Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women.
BACKGROUND
Recent prospective data suggest that intake of rapidly digested and absorbed carbohydrates with a high dietary glycemic load is associated with an increased risk of ischemic heart disease.


OBJECTIVE
We examined whether a high dietary glycemic load was associated with elevated hs-CRP concentrations and whether this association was modified by body mass index (BMI; in kg/m(2)).


METHODS
In 244 apparently healthy women, we measured plasma hs-CRP concentrations and determined average dietary glycemic loads with a validated semiquantitative food-frequency questionnaire. Using multiple regression models, we evaluated the association between dietary glycemic load and plasma hs-CRP after adjusting for age; treatment status; smoking status; BMI; physical activity level; parental history of myocardial infarction; history of hypertension, diabetes, and high cholesterol; postmenopausal hormone use; alcohol intake; and other dietary variables.


RESULTS
We found a strong and statistically significant positive association between dietary glycemic load and plasma hs-CRP. The median hs-CRP concentration for the lowest quintile of dietary glycemic load was 1.9 mg/L and for the highest quintile was 3.7 mg/L; corresponding multivariate-adjusted geometric means were 1.4 and 3.8 mg/L, respectively (P for trend < 0.01). This association was significantly modified by BMI. Among women with a BMI greater-than-or-equal 25, the multivariate-adjusted geometric mean hs-CRP concentration in the lowest quintile was 1.6 mg/L and in the highest quintile was 5.0 mg/L; however, among women with a BMI < 25, the corresponding means were 1.1 and 3.1 mg/L, respectively (P = 0.01 for interaction).


CONCLUSIONS
Dietary glycemic load is significantly and positively associated with plasma hs-CRP in healthy middle-aged women, independent of conventional risk factors for ischemic heart disease. Exacerbation of the proinflammatory process may be a mechanism whereby a high intake of rapidly digested and absorbed carbohydrates increases the risk of ischemic heart disease, especially in overweight women prone to insulin resistance.
Liu
Simin
S
Center of Cardiovascular Prevention, the Division of Preventive Medicine, Harvard Medical School, Boston 02215, USA. sliu@rics.bwh.harvard.edu
Manson
JoAnn E
JE
Buring
Julie E
JE
Stampfer
Meir J
MJ
Willett
Walter C
WC
Ridker
Paul M
PM
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000378:metabolism*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000209:etiology* / Q000378:metabolism; D015596:Nutrition Assessment; D009765:Obesity / Q000276:immunology / Q000378:metabolism*; D010919:Placebos; D012044:Regression Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016387:Women's Health
D015415:Biomarkers; D004040:Dietary Carbohydrates; D007328:Insulin; D010919:Placebos; D002097:C-Reactive Protein