Περίληψη:
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.
Συγγραφείς:
Sieri, S.
Agnoli, C.
Grioni, S.
Weiderpass, E.
Mattiello, A.
Sluijs, I.
Sanchez, M.J.
Jakobsen, M.U.
Sweeting, M.
van der Schouw, Y.T.
Nilsson, L.M.
Wennberg, P.
Katzke, V.A.
Kühn, T.
Overvad, K.
Tong, T.Y.N.
Conchi, M.-I.
Quirós, J.R.
García-Torrecillas, J.M.
Mokoroa, O.
Gómez, J.-H.
Tjønneland, A.
Sonestedt, E.
Trichopoulou, A.
Karakatsani, A.
Valanou, E.
Boer, J.M.A.
Monique Verschuren, W.M.
Boutron-Ruault, M.-C.
Fagherazzi, G.
Madika, A.-L.
Bergmann, M.M.
Schulze, M.B.
Ferrari, P.
Freisling, H.
Lennon, H.
Sacerdote, C.
Masala, G.
Tumino, R.
Riboli, E.
Wareham, N.J.
Danesh, J.
Forouhi, N.G.
Butterworth, A.S.
Krogh, V.
Λέξεις-κλειδιά:
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
