Glycemic index, glycemic load, and risk of coronary heart disease: a pan-European cohort study.
Sabina Sieri
(1)
,
Claudia Agnoli
(1)
,
Sara Grioni
(1)
,
Elisabete Weiderpass
(2)
,
Amalia Mattiello
(3)
,
Ivonne Sluijs
(4)
,
Maria Jose Sanchez
(5)
,
Marianne Uhre Jakobsen
(6)
,
Michael Sweeting
(7)
,
Yvonne T. van der Schouw
(4)
,
Lena Maria Nilsson
(8)
,
Patrik Wennberg
(9)
,
Verena A. Katzke
(10)
,
Tilman Kühn
(10)
,
Kim Overvad
(11)
,
Tammy Y. N. Tong
(12)
,
Moreno-Iribas Conchi
(13)
,
José Ramón Quirós
,
Juan Manuel García-Torrecillas
(14)
,
Olatz Mokoroa
(15)
,
Jesús-Humberto Gómez
(16)
,
Anne Tjønneland
(17)
,
Emiliy Sonestedt
(18)
,
Antonia Trichopoulou
(19)
,
Anna Karakatsani
(19)
,
Elissavet Valanou
(19)
,
Jolanda M. A. Boer
(20)
,
W. Monique M. Verschuren
(20)
,
Marie-Christine Boutron-Ruault
(21)
,
Guy Fagherazzi
(21)
,
Anne-Laure Madika
(22)
,
Manuela M. Bergmann
(23)
,
Matthias B. Schulze
(24)
,
Pietro Ferrari
(25)
,
Heinz Freisling
(25)
,
Hannah Lennon
(2)
,
Carlotta Sacerdote
(26)
,
Giovanna Masala
,
Rosario Tumino
(27)
,
Elio Riboli
(28)
,
Nicholas J. Wareham
(7)
,
John Danesh
(7)
,
Nita G. Forouhi
(7)
,
Adam S. Butterworth
(7)
,
Vittorio Krogh
(1)
1
IRCCS Istituto Nazionale dei Tumori [Milano]
2 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
3 University of Naples Federico II = Università degli studi di Napoli Federico II
4 Julius Center for Health Sciences and Primary Care
5 Andalusian School of Public Health [Granada]
6 DTU - Danmarks Tekniske Universitet = Technical University of Denmark
7 CAM - University of Cambridge [UK]
8 Nus - Umeå University Hospital = Norrlands universitetssjukhus
9 Umeå University, Sweden
10 DKFZ - German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg]
11 Aarhus University [Aarhus]
12 University of Oxford
13 UNAV - Universidad de Navarra [Pamplona]
14 UAL - Universidad de Almería
15 BIODonostia Research Institute
16 Universidad de Murcia
17 Department of Public Health [Copenhagen]
18 Lund University
19 Hellenic Health Foundation
20 RIVM - National Institute for Public Health and the Environment [Bilthoven]
21 CESP - Centre de recherche en épidémiologie et santé des populations
22 METRICS - Evaluation des technologies de santé et des pratiques médicales - ULR 2694
23 DIfE - German Institute of Human Nutrition Potsdam-Rehbrücke
24 University of Potsdam = Universität Potsdam
25 IACR - International Agency for Cancer Research
26 Azienda Ospedalerio - Universitaria Città della Salute e della Scienza di Torino = University Hospital Città della Salute e della Scienza di Torino
27 Civile - M.P.Arezzo Hospital
28 Imperial College London
2 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
3 University of Naples Federico II = Università degli studi di Napoli Federico II
4 Julius Center for Health Sciences and Primary Care
5 Andalusian School of Public Health [Granada]
6 DTU - Danmarks Tekniske Universitet = Technical University of Denmark
7 CAM - University of Cambridge [UK]
8 Nus - Umeå University Hospital = Norrlands universitetssjukhus
9 Umeå University, Sweden
10 DKFZ - German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg]
11 Aarhus University [Aarhus]
12 University of Oxford
13 UNAV - Universidad de Navarra [Pamplona]
14 UAL - Universidad de Almería
15 BIODonostia Research Institute
16 Universidad de Murcia
17 Department of Public Health [Copenhagen]
18 Lund University
19 Hellenic Health Foundation
20 RIVM - National Institute for Public Health and the Environment [Bilthoven]
21 CESP - Centre de recherche en épidémiologie et santé des populations
22 METRICS - Evaluation des technologies de santé et des pratiques médicales - ULR 2694
23 DIfE - German Institute of Human Nutrition Potsdam-Rehbrücke
24 University of Potsdam = Universität Potsdam
25 IACR - International Agency for Cancer Research
26 Azienda Ospedalerio - Universitaria Città della Salute e della Scienza di Torino = University Hospital Città della Salute e della Scienza di Torino
27 Civile - M.P.Arezzo Hospital
28 Imperial College London
José Ramón Quirós
- Fonction : Auteur
Guy Fagherazzi
- Fonction : Auteur
- PersonId : 775675
- ORCID : 0000-0001-5033-5966
- IdRef : 152542043
Giovanna Masala
- Fonction : Auteur
Résumé
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.