title: Dietary glycemic load and index and risk of coronary heart disease in a large italian cohort: the EPICOR study.
abstract: BACKGROUND
  Dietary glycemic load (GL) and glycemic index (GI) in relation to cardiovascular disease have been investigated in a few prospective studies with inconsistent results, particularly in men. The present EPICOR study investigated the association of GI and GL with coronary heart disease (CHD) in a large and heterogeneous cohort of Italian men and women originally recruited to the European Prospective Investigation into Cancer and Nutrition study.
  
  
  METHODS
  We studied 47 749 volunteers (15 171 men and 32 578 women) who completed a dietary questionnaire. Multivariate Cox proportional hazards modeling estimated adjusted relative risks (RRs) of CHD and 95% confidence intervals (CIs).
  
  
  RESULTS
  During a median of 7.9 years of follow-up, 463 CHD cases (158 women and 305 men) were identified. Women in the highest carbohydrate intake quartile had a significantly greater risk of CHD than did those in the lowest quartile (RR, 2.00; 95% CI, 1.16-3.43), with no association found in men (P = .04 for interaction). Increasing carbohydrate intake from high-GI foods was also significantly associated with greater risk of CHD in women (RR, 1.68; 95% CI, 1.02-2.75), whereas increasing the intake of low-GI carbohydrates was not. Women in the highest GL quartile had a significantly greater risk of CHD than did those in the lowest quartile (RR, 2.24; 95% CI, 1.26-3.98), with no significant association in men (P = .03 for interaction).
  
  
  CONCLUSIONS
  In this Italian cohort, high dietary GL and carbohydrate intake from high-GI foods increase the overall risk of CHD in women but not men.
authors.affiliation: Nutritional Epidemiology Unit, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Sabina
authors.initials: S
authors.lastname: Sieri
authors.forename: Vittorio
authors.initials: V
authors.lastname: Krogh
authors.forename: Franco
authors.initials: F
authors.lastname: Berrino
authors.forename: Alberto
authors.initials: A
authors.lastname: Evangelista
authors.forename: Claudia
authors.initials: C
authors.lastname: Agnoli
authors.forename: Furio
authors.initials: F
authors.lastname: Brighenti
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Pellegrini
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Giovanna
authors.initials: G
authors.lastname: Masala
authors.forename: Carlotta
authors.initials: C
authors.lastname: Sacerdote
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Veglia
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Graziella
authors.initials: G
authors.lastname: Frasca
authors.forename: Sara
authors.initials: S
authors.lastname: Grioni
authors.forename: Valeria
authors.initials: V
authors.lastname: Pala
authors.forename: Amalia
authors.initials: A
authors.lastname: Mattiello
authors.forename: Paolo
authors.initials: P
authors.lastname: Chiodini
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
mesh_terms: D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology*; D004034:Diet Surveys; D004040:Dietary Carbohydrates; D005260:Female; D038321:Glycemic Index; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D018579:Patient Selection; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires
chemical_list: D004040:Dietary Carbohydrates