TY - JOUR

T1 - Glycemic index, glycemic load, and risk of coronary heart disease

T2 - A pan-European cohort study

AU - Sieri, Sabina

AU - Agnoli, Claudia

AU - Grioni, Sara

AU - Weiderpass, Elisabete

AU - Mattiello, Amalia

AU - Sluijs, Ivonne

AU - Sanchez, Maria Jose

AU - Jakobsen, Marianne Uhre

AU - Sweeting, Michael

AU - van der Schouw, Yvonne T.

AU - Nilsson, Lena Maria

AU - Wennberg, Patrik

AU - Katzke, Verena A.

AU - Kühn, Tilman

AU - Overvad, Kim

AU - Tong, Tammy Y.N.

AU - Conchi, Moreno Iribas

AU - Quirós, José Ramón

AU - García-Torrecillas, Juan Manuel

AU - Mokoroa, Olatz

AU - Gómez, Jesús Humberto

AU - Tjønneland, Anne

AU - Sonestedt, Emiliy

AU - Trichopoulou, Antonia

AU - Karakatsani, Anna

AU - Valanou, Elissavet

AU - Boer, Jolanda M.A.

AU - Monique Verschuren, W. M.

AU - Boutron-Ruault, Marie Christine

AU - Fagherazzi, Guy

AU - Madika, Anne Laure

AU - Bergmann, Manuela M.

AU - Schulze, Matthias B.

AU - Ferrari, Pietro

AU - Freisling, Heinz

AU - Lennon, Hannah

AU - Sacerdote, Carlotta

AU - Masala, Giovanna

AU - Tumino, Rosario

AU - Riboli, Elio

AU - Wareham, Nicholas J.

AU - Danesh, John

AU - Forouhi, Nita G.

AU - Butterworth, Adam S.

AU - Krogh, Vittorio

PY - 2020

Y1 - 2020

N2 - 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.

AB - 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.

KW - Cohort study

KW - Coronary heart disease

KW - EPIC study

KW - EPIC-CVD study

KW - Glycemic index

KW - Glycemic load

U2 - 10.1093/ajcn/nqaa157

DO - 10.1093/ajcn/nqaa157

M3 - Journal article

C2 - 32619242

AN - SCOPUS:85090170246

VL - 112

SP - 631

EP - 643

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

SN - 0002-9165

IS - 3

ER -