Pasta consumed in the context of a low-glycemic index (GI) diet does not contribute to weight gain and does result in modest weight loss compared with a higher-GI diet, at least over a median follow-up of 12 weeks, a systematic review and meta-analysis indicates.
“Pasta is an important example of a food that is considered a refined carbohydrate but has a low GI,” Laura Chiavaroli, PhD, from the University of Toronto, Ontario, Canada, and colleagues write. “Lower-GI diets may result in greater body weight reduction compared with higher-GI diets because lower-GI foods have been shown to be more satiating and delay hunger and decrease subsequent energy intake,” they add. “[E]ncouragement of the consumption of pasta in the context of a low-GI dietary pattern does not cause harm and may even lead to spontaneous weight loss,” study authors reaffirm.
The study was published April 2 in BMJ Open.
Investigators were unable to identify any randomized controlled trial lasting 3 weeks or longer in which the effect of pasta alone was evaluated on measures of global or regional body fat. However, they did identify 32 trials involving 2448 adults that assessed the effect of pasta on global and regional indices of body fat in the context of low-GI dietary patterns. Measures of global body fat included weight and body mass index; measures of regional body fat included waist circumference, waist-to-hip ratio, and sagittal abdominal diameter adiposity.
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“Pooled analyses showed pasta in the context of low-GI dietary patterns had the effect of reducing body weight by −0.63 kg (95% [confidence interval], −0.84 to −0.42 kg; P<0.001) compared with higher-GI control diets with no evidence of heterogeneity,” the investigators observe. Pooled analyses again support a beneficial effect of pasta within the context of a low-GI diet on body mass index, where body mass index dropped by 0.26 kg/m2 (95% confidence interval, −0.36 to −0.16 kg/m2; P < .001) compared with higher-GI control diets.
In contrast, there was no effect from the same diet on waist circumference, waist-to-hip ratio, or sagittal abdominal diameter compared with higher-GI diets. Removal of two studies from the meta-analysis in which the effect of diet on waist circumference in the context of a low-GI diet was evaluated did show a significant effect from pasta on waist circumference, where the mean difference was a loss of approximately 60 cm compared with a higher-GI diet. “These findings were robust across subgroups,” the researchers point out, “[and they] did not differ by metabolic phenotype in those who were overweight or obese or had diabetes, which is noteworthy since these are populations who would benefit from weight management strategies,” they state.
Weight loss at 0.63 kg with pasta consumed in a low-GI context was similar among participants in trials lasting fewer than 24 weeks and those in trials lasting 24 weeks and longer. “This finding is of particular relevance since many dietary studies are successful in demonstrating weight loss in the short term but not over the long term,” the investigators observe. They acknowledge that pasta can vary widely not only in shape but also in ingredients and in processing techniques.
Despite slight variations in glycemic response brought about by these differences, “glycaemic responses are still lower [with pasta] compared with a control, for example, white bread,” they point out. They also point out that pasta has a similar GI as other fiber-rich carbohydrates such as steel cut oats, and its GI is actually lower than the GI of more commonly consumed foods such as breakfast cereals and skin-on potatoes. Most people eat white wheat pasta, the authors acknowledge.
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