TY - JOUR
TI - Glycemic index, glycemic load, and risk of coronary heart disease: A pan-European cohort study
AU - Sieri, S.
AU - Agnoli, C.
AU - Grioni, S.
AU - Weiderpass, E.
AU - Mattiello, A.
AU - Sluijs, I.
AU - Sanchez, M.J.
AU - Jakobsen, M.U.
AU - Sweeting, M.
AU - van der Schouw, Y.T.
AU - Nilsson, L.M.
AU - Wennberg, P.
AU - Katzke, V.A.
AU - Kühn, T.
AU - Overvad, K.
AU - Tong, T.Y.N.
AU - Conchi, M.-I.
AU - Quirós, J.R.
AU - García-Torrecillas, J.M.
AU - Mokoroa, O.
AU - Gómez, J.-H.
AU - Tjønneland, A.
AU - Sonestedt, E.
AU - Trichopoulou, A.
AU - Karakatsani, A.
AU - Valanou, E.
AU - Boer, J.M.A.
AU - Monique Verschuren, W.M.
AU - Boutron-Ruault, M.-C.
AU - Fagherazzi, G.
AU - Madika, A.-L.
AU - Bergmann, M.M.
AU - Schulze, M.B.
AU - Ferrari, P.
AU - Freisling, H.
AU - Lennon, H.
AU - Sacerdote, C.
AU - Masala, G.
AU - Tumino, R.
AU - Riboli, E.
AU - Wareham, N.J.
AU - Danesh, J.
AU - Forouhi, N.G.
AU - Butterworth, A.S.
AU - Krogh, V.
JO - AMERICAN JOURNAL OF CLINICAL NUTRITION
PY - 2020
VL - 112
TODO - 3
SP - 631-643
PB - Oxford University Press
SN - 0002-9165
TODO - 10.1093/ajcn/nqaa157
TODO - carbohydrate;  high density lipoprotein;  antihypertensive agent;  C reactive protein;  carbohydrate;  glucose;  hemoglobin A1c;  high density lipoprotein cholesterol;  low density lipoprotein cholesterol;  triacylglycerol, adult;  aged;  Article;  body mass;  cardiovascular risk;  cohort analysis;  dietary intake;  European;  female;  glycemic index;  glycemic load;  human;  ischemic heart disease;  major clinical study;  male;  proportional hazards model;  prospective study;  questionnaire;  sugar intake;  trend study;  coronary artery disease;  Europe;  middle aged;  risk assessment;  caloric intake;  carbohydrate analysis;  carbohydrate intake;  controlled study;  coronary risk;  diastolic blood pressure;  glucose blood level;  hypertension;  ICD-10;  observational study;  sex difference;  systolic blood pressure, Adult;  Aged;  Cohort Studies;  Coronary Artery Disease;  Europe;  Female;  Glycemic Index;  Glycemic Load;  Humans;  Male;  Middle Aged;  Risk Assessment
TODO - 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. Copyright © The Author(s) on behalf of the American Society for Nutrition 2020.
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