Glycemic index, glycemic load, and risk of coronary heart disease: a pan-European cohort study. Issue 3 (3rd July 2020)

• Record Type: Journal Article
• Authors: Sieri, Sabina; Agnoli, Claudia; Grioni, Sara; Weiderpass, Elisabete; Mattiello, Amalia; Sluijs, Ivonne; Sanchez, Maria Jose; Jakobsen, Marianne Uhre; Sweeting, Michael; van der Schouw, Yvonne T; Nilsson, Lena Maria; Wennberg, Patrik; Katzke, Verena A; Kühn, Tilman; Overvad, Kim; Tong, Tammy Y N; Conchi, Moreno-Iribas; Quirós, José Ramón; García-Torrecillas, Juan Manuel; Mokoroa, Olatz; Gómez, Jesús-Humberto; Tjønneland, Anne; Sonestedt, Emiliy; Trichopoulou, Antonia; Karakatsani, Anna; Valanou, Elissavet; Boer, Jolanda M A; Verschuren, W M Monique; Boutron-Ruault, Marie-Christine; Fagherazzi, Guy; Madika, Anne-Laure; Bergmann, Manuela M; Schulze, Matthias B; Ferrari, Pietro; Freisling, Heinz; Lennon, Hannah; Sacerdote, Carlotta; Masala, Giovanna; Tumino, Rosario; Riboli, Elio; Wareham, Nicholas J; Danesh, John; Forouhi, Nita G; Butterworth, Adam S; Krogh, Vittorio;
• Is Part Of: American journal of clinical nutrition. Volume 112:Issue 3(2020)
• Page Start: 631
• Page End: 643
• Publication Date: 2020-07-03
• Subjects: glycemic index -- glycemic load -- coronary heart disease -- cohort study -- EPIC study -- EPIC-CVD study; Diet therapy -- Periodicals; Nutrition -- Periodicals; Dietetics -- Periodicals; 613.205
• DOI: 10.1093/ajcn/nqaa157
• Languages: English
• ISSNs: 0002-9165

Abstract

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 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/m 2 ) ≥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.