REVIEW PAPER
Exogenous dietary factors as important modulator of human lipid profile
 
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1
Faculty of Pharmacy with Division of Laboratory Diagnostics, Department of Laboratory Diagnostics, Medical University, Wroclaw, Poland
2
Faculty of Pharmacy with Division of Laboratory Diagnostics, Diagnostics Laboratory for Teaching and Research, Medical University, Wroclaw, Poland
3
Faculty of Pharmacy with Division of Laboratory Diagnostics, Department of Toxicology, Medical University, Wroclaw, Poland
CORRESPONDING AUTHOR
Lilla Pawlik-Sobecka   

Wroclaw Medical University Faculty of Pharmacy with Division of Laboratory Diagnostics Department of Laboratory Diagnostics, ul. Borowska 211A, 50-556, Wrocław, Poland
 
J Pre Clin Clin Res. 2019;13(2):83–91
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Estimation of lipid profile parameters in blood is an important element in the diagnosis of metabolic diseases, especially for evaluation of the whole state of health and identification of risk factors of civilization diseases. Exogenous dietary factors have great influence on laboratory lipid parameters, and improper nutrition habits or application of different diets can change the lipid profile. This is important in making clinical decisions by the doctor. Knowledge of associations between lipid profiles and exogenous factors derived from diets is still incomplete and underestimated.

Objective:
The aim of this review is analysis of the role of the most popular diets, as an exogenous factor influencing the human lipid profile. Additionally, the role of the appropriate preparation of patients for laboratory examination of lipid profile is demonstrated.

State of knowledge:
The most popular diets taken into account were high-fat, vegetarian, Mediterranean, and high-fibre, as well as diets based on low or high glycaemic index. The most negative effect on the all lipid profile parameters is connected with nutritional factors derived from the high glycaemic index diet. The most positive effect demonstrates an appropriate balanced diet, such the vegetarian and Mediterranean diets, which can significantly improve lipid profile parameters.

 
REFERENCES (93)
1.
Kallner A. Measurement performance goals: How they can be estimated and a view to managing them. Scand J Clin Lab Invest Suppl. 2010; 242: 34–39. doi: 10.3109/00365513.2010.493364.
 
2.
Walz SE, Darcy YP. Patient safety & post-analytical error. Clin Lab Med. 2013; 33(1): 183–194. doi: 10.1016/j.cll.2012.10.001.
 
3.
Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, et al. ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2010; 56(25): e50–103. doi: 10.1016/j. jacc.2010.09.001.
 
4.
Rosenson RS, Davidson MH, Hirsh BJ, Kathiresan S, Gaudet D. Genetics and causality of triglyceride-rich lipoproteins in atherosclerotic cardiovascular disease. J Am Coll Cardiol. 2014; 64(23): 2525–2540. doi: 10.1016/j.jacc.2014.09.042.
 
5.
Dikmen ZG, Pinar A, Akbiyik F. Specimen rejection in laboratory medicine: Necessary for patient safety? Biochem Med. 2015; 25(3): 377–385. doi: 10.11613/BM.2015.037. eCollection 2015.
 
6.
Simundic AM, Lippi G. Preanalytical phase--a continuous challenge for laboratory professionals. Biochem Med. (Zagreb) 2012; 22(2): 145–149.
 
7.
Song S, Paik HY, Park M, Song Y. Dyslipidemia patterns are differentially associated with dietary factors. Clin Nutr. 2016; 35(4): 885–891. doi: 10.1016/j.clnu.2015.06.002.
 
8.
Heitmann BL, Lissner L. Can adverse effects of dietary fat intake be overestimated as a consequence of dietary fat underreporting? Public Health Nutr. 2005; 8(8): 1322–1327.
 
9.
Tangvik RJ, Tell GS, Eisman JA, Guttormsen AB, Henriksen A, Nilsen RM, et al. The nutritional strategy: four questions predict morbidity, mortality and health care costs. Clin Nutr. 2014; 33(4): 634–641. doi: 10.1016/j.clnu.2013.09.008.
 
10.
Brunzell JD, Davidson M, Furberg CD, Goldberg RB, Howard BV, Stein JH, et al. Lipoprotein management in patients with cardiometabolic risk: consensus conference report from the American Diabetes Association and the American College of Cardiology Foundation. J Am Coll Cardiol. 2008; 51(15): 1512–1524. doi: 10.1016/j.jacc.2008.02.034.
 
11.
Langsted A, Freiberg JJ, Nordestgaard BG. Fasting and nonfasting lipid levels: influence of normal food intake on lipids, lipoproteins, apolipoproteins, and cardiovascular risk prediction. Circulation 2008; 118(20): 2047–2056. doi: 10.1161/CIRCULATIONAHA.108.804146.
 
12.
Vesper HW, Wilson PW, Rifai N. A message from the laboratory community to the National Cholesterol Education Program Adult Treatment Panel IV. Clin Chem. 2012;58(3):523–527. doi: 10.1373/ clinchem.2011.178202.
 
13.
Catapano AL, Graham I, De Backer, Wiklund O, Chapman MJ, Drexel H, et al. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias: The Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) Developed with the special contribution of the European Assocciation for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016; 37(39): 2999–3058. doi: 10.1093/eurheartj/ehw272.
 
14.
Stępińska J, Solnica B, Kulpa J, Jankowski P, Kalarus Z, Opolski G, et al. The need to harmonize the target values of lipid research results in medical diagnostic laboratories in Poland. Diagn Lab. 2012; 48: 473–474.
 
15.
Teramoto T, Sasaki J, Ishibashi S, Birou S, Daida H, et al. Executive summary of the Japan Atherosclerosis Society (JAS) guidelines for the diagnosis and prevention of atherosclerotic cardiovascular diseases in Japan – 2012 version. J Atheroscler Thromb. 2013; 20(6): 517–523.
 
16.
Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 2004; 110(2): 227–239.
 
17.
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106(25): 3143–3421.
 
18.
An International Atherosclerosis Society Position Paper: Global recommendations for the management of dyslipidemia – full report. Expert Dyslipidemia Panel of the International Atherosclerosis Society Panel members. J Clin Lipidol. 2014; 8(1): 29–60. doi: 10.1016/j. jacl.2013.12.005.
 
19.
Bays HE, Jones PH, Orringer CE, Brown WV, Jacobson TA. National Lipid Association. National Lipid Association Annual Summary of Clinical Lipidology. J Clin Lipidol. 2016; 10(1 Suppl): S1–43. doi: 10.1016/j.jacl.2015.08.002.
 
20.
Lippi G, Banfi G, Church S, Cornes M, De Carli G, Grankvist K, et al. Preanalytical quality improvement. In pursuit of harmony, on behalf of European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working group for Preanalytical Phase (WG-PRE). Clin Chem Lab Med. 2015; 53(3): 357–370. doi: 10.1515/cclm-2014–1051.
 
21.
Hoerger TJ, Wittenborn JS, Young W. A cost-benefit analysis of lipid standardization in the UnitedStates. Prev Chronic Dis. 2011; 8(6): A136.
 
22.
Begum H, Li B, Shui G, Cazenave-Gassiot A, Soong R, Ong RT, et al. Discovering and validating between-subject variations in plasma lipids in healthy subjects. Sci Rep. 2016; 6: 19139. doi: 10.1038/srep19139.
 
23.
Zdrojewski T, Rutkowski M, Bandosz P, Gaciong Z, Jędrzejczyk T, Solnica B, et al. Prevalence and control of cardiovascular risk factors in Poland. Assumptions and objectives of the NATPOL 2011 Survey. Kardiol Pol. 2013; 71(4): 381–392. doi: 10.5603/KP.2013.0066.
 
24.
Craig SR, Amin RV, Russell DW, Paradise NF. Blood cholesterol screening influence of fasting state on cholesterol results and management decisions. J Gen Intern Med. 2000; 15(6): 395–399.
 
25.
Descamps OS, Cooney MT, De Backer G, Graham I. A simple multiplier to calculate the impact of HDL cholesterol on cardiovascular risk estimation using SCORE. Atherosclerosis 2012; 222(2): 564–566. doi: 10.1016/j.atherosclerosis.2012.03.035.
 
26.
Misra S, Moberg-Aakre K, Langlois M, Watine J, Twomey PJ, Oosterhuis WP, et al. How Useful are Laboratory Practice Guidelines? EJIFCC 2015; 26(3): 190–196.
 
27.
Flink L, Underberg JA, Newman JD, Gianos E. The recent national lipid association recommendations: how do they compare to other established dyslipidemia guidelines? Curr Atheroscler Rep. 2015; 17(4): 494. doi: 10.1007/s11883-015-0494-9.
 
28.
Sidhu D, Naugler C. Fasting time and lipid levels in a community-based population: a cross-sectional study. Arch Intern Med. 2012; 172(22): 1707–1710.
 
29.
Nordestgaard BG, Langsted A, Mora S, Kolovou G, Baum H, et al. Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut-points-a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. Eur Heart J. 2016; 37(25): 1944–1958. doi: 10.1093/eurheartj/ehw152.
 
30.
Bravo E, Napolitano M, Botham KM. Postprandial Lipid Metabolism: The Missing Link Between Life-Style Habits and the Increasing Incidence of Metabolic Diseases in Western Countries? The Open Translational Medicine Journal. 2010; 2: 1–13.
 
31.
Cybulska B, Szostak WB, Podolec P, Kopeć G, Naruszewic M, Undas A, et al. Polish Forum for Prevention Guidelines on Dyslipidaemia. Kardiol Pol. 2008; 66(11): 1239–1242.
 
32.
Lillo R, Salinas M, Lopez-Garrigos M, Naranjo-Santana Y, Gutiérrez M, Marín MD, et al. Reducing preanalytical laboratory sample errors through educational and technological interventions. Clin Lab. 2012; 58(9–10): 911–917.
 
33.
Plebani M. Towards a new paradigm in laboratory medicine: the five rights. Clin Chem Lab Med. 2016; 54(12): 1881–1891. doi: 10.1515/ cclm-2016-0848.
 
34.
Hata Y, Nakajima K. Life-style and serum lipids and lipoproteins. J Atheroscler Thromb. 2000; 7(4): 177–197.
 
35.
Jaksz-Recmanik E, Bobiński R. Pre-analytical errors in nurse practice. Probl Pielęg. 2011; 19(3): 386–390.
 
36.
Stańda-Nowakowska M, Zurzycka P, Repka I. Assessment of knowledge of patients responding to laboratory tests – preliminary results. Pielęg XXI w. 2014; 47(2): 11–15.
 
37.
Cramb R, French J, Mackness M, Neely RD, Caslake M, MacKenzie F. Lipid external quality assessment: commutability between external quality assessment and clinical specimens. Ann Clin Biochem. 2008; 45(Pt 3): 260–265. doi: 10.1258/acb.2007.007120.
 
38.
Fatati G. Sustainable diet: history lessons. Recenti Prog Med. 2015; 106(11): 540–544. doi: 10.1701/2074.22486.
 
39.
Thiengwiboonwong S, Chongsuwat R, Temcharoen P, Pandii W, Pavadhgul P. Efficacy of dietary modification following the National Cholesterol Education Program (NCEP) recommendation on lipid profiles among hyperlipidemia subjects. J Med Assoc Thai. 2013; 96(10): 1257–1267.
 
40.
Thompson RL, Summerbell CD, Hooper L, Higgins JPT, Little P, Talbot D, et al. Dietary advice given by a dietitian versus other health professional or self-help resources to reduce blood cholesterol. Cochrane Database Syst Rev. 2003; 3: CD001366.
 
41.
Reid R, Fodor G, Lydon-Hassen K, McCrea J, Bowlby M, Difrancesco L, et al. Dietary counselling for dyslipidemia in primary care: results of a randomized trial. Can J Diet Pract Res. 2002; 63(4): 169–175.
 
42.
Berry EM, Dernini S, Burlingame B, Meybeck A. Food security and sustainability: can one exist without the other? Public Health Nutr. 2015; 18(13): 2293–2302. doi: 10.1017/S136898001500021X. Epub 2015 Feb 16.
 
43.
Dudzińska M, Neć M, Zwolak A, Oszywa-Chabros A, Malicka J, Smoleń A, et al. The role of the primary care outpatient clinic in the promotion of healthy nutrition – preliminary reports. Fam Med Primary Care Rev. 2016; 18(3): 230–234.
 
44.
Imanaka M, Ando M, Kitamura T, Kawamura T. Impact of Registered Dietitian Expertise in Health Guidance for Weight Loss. PLoS One 2016; 11(3): e0151456. doi: 10.1371/journal.pone.0151456. eCollection 2016.
 
45.
Nazarewicz R. The effect of vegetarian diet on selected biochemical and blood morphology parameters. Rocz Panstw Zakl Hig. 2007; 58(1): 23–27.
 
46.
Sicińska P, Pytel E, Maćczak A, Koter-Michalak M. The use of various diet supplements in metabolic syndrome. Postepy Hig Med Dosw. 2015; 69: 25–33.
 
47.
Winiarska-Mieczan A, Mazurek K. Comparison of the nutritional value of traditional, semivegan and vegan diets. Żywienie Człowieka i Metabolizm. 2005; 3: 203–213.
 
48.
Bałasińska B, Mazur A. Oxidized dietary lipids may participate in the development of atherosclerosis. Postepy Hig Med Dosw. 2004; 58: 176–182.
 
49.
Hodson L, Skeaff CM, Chisholm WA. The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults. Eur J Clin Nutr. 2001; 55(10): 908–915.
 
50.
Li Y, Hruby A, Bernstein AM, Ley SH, Wang DD, Chiuve SE, et al. Saturated Fats Compared With Unsaturated Fats and Sources of Carbohydrates in Relation to Risk of Coronary Heart Disease: A Prospective Cohort Study. J Am Coll Cardiol. 2015; 66(14): 1538–1548. doi: 10.1016/j.jacc.2015.07.055.
 
51.
Mensink RP, Zock PL, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr. 2003; 77(5): 1146–1155.
 
52.
Nowicka G, Panczenko-Kresowska G. Hypolipidemic action of protein of legume seeds. Żywienie Człowieka i Metabolizm. 2005; 32: 47–53.
 
53.
Reynolds K, Chin A, Lees KA, Nguyen A, Bujnowski D, He J. A metaanalysis of the effect of soy protein supplementation on serum lipids. Am J Cardiol. 2006; 98(5): 633–640.
 
54.
Donini LM, Dernini S, Lairon D, Serra-Majem L, Amiot MJ, Del Balzo V, et al. A Consensus Proposal for Nutritional Indicators to Assess the Sustainability of a Healthy Diet: The Mediterranean Diet as a Case Study. Front Nutr. 2016; 3: 37. doi: 10.3389/fnut.2016.00037. eCollection 2016.
 
55.
Wu T, Fu J, Yang Y, Zhang L, Han J. The effects of phytosterols/stanols on blood lipid profiles: a systematic review with meta-analysis. Asia Pac J Clin Nutr. 2009; 18(2): 179–186.
 
56.
Mitjavila MT, Fandos M, Salas-Salvadó J, Covas MI, Borrego S, Estruch R, et al. The Mediterranean diet improves the systemic lipid and DNA oxidative damage in metabolic syndrome individuals. A randomized, controlled, trial. Clin Nutr. 2013; 32(2): 172–178. doi: 10.1016/j.clnu.2012.08.002.
 
57.
Richard C, Couture P, Desroches S, Charest A, Lamarche B. Effect of the Mediterranean diet with and without weight loss on cardiovascular risk factors in men with the metabolic syndrome. Nutr Metab Cardiovasc Dis. 2011; 21(9): 628–635. doi: 10.1016/j.numecd.2010.01.012.
 
58.
Park YM, Steck SE, Fung TT, Zhang J, Hazlett LJ, Han K, et al. Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH) style diet, and metabolic health in U.S. adults. Clin Nutr. 2017; 36(5): 1301–1309. doi: 10.1016/j.clnu.2016.08.018.
 
59.
Martínez-González MA, Salas-Salvadó J, Estruch R, Corella D, Fitó M, Ros E, et al. Benefits of the Mediterranean Diet: Insights From the PREDIMED Study. Prog Cardiovasc Dis. 2015; 58(1): 50–60. doi: 10.1016/j.pcad.2015.04.003.
 
60.
Ros E. The PREDIMED study. Endocrinol Diabetes Nutr. 2017; 64(2): 63–66. doi: 10.1016/j.endinu.2016.11.003.
 
61.
Dashti HM, Al-Zaid NS, Mathew TC, Al-Mousawi M, Talib H, Asfar SK, et al. Long term effects of ketogenic diet in obese subjects with high cholesterol level. Mol Cell Biochem. 2006; 286(1–2): 1–9.
 
62.
Wolfe BM, Piché LA. Replacement of carbohydrate by protein in a conventional-fat diet reduces cholesterol and triglyceride concentrations in healthy normolipidemic subjects. Clin Invest Med. 1999; 22(4): 140–148.
 
63.
Archer WR, Lamarche B, St-Pierre AC, Mauger JF, Deriaz O, Landry N, et al. High carbohydrate and high monounsaturated fatty acid diets similarly affect LDL electrophoretic characteristics in men who are losing weight. J Nutr. 2003; 133(10): 3124–3129.
 
64.
Grieb P, Kłapcińska B, Smól E, Pilis T, Pilis W, Sadowska-Krepa E, et al. Long-term consumption of a carbohydrate-restricted diet does not induce deleterious metabolic effects. Nutr Res. 2008; 28(12): 825–833. doi: 10.1016/j.nutres.2008.09.011.
 
65.
Harman NL, Leeds AR, Griffin BA. Increased dietary cholesterol does not increase plasma low density lipoprotein when accompanied by an energy-restricted diet and weight loss. Eur J Nutr. 2008; 47(6): 287–293. doi: 10.1007/s00394-008-0730-y.
 
66.
Dattilo AM, Kris-Etherton PM. Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. Am J Clin Nutr. 1992; 56(2): 320–328.
 
67.
Matthew J, Sharman MJ, Kraemer WJ, Love DM, Avery NG, Gómez AL, et al. A ketogenic diet favourably affects serum biomarkers for cardiovascular disease in normal-weight men. J Nutr. 2002; 132(7): 1879–1885.
 
68.
Bolesławska I, Przysławski J, Szczepanik A, Chuchracki M, Żwirska J. Lipid profile and parameters of oxidative stress in women and men using/applaying the optimal model of nutrition. Bromat Chem Toksykol. 2010; 3: 276–280.
 
69.
Winiarska-Mleczan A, Pyzik D. Evaluation of the nutritional value of menus, high-fat diet “optimal”. Żyw Człow Matab. 2006; 33: 73–82.
 
70.
Ciborowska H, Rudnicka A. Dietetics – Nutrition of healthy and sick individuals. Wyd. PZWL, Warszawa, 2014.
 
71.
Pesta DH, Samuel VT. A high-protein diet for reducing body fat: mechanisms and possible caveats. Nutr Metab. 2014; 11(1): 53. doi: 10.1186/1743-7075-11-53. eCollection 2014.
 
72.
Brar P, Kwon GY, Holleran S, Bai D, Tall AR, Ramakrishnan R, et al. Change in lipid profile in celiac disease: beneficial effect of gluten-free diet. Am J Med. 2006; 119(9): 786–790.
 
73.
Dittfeld A, Gwizdek K, Parol D, Michalski M. Glutenfree diet: Characteristics of target groups. Postepy Hig Med Dosw. 2018; 72: 227–239.
 
74.
Jenkins DJ, Kendall CW, Vidgen E, Augustin LS, van Erk M, Geelen A, et al. High-protein diets in hyperlipidemia, effect of wheat gluten on serum lipids, uric acid and renal function. Am J Clin Nutr. 2001; 74(1): 57–63.
 
75.
Antonio J, Ellerbroek A, Silver T, Vargas L, Tamayo A, Buehn R, et al. A High Protein Diet Has No Harmful Effects: A One-Year Crossover Study in Resistance-Trained Males. J Nutr Metab. 2016; 2016: 9104792.
 
76.
Schwingshackl L, Hoffmann G. Comparison of high vs. normal/low protein diets on renal function in subjects without chronic kidney disease: a systematic review and meta-analysis. PLoS One 2014; 9(5): e97656. doi: 10.1371/journal.pone.0097656. eCollection 2014.
 
77.
Theuwissen E, Mensink R. Water-soluble dietary fibers and cardiovascular disease. Physiol Behav. 2008; 94(2): 285–292. doi: 10.1016/j.physbeh.2008.01.001.
 
78.
Veldhorst M, Smeets A, Soenen S, Hochstenbach-Waelen A, Hursel R, Diepvens K, et al. Protein-induced satiety: effects and mechanisms of different proteins. Physiol Behav. 2008; 94(2): 300–307. doi: 10.1016/j. physbeh.2008.01.003.
 
79.
Anderson JW, Allgood LD, Turner J, Oeltgen PR, Daggy BP. Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia. Am J Clin Nutr. 1999; 70(4): 466–473.
 
80.
Brown L, Rosner B, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr. 1999; 69(1): 30–42.
 
81.
Wu H, Dwyer KM, Fan Z, Shircore A, Fan J, Dwyer JH. Dietary fiber and progression of atherosclerosis: The Los Angeles Atherosclerosis Study. Am J Clin Nutr. 2003; 78(6): 1085–1091.
 
82.
Mikołajczak J, Bator E, Bronkowska M, Piotrowska E, Orzeł D, Wyka J, et al. The value of the glycemic indexes and loads of selected cereals consumed with milk. Rocz Panstw Zakl Hig. 2012; 63(4): 433–440.
 
83.
Ciok J, Dolna A. The glycemic index, and lipid disorders. Żyw Człow Metab. 2005; 32: 38–45.
 
84.
Dumesnil JG, Turgeon J, Tremblay A, Poirier P, Gilbert M, Gagnon L, et al. Effect of a low-glycaemic index-low-fat-high protein diet on the atherogenic metabolic risk profile of abdominally obese men. Br J Nutr. 2001; 86(5): 557–568.
 
85.
Denova-Gitierrez E, Huitron-Bravo G, Talavera JO, Castañón S, Gallegos-Carrillo K, Flores Y, et al. Dietary glycemic index, dietary glycemic load, blood lipids and coronary heart disease. J Nutr Metab. 2010; 2010: 170680. doi: 10.1155/2010/170680.
 
86.
Fried SK, Frao SP. Sugars, hypertriglyceridemia and cardiovascular disease. Am J Clin Nutr. 2003; 78(4): 873S-880S.
 
87.
Venn BJ, Green TJ. Glycemic index and glycemic load: measurement issues and their effect on diet-disease relationships. Eur J Clin Nutr. 2007; 61: S122–S131.
 
88.
Adamska E, Górska M. Index and glycemic load. Przegl Kardiodiabetol. 2008; 3: 223–231.
 
89.
Shikany JM, Phadke RP, Redden DT, Gower BA. Effects of low- and high-glycemic index/glycemic load diets on coronary heart disease risk factors in overweight/obese men. Metabolism 2009; 58(12): 1793–1801. doi: 10.1016/j.metabol.2009.06.006.
 
90.
Slyper A, Jurva J, Pleuss J, Hoffmann R, Gutterman D. Influence of glycemic load on HDL cholesterol in youth. Am J Clin Nutr. 2005; 81(2): 376–379.
 
91.
The rules of proper nutrition. http://www.izz.waw.pl/pl?/ option=comcontent-&view=article&id=7. (access: 2019.04.17).
 
92.
Całyniuk B, Grochowska-Niedworok E, Białek A, Czech N, Kukielczak A. Food guide pyramid – its past and present. Probl Hig Epidemiol 2011; 92(1): 20–24.
 
93.
The Nutrition Sources. Harvard T.H.N. School Of Public Health. www.hsph.harvard.edu/nutrition.... (access: 2019.04.17).
 
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