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

Little is known about the effects of the amount and type of carbohydrates on risk of coronary heart disease (CHD). The objective of this study was to prospectively evaluate the relations of the amount and type of carbohydrates with risk of CHD. A cohort of 75521 women aged 38-63 y with no previous d...

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Bibliographic Details
Published in:The American journal of clinical nutrition 2000-06, Vol.71 (6), p.1455-1461
Main Authors: SIMIN LIU, WILLETT, W. C, STAMPFER, M. J, HU, F. B, FRANZ, M, SAMPSON, L, HENNEKENS, C. H, MANSON, J. E
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Blood Glucose - metabolism
Body Mass Index
Carbohydrates
Cardiology. Vascular system
Cardiovascular disease
Cohort Studies
Coronary Disease - epidemiology
Coronary heart disease
Diet
Dietary Carbohydrates - administration & dosage
Dietary Fats - administration & dosage
Dietary Fiber - administration & dosage
Edible Grain
Female
Folic Acid - administration & dosage
Heart
Humans
Medical research
Medical sciences
Middle Aged
Nurses
Prospective Studies
Risk Factors
United States
Vitamin E - administration & dosage
Women
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Summary:Little is known about the effects of the amount and type of carbohydrates on risk of coronary heart disease (CHD). The objective of this study was to prospectively evaluate the relations of the amount and type of carbohydrates with risk of CHD. 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. 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/m(2)) >/= 23. 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.
ISSN:0002-9165
1938-3207
DOI:10.1093/ajcn/71.6.1455