Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT, United States.
Department of Physics and Astronomy, Brigham Young University, Provo, UT, United States.
Am J Clin Nutr. 2024 Aug;120(2):380-388. doi: 10.1016/j.ajcnut.2024.06.001. Epub 2024 Jun 7.
The quality of carbohydrate intake, as measured by the glycemic index (GI), has not been evaluated nationally over the past 2 decades in the United States.
We aimed to develop a comprehensive and nationally representative dietary GI and glycemic load (GL) database from 1999 to 2018 National Health and Nutrition Examination Survey (NHANES) and to examine GI and GL time trends and subpopulation differences.
We used an artificial intelligence (AI)-enabled model to match GI values from 2 GI databases to food codes from United States Department of Agriculture, which were manually validated. We examined nationally representative distributions of dietary GI and GL from 1999 to 2018 using the multistage, clustered sampling design of NHANES.
Assigned GI values covered 99.9% of total carbohydrate intake. The initial AI accuracy was 75.0%, with 31.3% retained after manual curation guided by substantive domain expertise. A total of 7976 unique food codes were matched to GI values, of which soft drinks and white bread were top contributors to dietary GI and GL. Of the 49,205 NHANES adult participants, the mean dietary GI was 55.7 (95% confidence interval [CI]: 55.5, 55.8) and energy-adjusted dietary GL was 133.0 (95% CI: 132.3, 133.8). From 1999 to 2018, dietary GI and GL decreased by 4.6% and 13.8%, respectively. Dietary GL was higher among females (134.6; 95% CI: 133.8, 135.5) than among males (131.3; 95% CI: 130.3, 132.3), those with ≤high school degree (137.7; 95% CI: 136.8, 138.7) than among those with ≥college degree (126.5; 95% CI: 125.3, 127.7), and those living under the poverty level (140.9; 95% CI: 139.6, 142.1) than among those above the poverty level. Differences in race were observed (Black adults, 139.4; 95% CI: 138.2, 140.7; White adults, 131.6; 95% CI: 130.5, 132.6).
The national GI and GL database facilitates large-scale and high-quality surveillance or cohort studies of diet and health outcomes in the United States.
在过去的 20 年里，美国并没有对碳水化合物摄入量的质量（用血糖指数 [GI] 来衡量）进行全国性评估。
我们旨在从 1999 年至 2018 年的全国健康与营养调查（NHANES）中建立一个全面且具有全国代表性的饮食 GI 和血糖负荷（GL）数据库，并研究 GI 和 GL 的时间趋势和亚人群差异。
我们使用人工智能（AI）驱动的模型将来自两个 GI 数据库的 GI 值与美国农业部的食品代码相匹配，并对这些食品代码进行手动验证。我们使用 NHANES 的多阶段、聚类抽样设计，研究了 1999 年至 2018 年的具有全国代表性的饮食 GI 和 GL 分布情况。
分配的 GI 值涵盖了总碳水化合物摄入量的 99.9%。最初的 AI 准确率为 75.0%，经过由实质性领域专业知识指导的人工策后，保留了 31.3%。共有 7976 个独特的食品代码与 GI 值相匹配，其中软饮料和白面包是饮食 GI 和 GL 的主要贡献者。在 49205 名 NHANES 成年参与者中，平均饮食 GI 为 55.7（95%置信区间[CI]：55.5，55.8），能量调整后的饮食 GL 为 133.0（95%CI：132.3，133.8）。从 1999 年到 2018 年，饮食 GI 和 GL 分别下降了 4.6%和 13.8%。女性（134.6；95%CI：133.8，135.5）的饮食 GL 高于男性（131.3；95%CI：130.3，132.3），受教育程度低于高中（137.7；95%CI：136.8，138.7）的人群高于受教育程度高于高中（126.5；95%CI：125.3，127.7）的人群，以及生活在贫困线以下（140.9；95%CI：139.6，142.1）的人群高于生活在贫困线以上的人群。观察到种族差异（黑人成年人，139.4；95%CI：138.2，140.7；白人成年人，131.6；95%CI：130.5，132.6）。
该全国性的 GI 和 GL 数据库为在美国进行饮食与健康结果的大规模高质量监测或队列研究提供了便利。
