Carbohydrate nutrition and inflammatory disease mortality in older adults.
BACKGROUND
Several studies suggest that carbohydrate nutrition is related to oxidative stress and inflammatory markers.


OBJECTIVE
We examined whether dietary glycemic index (GI), dietary fiber, and carbohydrate-containing food groups were associated with the mortality attributable to noncardiovascular, noncancer inflammatory disease in an older Australian cohort.


METHODS
Analysis included 1490 postmenopausal women and 1245 men aged ge 49 y at baseline (1992-1994) from a population-based cohort who completed a validated food-frequency questionnaire. Cox proportional hazards ratios were calculated both for death from diseases in which inflammation or oxidative stress was a predominant contributor and for cardiovascular mortality.


RESULTS
Over a 13-y period, 84 women and 86 men died of inflammatory diseases. Women in the highest GI tertile had a 2.9-fold increased risk of inflammatory death compared with women in the lowest GI tertile [multivariate hazard ratio in energy-adjusted tertile 3 (tertile 1 as reference): 2.89; 95% CI: 1.52, 5.51; P for trend: 0.0006, adjusted for age, smoking, diabetes, and alcohol and fiber consumption]. Increasing intakes of foods high in refined sugars or refined starches (P = 0.04) and decreasing intakes of bread and cereals (P = 0.008) or vegetables other than potatoes (P = 0.007) also independently predicted a greater risk, with subjects' GI partly explaining these associations. In men, only an increased consumption of fruit fiber (P = 0.005) and fruit (P = 0.04) conferred an independent decrease in risk of inflammatory death. No associations were observed with cardiovascular mortality.


CONCLUSIONS
These data provide new epidemiologic evidence of a potentially important link between GI and inflammatory disease mortality among older women.
Buyken
Anette E
AE
Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Australia.
Flood
Victoria
V
Empson
Marianne
M
Rochtchina
Elena
E
Barclay
Alan W
AW
Brand-Miller
Jennie
J
Mitchell
Paul
P
D000368:Aged; D001315:Australia; D002318:Cardiovascular Diseases / Q000401:mortality; D004034:Diet Surveys; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004043:Dietary Fiber / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D038321:Glycemic Index; D006801:Humans; D007249:Inflammation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D017698:Postmenopause; D016016:Proportional Hazards Models; D012307:Risk Factors; D011795:Surveys and Questionnaires
D004040:Dietary Carbohydrates; D004043:Dietary Fiber