A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women

http://www.ajcn.org/cgi/content/abstract/71/6/1455

A prospective study of dietary glycemic load, carbohydrate intake, and
risk of coronary heart disease in US women1,2,3
Simin Liu, Walter C Willett, Meir J Stampfer, Frank B Hu, Mary Franz,
Laura Sampson, Charles H Hennekens and JoAnn E Manson
1 From the Departments of Epidemiology and Nutrition, the Harvard
School of Public Health; the Channing Laboratory; and the Division of
Preventive Medicine, the Department of Medicine, Brigham and Women's
Hospital and Harvard Medical School, Boston.


Background: Little is known about the effects of the amount and type
of carbohydrates on risk of coronary heart disease (CHD).

Objective: The objective of this study was to prospectively evaluate
the relations of the amount and type of carbohydrates with risk of
CHD.

Design: A cohort of 75521 women aged 38-63 y with no previous
diagnosis of diabetes mellitus, myocardial infarction, angina, stroke,
or other cardiovascular diseases in 1984 was followed for 10 y. Each
participant's dietary glycemic load was calculated as a function of
glycemic index, carbohydrate content, and frequency of intake of
individual foods reported on a validated food-frequency questionnaire
at baseline. All dietary variables were updated in 1986 and 1990.

Results: During 10 y of follow-up (729472 person-years), 761 cases of
CHD (208 fatal and 553 nonfatal) were documented. Dietary glycemic
load was directly associated with risk of CHD after adjustment for
age, smoking status, total energy intake, and other coronary disease
risk factors. The relative risks from the lowest to highest quintiles
of glycemic load were 1.00, 1.01, 1.25, 1.51, and 1.98 (95% CI: 1.41,
2.77 for the highest quintile; P for trend < 0.0001). Carbohydrate
classified by glycemic index, as opposed to its traditional
classification as either simple or complex, was a better predictor of
CHD risk. The association between dietary glycemic load and CHD risk
was most evident among women with body weights above average [ie, body
mass index (in kg/m2) 23].

Conclusion: These epidemiologic data suggest that a high dietary
glycemic load from refined carbohydrates increases the risk of CHD,
independent of known coronary disease risk factors.

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TC

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