Dietary glycemic load and index and risk of coronary heart disease in a large italian cohort: the EPICOR study.
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.
Sieri
Sabina
S
Nutritional Epidemiology Unit, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Istituto Nazionale Tumori, Milan, Italy.
Krogh
Vittorio
V
Berrino
Franco
F
Evangelista
Alberto
A
Agnoli
Claudia
C
Brighenti
Furio
F
Pellegrini
Nicoletta
N
Palli
Domenico
D
Masala
Giovanna
G
Sacerdote
Carlotta
C
Veglia
Fabrizio
F
Tumino
Rosario
R
Frasca
Graziella
G
Grioni
Sara
S
Pala
Valeria
V
Mattiello
Amalia
A
Chiodini
Paolo
P
Panico
Salvatore
S
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
D004040:Dietary Carbohydrates