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ORIGINAL ARTICLE

HIGH GLYCEMIC FOOD CONSUMPTION AND NUTRITIONAL STATUS AMONG ADOLESCENTS

IN ABBOTTABAD, PAKISTAN

Anwar Shahzad

, Malik Fayyaz Hussain Awaan

, Maheen Shah

, Amber Tasnim

, Anila Farid

ABSTRACT

OBJECTIVES

The study aimed to investigate the correlation between high glycemic food

consumption and nutritional status among adolescent students in government

and private schools.

METHODOLOGY

A cross-sectional study was conducted over 6 months on 350 adolescent

students aged 14 to 19 years studying in government and private schools,

selected through simple random sampling in Abbottabad between January

2025 and June 2025. Nutritional status was assessed through selective

anthropometric measurements, while glycemic loads were calculated using

standard parameters from a food frequency questionnaire (FFQ). SPSS 26

version was used for descriptive and inferential analysis

RESULTS

Among 350 students of 14 to 19 years included (53%) male and (47%) female

students of Govt School (53.8%) and Private school (46.2%) students,205

girls participated in the study. Results show that the minimum weight of the

participants was 41 kg, with a maximum of 84 kg and a mean of 57.25 kg.

The minimum height was 132 cm, and the maximum was 185 cm, with a mean

of 162.97 cm. Waist circumference was minimum 65 cm and maximum 95 cm,

with a mean of 76 cm, and (σ) was 6.69. Hip circumference was minimum

78.5 cm and maximum 100 cm, with a mean of 86.46 cm, and (σ) was 4.41.

Waist/Hip ratio was minimum 0.76 cm and maximum 0.97 with a mean of .88,

and (σ) was. 055. Glycemic load was 94, with a minimum and maximum of

168, with 120.42 mean and a standard deviation (σ) of 13.15. Z scores were

1.67, the minimum and maximum were 2.74, and the standard deviation (σ)

was 10.0. Z-scores and Glycemic loads also showed a correlation with p-

values of 0.5. However, with a p -value of 0.02, a robust correlation was

found between the waist-hip ratio and Glycemic loads of foods. Additionally,

p-values of 0.03 with a correlation coecient of 0.2 and p-values of 0.00 in a

2-tailed test showed a strong correlation.

CONCLUSION

A high frequency of SSI was observed following primary closure in enteric

perforation. Neither age nor gender was signicantly associated with SSI,

indicating that other factors, such as contamination level, surgical technique,

and perioperative management, may play a more critical role. Consideration

of delayed primary closure and strict infection-control measures may help

reduce SSI in these high-risk cases.

KEYWORDS: Anthropometric Measurements, Circumference, Correlation,

FFQ (Food Frequency Questionnaire, Glycemic Loads

How to cite this article

Shahzad A, Awaan MFH, Shah M,

Tasnim A, Farid A. High Glycemic

Food Consumption and Nutritional

Status among Adolescents in

Abbottabad, Pakistan. J Gandhara Med

Dent Sci. 2025;12(4):102-105. https://doi.

org/10.37760/jgmds.12-4.667

Date of Submission: 31-08-2025

Date Revised: 25-09-2025

Date Acceptance: 27-09-2025

Senior Registrar, Department of

Endocrinology, Abbottabad International

Medical Institute, Abbottabad

Associate Professor, Department of

Physiology, Abbottabad International

Medical Institute, Abbottabad

Assistant Professor, Department of

Medicine, Abbottabad International

Medical Institute, Abbottabad

Lecturer, Department of Biochemistry,

Abbottabad International Medical

Institute, Abbottabad

Correspondence

Anwar Shahzad, Associate Professor,

Department of Community Medicine,

Abbottabad International Medical

Institute, Abbottabad

+92-3142244567

redline.shahzad@gmail.com

INTRODUCTION

The glycemic load (GL) of food is an important dietary

concept that combines both the glycemic index (GI) and

the carbohydrate content of food to estimate how much

a food will raise a person’s blood glucose level.

In the

context of adolescents, understanding the relationship

between glycemic load and anthropometric

measurements (such as BMI, weight, waist

circumference, body fat %, etc.) is increasingly

important due to the rising rates of childhood and

adolescent obesity, type 2 diabetes, and other metabolic

disorders.

High-GL foods cause rapid glucose spikes

followed by insulin surges and eventual hypoglycemia,

leading to increased hunger and overeating.

Insulin and

Fat Storage: Insulin promotes fat storage; frequent

spikes in insulin levels may contribute to increased

body fat.

Chronic high-GL diets may induce low-grade

inammation, promoting adipose tissue, and may

inuence hormones such as leptin and Ghrelin that

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regulate appetite.

Cardiovascular diseases, cancer, and

other health problems, such as age-related macular

degeneration.

Several pieces of evidence regarding the

effects of dietary GL on diabetes, obesity, and

hypertension in adolescents have been noted.

The

comparison of a low-glycemic-load diet showed neutral

effects on obesity in adulthood; observational studies

have reported controversial ndings among children.

Waist circumference (WC), Body mass index (BMI),

and body fat were evaluated in the mentioned studies.

Some studies have focused on a single meal, examining

appetite, satiety, food intake, and energy intake.

METHODOLOGY

RESULTS

A study was carried out on 350 students, including

adolescent age students between 14 and 19 years, which

included (54%) male and (46%) female students. This

study includes students from government schools (55%)

and private schools (45%). Findings were based on

Nutritional measurements, including anthropometric

measurements, nutritional behavior, and Glycemic

consumption of food. Table 1 shows that the minimum

weight of the participants was 41 kg, the maximum was

84 kg, and the mean was 57.25 kg. Waist/Hip ratio was

minimum 0.76 cm and maximum 0.97, with a standard

deviation of 0.05. The Maximum Glycemic load was

168 with a standard deviation (σ). Maximum Z scores

were 2.74, with a 1.54 mean and a standard deviation

(σ) of 1.00. The table shows the. Correlation of the

dierent variables with p values and 2-tailed Pearson

correlation. There is a positive correlation with

significant p-values of 0.05 between weight and

Glycemic loads; likewise, Z-scores and Glycemic loads

also show correlations with p-values of 0.05. There is a

robust correlation between waist-hip ratio and

Glycemic loads of foods, with a p-value of 0.03.

Table 1: Demographics of the participants

Descriptive

statistics

Minimu

Maxim

Mean Std.

Deviat

ion

Weight of the

participants (Kg)

41 Kg 84 Kg 57Kg 3.7

Waist-Hip Ratio

of the participants

0.76 0.97 0.88 2.1

Glycemic load of

the participants

94.00 168.00 120.42 2.2

Z Scores 1.06 2.74 1.54 1.00

Table 2: Correlation of the Demographic DATA to Nutritional

DATA

Glyce

mic

Load

Scores

Daily

caloric

count

Waist-

Hip

Ratio

Weig

(Kg)

Glycem

ic Load

Pearson

Correlation

- +0.6 +0.7 +0.3 +0.6

Sig. (2-

tailed)

- 0.00 0.00 0.00 0.00

Scores

Pearson

Correlation

+0.6 +1 +1 +0.5 +1.0

Sig. (2-

tailed)

0.00 - 0.00 0.00 0.00

Daily

caloric

count

Pearson

Correlation

+0.8 +0.6 +1 0.0 +0.6

Sig. (2-

tailed)

0.00 0.00 - 0.00 0.00

Waist-

Hip

Ratio

Pearson

Correlation

+0.5 +0.5 +0.35

+1 +0.5

Sig. (2-

tailed)

0.00 0.00 0.00 - 0.00

Weight

(Kg)

Pearson

Correlation

+0.6 +0.8 +0.6 +0.5 +1

Sig. (2-

tailed)

0.00 0.00 0.00 0.00 -

Figure 1: Shows a Strong Positive Correlation between Glycemic

Load and the Weights of the Study Population

High Glycemic Food Consumption and Nutritional Status

A cross-sectional study was conducted among 350

students from the 14-year to 19-year age group with no

apparent metabolic disorders in selected Government

and private schools of Abbottabad. Ethical Approval was

taken from the institution having reference:R/AIMC/

14/2025, dated: 2nd January 2025. Students were

selected through simple random sampling, including

both girls and boys. Students below 13 years of age and

those above 19 Years of age, as well as those with

apparent metabolic disorders, were excluded. To conduct

this research, dierent study tools were used, including

FFQs, Anthropometric measurements (such as weight,

Height, BMI, and waist circumference), and a survey

questionnaire. The research primarily focused on

observing the dietary habits of the students in relation to

the glycemic loads of the foods consumed by the study

population. The specied FFQ was used to measure the

grams of dierent foods consumed, and the standard

Glycemic index of the consumed foods was used to

calculate the glycemic loads of the foods. GL (Glycemic

Load) = Glycemic Index x Grams (food consumed)/100.

Z-scores of the values were calculated by the formula Z=

X-ꭒ/ȏ. SPSS version 26 was used for statistical analysis.

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Figure 2: Shows a Strong Correlation between Glycemic Load

and the Waist/Hip Ratio

Figure 3: Glycemic Load with Daily Caloric Count

Figure 4: Glycemic Load with Z Scores

DISCUSSION

Study shows a positive correlation with signicant P

values 0.00 with Gender and weight, Glycemic loads,

and Z scores show a strong correlation with p values <

0.05. A study by Murakami et al.

(2011) focused on a

food frequency questionnaire designed to assess daily

food intake. Nutrient proles gathered from the FFQ

were compared with those obtained from a self-report

assessment form compiled after every meal.

In this

study, regression analysis and correlation coecients

were calculated using the data obtained from the food

frequency questionnaire and the self-report forms.

Correlation coecients ranged from 0.23 to 0.91, with

85% of the values exceeding 0.50 and 55% exceeding

0.71, as noted in the study by Previa et al.

A study by

Queiro et al does not support an eect of GL on weight

change. The positive and signicant association

between GL and subsequent gain in waist

circumference may imply a benecial role of lower GI

diets in preventing abdominal obesity. An Italian study

in both genders also showed a positive association

between GL and BMI. However, data from

subpopulations of a Danish cohort presented a different

picture from that presented in the Italian study.

There

was a positive association between GL and BMI in

sedentary Danish women, with the more remarkable

association likewise in school-age children in Hong

Kong, Latino teens, Danish girls under 16 years old,

and Danish boys under 10 years, However, in Danish

boys 10-16 years old, observed positive association

between GL and skin fold measures of fatness.

Numerous studies conrm that weight loss can occur in

the short term (less than 6 months) when dietitians

employ a low-glycemic index (low GI) strategy

compared to other diet strategies. However, in strictly

controlled calories, the GL of the diet makes no

difference.

Such ndings were armed in a Cochrane

review. Mean BMI lowered from the lowest to the

highest tertile of Gl by 26.59 to 26.18 kg/m² in men (p

~ 0.03), and by 24.71 to 25.69 kg/m² in women (p <

0.001).

A recent randomized trial of 330 individuals

with obesity (mean BMI = 36) in a dieting situation

with intensive behavioral interventions showed that a

reduced-carbohydrate, low-glycemic index diet

achieved the same weight loss over 2 years.

Based on

the ndings, it can be assumed that overweight/obese

adolescents from public schools were more responsive

to the study recruitment and more homogeneously

interested in being evaluated. In a study conducted by

Smith et al., Waist circumference and waist-to-hip ratio

were the strongest predictors of BMI (p = 0.001). Over

one-third of the participants were overweight.

LIMITATIONS

This study is limited to adolescent-age students, whose

dietary habits are often disrupted by their busy

schedules.

CONCLUSIONS

High glycemic loads of food consumed in

the

High Glycemic Food Consumption and Nutritional Status

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J Gandhara Med Dent Sci

October - December 2025

adolescent age group result in a deranged nutritional

status and weight gain. Additionally, other parameters,

such as waist circumference and waist-to-hip ratios, are

affected by the consumption of high-glycemic foods in

adolescent age groups.

CONFLICT OF INTEREST: None

FUNDING SOURCES: None

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AUTHORS CONTRIBUTION

The authors accept responsibility for all aspects of the work

and will ensure that any concerns regarding the accuracy or

integrity of any part are properly investigated and resolved.

Anwar Shahzad - Concept & Design; Data

Analysis/Interpretation; Drafting Manuscript; Final Approval

Malik Fayyaz Hussain Awaan - Concept & Design; Data

Acquisition; Drafting Manuscript; Final Approval

Maheen Shah - Concept & Design; Data

Analysis/Interpretation; Drafting Manuscript; Critical

Revision; Final Approval

Amber Tasnim - Concept & Design; Data Acquisition; Drafting

Manuscript; Supervision; Final Approval

Anila Farid - Concept & Design; Data Analysis/Interpretation;

Drafting Manuscript; Final Approval

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High Glycemic Food Consumption and Nutritional Status