohydrate quality and the prevalence of metabolic syndrome: challenges of glycemic index and glycemic load Mariane de Mello Fontanelli 1  · Cristiane Hermes Sales 1  · Antonio Augusto Ferreira Carioca 1  · Dirce Maria Marchioni 1  · Regina Mara Fisberg 1   Received: 12 November 2016 / Accepted: 10 February 2017 © Springer-Verlag Berlin Heidelberg 2017 and OR = 1.019 (95% CI 1.002–1.037), respectively. GL was inversely associated with high blood pressure and this association difered by age group (OR = 0.981; 95% CI 0.964–0.998). Foods that most contributed to dietary GI and GL were sugar, white rice and French bread. Conclusions Considering the high prevalence of low HDL-c in the population of São Paulo, GI and GL may contribute to the nutritional therapy of this dyslipidemia. However, fndings should be treated with caution, consider- ing several conficting results between studies. Keywords Metabolic Syndrome · Glycemic Index · Glycemic Load · Cross-sectional studies · Prevalence Introduction The prevalence of metabolic syndrome (MetS) in the world’s adult population is estimated to be between 20 and 25% [1]; however, data from studies involving Brazil- ian citizens between 19 and 64 years suggest higher rates (29.6%) [2]. In the United States of America (USA), the prevalence of MetS was found to be 34.7% between 2011 and 2012, 18.3% in individuals between 20 and 39 years and 46.7% between individuals with 60 or more years. Data from the National Health and Nutrition Examination Sur- vey (NHANES) point to an increase in the prevalence of MetS, from 32.9% in 2003–2004 to 34.7% in 2011–2012. However, these fgures have remained stable since 2007, a fact that was attributed to the stabilization of obesity rates in the country [3]. Overweight and obesity are responsible for 3.4 mil- lion deaths per year and 93.6 million disability-adjusted life years (DALYs) in 2010, with the highest prevalence in North and South America (61%) [4]. In 2013, the Abstract Purpose To estimate the prevalence of metabolic syn- drome (MetS) and its components in adults and older adults residents of São Paulo, the association of MetS with the glycemic index (GI) and glycemic load (GL) and the foods that contribute to dietary GI and GL in this population. Methods Data from 591 adults and older adults partici- pants in the Health Survey of São Paulo were used. This is a cross-sectional, population-based study with a complex multistage sample design of residents in the urban area of the municipality. Dietary consumption data, anthropomet- ric measurements, blood pressure and blood samples were collected. The associations between GI, GL and MetS and its components were tested using logistic regression mod- els, considering the sample design of the study. Results The prevalence of MetS in the adult and older adults residents of São Paulo was 30.3%. There was no association between GI, GL and MetS. GI and GL were positively associated with low high-density lipoprotein cholesterol (HDL-c), OR = 1.113 (95% CI 1.007–1.230) * Regina Mara Fisberg rfsberg@usp.br Mariane de Mello Fontanelli marianefontanelli@gmail.com Cristiane Hermes Sales cristianehermes@yahoo.com.br Antonio Augusto Ferreira Carioca nutriaugusto@gmail.com Dirce Maria Marchioni marchioni@usp.br 1 Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, 01246-904 Sao Paulo, SP, Brazil