Response to Sacks

Account for the discrepancy? Among eligible patients at our medical center, both options are presented as clinically equivalent.

Low vs High Glycemic Index Diet
To the EditorIn the OmniCarb randomized clinical trial, Dr Sacks and colleagues1 concluded that a 5-week, low glycemic index version of the Dietary Approaches to Stop Hypertension diet did not improve insulin sensitivity or cardiovascular risk factors compared with a higher glycemic index diet. We are concerned that the duration of the trial was too short. Longer 12- to 26-week studies have demonstrated that low glycemic index diets progressively enhance glycemic control2 and insulin sensitivity.3 High-density lipoprotein (HDL) cholesterol level can increase while patients are on low glycemic index diets over time (approximately 10 weeks).4 Weight loss maintenance and levels of low-density lipoprotein (LDL) cholesterol and C-reactive protein (CRP) also were improved in overweight and obese participants in the Diet, Obesity, and Genes (DIOGENES) study (26 weeks).

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