Association of glycemic index and glycemic load with risk of incident coronary heart disease among Whites and African Americans with and without type 2 diabetes: the Atherosclerosis Risk in Communities study.
OBJECTIVE
In this study we examined whether high glycemic index (GI) and glycemic load (GL) diets are associated with increased risk of developing coronary heart disease (CHD) in Whites and African Americans with and without type 2 diabetes.


METHODS
Data on 13,051 patients ages 45 to 64 years from the Atherosclerosis Risk in Communities study were analyzed. The ARIC food frequency questionnaire baseline data provided GI and GL indices. A propensity score was created to estimate the effect of a patient's covariates on energy-adjusted GI or GL. During a maximum of 17 years of follow-up, 1683 cases of CHD (371 with diabetes and 1312 without diabetes) were recorded.


RESULTS
For every 5-units increase in GI, there was a 1.16-fold (95% confidence interval [95% CI], 1.01-1.33) increased risk of incident CHD in African Americans. For every 30-units increase in GL, there was a 1.11-fold (95% CI, 1.01-1.21) increased risk of incident CHD in Whites. High GL was an especially important CHD risk factor for Whites without diabetes (per 30-units increase; hazard ratio, 1.14; 95% CI, 1.02-1.26). However, these relationships were not seen in individuals with diabetes.


CONCLUSIONS
Nutritional advice to reduce the GI and GL in diets of African Americans and Whites subjects (without diabetes) may play a role in reducing CHD risk.
Hardy
Dale S
DS
Division of Epidemiology, University of Texas School of Public Health, Houston, TX 77225, USA.
Hoelscher
Deanna M
DM
Aragaki
Corinne
C
Stevens
June
J
Steffen
Lyn M
LM
Pankow
James S
JS
Boerwinkle
Eric
E
D001741:Black or African American / Q000208:ethnology*; D003327:Coronary Disease / Q000150:complications / Q000208:ethnology* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000208:ethnology*; D004032:Diet / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D038321:Glycemic Index / Q000208:ethnology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods; D011795:Surveys and Questionnaires; D044465:White People / Q000208:ethnology*