Glycemic index, glycemic load, and risk of coronary heart disease: a pan-European cohort study-Reference-Cited by-同舟云学术

Glycemic index, glycemic load, and risk of coronary heart disease: a pan-European cohort study

Published:2020-07-03 Issue:3 Volume:112 Page:631-643
ISSN:0002-9165
Container-title:The American Journal of Clinical Nutrition
language:en
Short-container-title:

Author:

Sieri Sabina¹^ORCID,Agnoli Claudia¹^ORCID,Grioni Sara¹^ORCID,Weiderpass Elisabete²,Mattiello Amalia³,Sluijs Ivonne⁴,Sanchez Maria Jose⁵⁶⁷⁸,Jakobsen Marianne Uhre⁹,Sweeting Michael¹⁰¹¹,van der Schouw Yvonne T⁴,Nilsson Lena Maria¹²,Wennberg Patrik¹³,Katzke Verena A¹⁴^ORCID,Kühn Tilman¹⁴,Overvad Kim¹⁵,Tong Tammy Y N¹⁶,Conchi Moreno-Iribas¹⁷,Quirós José Ramón¹⁸,García-Torrecillas Juan Manuel¹⁹,Mokoroa Olatz²⁰^ORCID,Gómez Jesús-Humberto²¹,Tjønneland Anne²²²³^ORCID,Sonestedt Emiliy²⁴^ORCID,Trichopoulou Antonia²⁵^ORCID,Karakatsani Anna²⁵²⁶^ORCID,Valanou Elissavet²⁵,Boer Jolanda M A²⁷^ORCID,Verschuren W M Monique²⁷,Boutron-Ruault Marie-Christine²⁸²⁹,Fagherazzi Guy²⁸²⁹^ORCID,Madika Anne-Laure²⁸²⁹³⁰,Bergmann Manuela M³¹,Schulze Matthias B³²³³³⁴^ORCID,Ferrari Pietro²,Freisling Heinz²^ORCID,Lennon Hannah²,Sacerdote Carlotta³⁵^ORCID,Masala Giovanna³⁶,Tumino Rosario³⁷,Riboli Elio³⁸^ORCID,Wareham Nicholas J³⁹^ORCID,Danesh John¹⁰,Forouhi Nita G³⁹^ORCID,Butterworth Adam S¹⁰,Krogh Vittorio¹^ORCID

Affiliation:

1. Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

2. International Agency for Research on Cancer, WHO, Lyon, France

3. Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy

4. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands

5. Andalusian School of Public Health, Granada, Spain

6. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

7. Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain

8. Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain

9. National Food Institute, Division for Diet, Disease Prevention, and Toxicology, Technical University of Denmark, Kongens Lyngby, Denmark

10. MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom

11. Department of Health Sciences, University of Leicester, Leicester, United Kingdom

12. Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden

13. Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden

14. Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany

15. Department of Public Health, Aarhus University, Aarhus, Denmark

16. Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom

17. Public Health Institute of Navarra, IdiSNA, Pamplona, Spain

18. Public Health Directorate, Asturias, Spain

19. Hospital Universitario Torrecárdenas, Almería, Spain

20. Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain

21. Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain

22. Diet, Genes, and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark

23. Department of Public Health, University of Copenhagen, Copenhagen, Denmark

24. Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden

25. Hellenic Health Foundation, Athens, Greece

26. 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Haidari, Greece

27. National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands

28. Center for Research in Epidemiology and Population Health, University Paris-South, Faculty of Medicine, University Versailles-St Quentin, National Institute for Health and Medical Research, Université Paris-Saclay, Villejuif, France

29. Gustave Roussy, Villejuif, France

30. Université Lille, CHU Lille, Lille, France

31. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany

32. Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany

33. DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany

34. University of Potsdam, Institute of Nutritional Sciences, Nuthetal, Germany

35. Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention, Turin, Italy

36. Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy

37. Cancer Registry and Histopathology Department, “Civic-M.P.Arezzo” Hospital, ASP Ragusa, Ragusa, Italy

38. Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom

39. MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom

Abstract

ABSTRACT 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.

Funder

European Union Framework 7

European Research Council

UK Medical Research Council

British Heart Foundation

UK National Institute of Health Research

Medical Research Council Epidemiology Unit

NJW

NGF

NIHR Biomedical Research Centre Cambridge

Hellenic Health Foundation

EPIC-Heidelberg