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Glycemic index, glycemic load, and risk of coronary heart disease : a pan-European cohort study

Sieri, Sabina ; Agnoli, Claudia ; Grioni, Sara ; Weiderpass, Elisabete ; Mattiello, Amalia ; Sluijs, Ivonne ; Sanchez, Maria Jose ; Jakobsen, Marianne Uhre ; Sweeting, Michael and van der Schouw, Yvonne T. , et al. (2020) In The American journal of clinical nutrition 112(3). p.631-643
Abstract

BACKGROUND: High carbohydrate intake raises blood triglycerides, glucose, and insulin; reduces HDLs; and may increase risk of coronary heart disease (CHD). Epidemiological studies indicate that high dietary glycemic index (GI) and glycemic load (GL) are associated with increased CHD risk. OBJECTIVES: The aim of this study was to determine whether dietary GI, GL, and available carbohydrates are associated with CHD risk in both sexes. METHODS: This large prospective study-the European Prospective Investigation into Cancer and Nutrition-consisted of 338,325 participants who completed a dietary questionnaire. HRs with 95% CIs for a CHD event, in relation to intake of GI, GL, and carbohydrates, were estimated using covariate-adjusted Cox... (More)

BACKGROUND: High carbohydrate intake raises blood triglycerides, glucose, and insulin; reduces HDLs; and may increase risk of coronary heart disease (CHD). Epidemiological studies indicate that high dietary glycemic index (GI) and glycemic load (GL) are associated with increased CHD risk. OBJECTIVES: The aim of this study was to determine whether dietary GI, GL, and available carbohydrates are associated with CHD risk in both sexes. METHODS: This large prospective study-the European Prospective Investigation into Cancer and Nutrition-consisted of 338,325 participants who completed a dietary questionnaire. HRs with 95% CIs for a CHD event, in relation to intake of GI, GL, and carbohydrates, were estimated using covariate-adjusted Cox proportional hazard models. RESULTS: After 12.8 y (median), 6378 participants had experienced a CHD event. High GL was associated with greater CHD risk [HR 1.16 (95% CI: 1.02, 1.31) highest vs. lowest quintile, p-trend 0.035; HR 1.18 (95% CI: 1.07, 1.29) per 50 g/day of GL intake]. The association between GL and CHD risk was evident in subjects with BMI (in kg/m2) ≥25 [HR: 1.22 (95% CI: 1.11, 1.35) per 50 g/d] but not in those with BMI <25 [HR: 1.09 (95% CI: 0.98, 1.22) per 50 g/d) (P-interaction = 0.022). The GL-CHD association did not differ between men [HR: 1.19 (95% CI: 1.08, 1.30) per 50 g/d] and women [HR: 1.22 (95% CI: 1.07, 1.40) per 50 g/d] (test for interaction not significant). GI was associated with CHD risk only in the continuous model [HR: 1.04 (95% CI: 1.00, 1.08) per 5 units/d]. High available carbohydrate was associated with greater CHD risk [HR: 1.11 (95% CI: 1.03, 1.18) per 50 g/d]. High sugar intake was associated with greater CHD risk [HR: 1.09 (95% CI: 1.02, 1.17) per 50 g/d]. CONCLUSIONS: This large pan-European study provides robust additional support for the hypothesis that a diet that induces a high glucose response is associated with greater CHD risk.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cohort study, coronary heart disease, EPIC study, EPIC-CVD study, glycemic index, glycemic load
in
The American journal of clinical nutrition
volume
112
issue
3
pages
13 pages
publisher
American Society for Clinical Nutrition
external identifiers
  • pmid:32619242
  • scopus:85090170246
ISSN
1938-3207
DOI
10.1093/ajcn/nqaa157
language
English
LU publication?
yes
id
71813e92-8cae-4d78-adf3-9497864000c8
date added to LUP
2020-09-25 11:28:35
date last changed
2020-09-27 01:59:49
@article{71813e92-8cae-4d78-adf3-9497864000c8,
  abstract     = {<p>BACKGROUND: High carbohydrate intake raises blood triglycerides, glucose, and insulin; reduces HDLs; and may increase risk of coronary heart disease (CHD). Epidemiological studies indicate that high dietary glycemic index (GI) and glycemic load (GL) are associated with increased CHD risk. OBJECTIVES: The aim of this study was to determine whether dietary GI, GL, and available carbohydrates are associated with CHD risk in both sexes. METHODS: This large prospective study-the European Prospective Investigation into Cancer and Nutrition-consisted of 338,325 participants who completed a dietary questionnaire. HRs with 95% CIs for a CHD event, in relation to intake of GI, GL, and carbohydrates, were estimated using covariate-adjusted Cox proportional hazard models. RESULTS: After 12.8 y (median), 6378 participants had experienced a CHD event. High GL was associated with greater CHD risk [HR 1.16 (95% CI: 1.02, 1.31) highest vs. lowest quintile, p-trend 0.035; HR 1.18 (95% CI: 1.07, 1.29) per 50 g/day of GL intake]. The association between GL and CHD risk was evident in subjects with BMI (in kg/m2) ≥25 [HR: 1.22 (95% CI: 1.11, 1.35) per 50 g/d] but not in those with BMI &lt;25 [HR: 1.09 (95% CI: 0.98, 1.22) per 50 g/d) (P-interaction = 0.022). The GL-CHD association did not differ between men [HR: 1.19 (95% CI: 1.08, 1.30) per 50 g/d] and women [HR: 1.22 (95% CI: 1.07, 1.40) per 50 g/d] (test for interaction not significant). GI was associated with CHD risk only in the continuous model [HR: 1.04 (95% CI: 1.00, 1.08) per 5 units/d]. High available carbohydrate was associated with greater CHD risk [HR: 1.11 (95% CI: 1.03, 1.18) per 50 g/d]. High sugar intake was associated with greater CHD risk [HR: 1.09 (95% CI: 1.02, 1.17) per 50 g/d]. CONCLUSIONS: This large pan-European study provides robust additional support for the hypothesis that a diet that induces a high glucose response is associated with greater CHD risk.</p>},
  author       = {Sieri, Sabina and Agnoli, Claudia and Grioni, Sara and Weiderpass, Elisabete and Mattiello, Amalia and Sluijs, Ivonne and Sanchez, Maria Jose and Jakobsen, Marianne Uhre and Sweeting, Michael and van der Schouw, Yvonne T. and Nilsson, Lena Maria and Wennberg, Patrik and Katzke, Verena A. and Kühn, Tilman and Overvad, Kim and Tong, Tammy Y.N. and Conchi, Moreno Iribas and Quirós, José Ramón and García-Torrecillas, Juan Manuel and Mokoroa, Olatz and Gómez, Jesús Humberto and Tjønneland, Anne and Sonestedt, Emiliy and Trichopoulou, Antonia and Karakatsani, Anna and Valanou, Elissavet and Boer, Jolanda M.A. and Verschuren, W. M.Monique and Boutron-Ruault, Marie Christine and Fagherazzi, Guy and Madika, Anne Laure and Bergmann, Manuela M. and Schulze, Matthias B. and Ferrari, Pietro and Freisling, Heinz and Lennon, Hannah and Sacerdote, Carlotta and Masala, Giovanna and Tumino, Rosario and Riboli, Elio and Wareham, Nicholas J. and Danesh, John and Forouhi, Nita G. and Butterworth, Adam S. and Krogh, Vittorio},
  issn         = {1938-3207},
  language     = {eng},
  number       = {3},
  pages        = {631--643},
  publisher    = {American Society for Clinical Nutrition},
  series       = {The American journal of clinical nutrition},
  title        = {Glycemic index, glycemic load, and risk of coronary heart disease : a pan-European cohort study},
  url          = {http://dx.doi.org/10.1093/ajcn/nqaa157},
  doi          = {10.1093/ajcn/nqaa157},
  volume       = {112},
  year         = {2020},
}