Journal article
Glycemic index, glycemic load, and risk of coronary heart disease: a pan-European cohort study
Istituto Nazionale dei Tumori1
German Cancer Research Center2
Aarhus University3
Oxford University Press4
Public University of Navarre5
Ministry of Health, Consumption and Social Welfare6
Torrecárdenas University Hospital7
BioDonostia Health Research Institute8
Department of Epidemiology Lazio Regional Health Service9
Danish Cancer Society10
Lund University Hospital11
International Agency for Research on Cancer12
Hellenic Health Foundation13
National Institute of Public Health and the Environment14
University of Paris-Sud - University of Paris XI15
German Institute of Human Nutrition Potsdam-Rehbruecke16
University-Hospital and Center for Cancer Prevention17
Ludwig Institute for Cancer Research18
'Civic MP Arezzo' Hospital19
Imperial College London20
University of Cambridge21
University of Naples Federico II22
Utrecht University of Applied Sciences23
Andalusian School of Public Health24
Research Group for Risk Benefit, National Food Institute, Technical University of Denmark25
National Food Institute, Technical University of Denmark26
Cambridge University Press27
Umeå University28
...and 18 moreBACKGROUND: 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.
Language: | English |
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Publisher: | Oxford University Press |
Year: | 2020 |
Pages: | 631-643 |
ISSN: | 19383207 and 00029165 |
Types: | Journal article |
DOI: | 10.1093/ajcn/nqaa157 |
ORCIDs: | 0000-0001-6429-7921 , 0000-0001-5201-172X , 0000-0003-4472-1179 , 0000-0002-5891-8426 , 0000-0002-6509-6555 , 0000-0003-3831-6089 , 0000-0003-4385-2097 , 0000-0002-0747-4562 , 0000-0002-7204-6396 , 0000-0002-3275-2026 , 0000-0002-9714-4304 , 0000-0001-5033-5966 , 0000-0002-0830-5277 , 0000-0001-8648-4998 , 0000-0002-8008-5096 , 0000-0001-6795-6080 , 0000-0003-1422-2993 , 0000-0002-5041-248X , 0000-0003-0122-8624 and Jakobsen, Marianne Uhre |
Adult Aged Cohort Studies Cohort study Coronary Artery Disease Coronary heart disease EPIC study EPIC-CVD study Europe Female Glycemic Index Glycemic Load Glycemic index Glycemic load Humans Male Middle Aged Risk Assessment cohort study coronary heart disease glycemic index glycemic load