The effect of low glycemic index diet on body weight status and blood pressure in overweight adolescent girls: a randomized clinical trial

  • Rouhani, Mohammad Hossein (Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences) ;
  • Kelishadi, Roya (Department of Pediatrics, Child Growth and Development Research Center, and School of Medicine, Isfahan University of Medical Sciences) ;
  • Hashemipour, Mahin (Department of Pediatrics, Child Growth and Development Research Center, and School of Medicine, Isfahan University of Medical Sciences) ;
  • Esmaillzadeh, Ahmad (Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences) ;
  • Azadbakht, Leila (Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences)
  • Received : 2012.12.04
  • Accepted : 2013.05.14
  • Published : 2013.10.01


Although several studies have assessed the influence of the glycemic index on body weight and blood pressure among adults, limited evidence exists for the pediatric age population. In the current study, we compared the effects of low glycemic index (LGI) diet to the healthy nutritional recommendation (HNR)-based diet on obesity and blood pressure among adolescent girls in pubertal ages. This 10-week parallel randomized clinical trial comprised of 50 overweight or obese and sexually mature girls less than 18 years of age years, who were randomly assigned to LGI or HNR-based diet. Macronutrient distribution was equivalently prescribed in both groups. Blood pressure, weight and waist circumference were measured at baseline and after intervention. Of the 50 participants, 41 subjects (include 82%) completed the study. The GI of the diet in the LGI group was $42.67{\pm}0.067$. A within-group analysis illustrated that in comparison to the baseline values, the body weight and body mass index (not waist circumference and blood pressure) decreased significantly after the intervention in both groups (P = 0.0001). The percent changes of the body weight status, waist circumference and blood pressure were compared between the two groups and the findings did not show any difference between the LGI diet consumers and those in the HNR group. In comparison to the HNR, LGI diet could not change the weight and blood pressure following a 10-week intervention. Further longitudinal studies with a long-term follow up should be conducted in this regard.


  1. Azadbakht L, Mirmiranr R, Azizi F. Predictors of cardiovascular risk factors in Tehranian adults: diet and lifestyle. East Mediterr Health J 2006;12:88-97.
  2. Kelishadi R. Childhood overweight, obesity, and the metabolic syndrome in developing countries. Epidemiol Rev 2007;29:62-76.
  3. Reinehr T, de Sousa G, Toschke AM, Andler W. Long-term follow-up of cardiovascular disease risk factors in children after an obesity intervention. Am J Clin Nutr 2006;84:490-6.
  4. Gaeini A, Kashef M, Samadi A, Fallahi A. Prevalence of underweight, overweight and obesity in preschool children of Tehran, Iran. J Res Med Sci 2011;16:821-7.
  5. Acheson KJ. Carbohydrate for weight and metabolic control: where do we stand? Nutrition 2010;26:141-5.
  6. Livesey G. Low-glycaemic diets and health: implications for obesity. Proc Nutr Soc 2005;64:105-13.
  7. van Woudenbergh GJ, Kuijsten A, Sijbrands EJ, Hofman A, Witteman JC, Feskens EJ. Glycemic index and glycemic load and their association with C-reactive protein and incident type 2 diabetes. J Nutr Metab 2011;2011:623076.
  8. Sakurai M, Nakamura K, Miura K, Takamura T, Yoshita K, Morikawa Y, Ishizaki M, Kido T, Naruse Y, Suwazono Y, Kaneko S, Sasaki S, Nakagawa H. Dietary glycemic index and risk of type 2 diabetes mellitus in middle-aged Japanese men. Metabolism 2012;61:47-55.
  9. Sloth B, Krog-Mikkelsen I, Flint A, Tetens I, Björck I, Vinoy S, Elmståhl H, Astrup A, Lang V, Raben A. No difference in body weight decrease between a low-glycemic-index and a highglycemic- index diet but reduced LDL cholesterol after 10-wk ad libitum intake of the low-glycemic-index diet. Am J Clin Nutr 2004;80:337-47.
  10. Iannuzzi A, Licenziati MR, Vacca M, De Marco D, Cinquegrana G, Laccetti M, Bresciani A, Covetti G, Iannuzzo G, Rubba P, Parillo M. Comparison of two diets of varying glycemic index on carotid subclinical atherosclerosis in obese children. Heart Vessels 2009;24:419-24.
  11. Sahyoun NR, Anderson AL, Kanaya AM, Koh-Banerjee P, Kritchevsky SB, de Rekeneire N, Tylavsky FA, Schwartz AV, Lee JS, Harris TB. Dietary glycemic index and load, measures of glucose metabolism, and body fat distribution in older adults. Am J Clin Nutr 2005;82:547-52.
  12. Murakami K, Sasaki S, Okubo H, Takahashi Y, Hosoi Y, Itabashi M. Dietary fiber intake, dietary glycemic index and load, and body mass index: a cross-sectional study of 3931 Japanese women aged 18-20 years. Eur J Clin Nutr 2007;61:986-95.
  13. Lau C, Toft U, Tetens I, Richelsen B, Jørgensen T, Borch- Johnsen K, Glümer C. Association between dietary glycemic index, glycemic load, and body mass index in the Inter99 study: is underreporting a problem? Am J Clin Nutr 2006;84:641-5.
  14. Ebbeling CB, Leidig MM, Feldman HA, Lovesky MM, Ludwig DS. Effects of a low-glycemic load vs low-fat diet in obese young adults: a randomized trial. JAMA 2007;297:2092-102.
  15. Barba G, Sieri S, Russo MD, Donatiello E, Formisano A, Lauria F, Sparano S, Nappo A, Russo P, Brighenti F, Krogh V, Siani A; ARCA Project Study Group. Glycaemic index and body fat distribution in children: the results of the ARCA project. Nutr Metab Cardiovasc Dis 2012;22:28-34.
  16. Buyken AE, Trauner K, Günther AL, Kroke A, Remer T. Breakfast glycemic index affects subsequent daily energy intake in free-living healthy children. Am J Clin Nutr 2007;86:980-7.
  17. Buyken AE, Cheng G, Günther AL, Liese AD, Remer T, Karaolis- Danckert N. Relation of dietary glycemic index, glycemic load, added sugar intake, or fiber intake to the development of body composition between ages 2 and 7 y. Am J Clin Nutr 2008;88: 755-62.
  18. Ball SD, Keller KR, Moyer-Mileur LJ, Ding YW, Donaldson D, Jackson WD. Prolongation of satiety after low versus moderately high glycemic index meals in obese adolescents. Pediatrics 2003;111:488-94.
  19. Henry CJ, Lightowler HJ, Strik CM. Effects of long-term intervention with low- and high-glycaemic-index breakfasts on food intake in children aged 8-11 years. Br J Nutr 2007;98:636-40.
  20. Warren JM, Henry CJ, Simonite V. Low glycemic index breakfasts and reduced food intake in preadolescent children. Pediatrics 2003;112:e414.
  21. Siegel RM, Neidhard MS, Kirk S. A comparison of low glycemic index and staged portion-controlled diets in improving BMI of obese children in a pediatric weight management program. Clin Pediatr (Phila) 2011;50:459-61.
  22. Young PC, West SA, Ortiz K, Carlson J. A pilot study to determine the feasibility of the low glycemic index diet as a treatment for overweight children in primary care practice. Ambul Pediatr 2004;4:28-33.<0028:APSTDT>2.0.CO;2
  23. Rovner AJ, Nansel TR, Gellar L. The effect of a low-glycemic diet vs a standard diet on blood glucose levels and macronutrient intake in children with type 1 diabetes. J Am Diet Assoc 2009; 109:303-7.
  24. Fajcsak Z, Gabor A, Kovacs V, Martos E. The effects of 6-week low glycemic load diet based on low glycemic index foods in overweight/obese children--pilot study. J Am Coll Nutr 2008;27: 12-21.
  25. Papadaki A, Linardakis M, Larsen TM, van Baak MA, Lindroos AK, Pfeiffer AF, Martinez JA, Handjieva-Darlenska T, Kunesová M, Holst C, Astrup A, Saris WH, Kafatos A; DiOGenes Study Group. The effect of protein and glycemic index on children's body composition: the DiOGenes randomized study. Pediatrics 2010;126:e1143-52.
  26. Kelishadi R, Pour MH, Sarraf-Zadegan N, Sadry GH, Ansari R, Alikhassy H, Bashardoust N. Obesity and associated modifiable environmental factors in Iranian adolescents: Isfahan Healthy Heart Program - Heart Health Promotion from Childhood. Pediatr Int 2003;45:435-42.
  27. Cameron N, Pettifor J, De Wet T, Norris S. The relationship of rapid weight gain in infancy to obesity and skeletal maturity in childhood. Obes Res 2003;11:457-60.
  28. World Health Organization. BMI-for-age GIRLS. Geneva: World Health Organization; 2007 [cited 2011 Sep]. Available from:
  29. Fleiss JL. The Design and Analysis of Clinical Experiments. London: John Wiley and Sons; 1986. p.263-271.
  30. Rahmani K, Djazayery A, Habibi MI, Heidari H, Dorosti- Motlagh AR, Pourshahriari M, Azadbakht L. Effects of daily milk supplementation on improving the physical and mental function as well as school performance among children: results from a school feeding program. J Res Med Sci 2011;16:469-76.
  31. Institute of Medicine (US). Energy. In: Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, D.C.: National Academies Press; 2005. p.217.
  32. Azam-Taleban F, Esmaeili M. Glycemic Index of Iranian Foods. 1st ed. Tehran: National Nutrition and Food Technology Research Institute; 1999.
  33. Foster-Powell K, Holt SH, Brand-Miller JC. International table of glycemic index and glycemic load values: 2002. Am J Clin Nutr 2002;76:5-56.
  34. de Rougemont A, Normand S, Nazare JA, Skilton MR, Sothier M, Vinoy S, Laville M. Beneficial effects of a 5-week low-glycaemic index regimen on weight control and cardiovascular risk factors in overweight non-diabetic subjects. Br J Nutr 2007;98:1288-98.
  35. Moreno LA, Pineda I, Rodríguez G, Fleta J, Sarría A, Bueno M. Waist circumference for the screening of the metabolic syndrome in children. Acta Paediatr 2002;91:1307-12.
  36. National High Blood Pressure Education Program Working Group on high blood pressure in children and adolescents. Pediatrics 2004;114:iv.
  37. Parillo M, Licenziati MR, Vacca M, De Marco D, Iannuzzi A. Metabolic changes after a hypocaloric, low-glycemic-index diet in obese children. J Endocrinol Invest 2012;35:629-33.
  38. LaCombe A, Ganji V. Influence of two breakfast meals differing in glycemic load on satiety, hunger, and energy intake in preschool children. Nutr J 2010;9:53.
  39. Azadbakht L, Esmaillzadeh A. Dietary patterns and attention deficit hyperactivity disorder among Iranian children. Nutrition 2012;28:242-9.
  40. Azadbakht L, Haghighatdoost F, Esmaillzadeh A. Legumes: a component of a healthy diet. J Res Med Sci 2011;16:121-2.

Cited by

  1. Low glycaemic index diets as an intervention for obesity: a systematic review and meta-analysis pp.14677881, 2018,