title: Associations of glycemic index and load with coronary heart disease events: a systematic review and meta-analysis of prospective cohorts.
abstract: BACKGROUND
  Glycemic index (GI) and glycemic load (GL) have been associated with coronary heart disease (CHD) risk in some but not all cohort studies. We therefore assessed the association of GI and GL with CHD risk in prospective cohorts.
  
  
  RESULTS
  We searched MEDLINE, EMBASE, and CINAHL (through April 5, 2012) and identified all prospective cohorts assessing associations of GI and GL with incidence of CHD. Meta-analysis of observational studies in epidemiology (MOOSE) methodologies were used. Relative measures of risk, comparing the group with the highest exposure (mean GI of cohorts=84.4 GI units, range 79.9 to 91; mean GL of cohorts=224.8, range 166 to 270) to the reference group (mean GI=72.3 GI units, range 68.1 to 77; mean GL=135.4, range 83 to 176), were pooled using random-effects models, expressed as relative risk (RR) with heterogeneity assessed by χ(2) and quantified by I(2). Subgroups included sex and duration of follow-up. Ten studies (n=240 936) were eligible. Pooled analyses showed an increase in CHD risk for the highest GI quantile compared with the lowest, with RR=1.11 (95% confidence interval [CI] 0.99 to 1.24) and for GL, RR=1.27 (95% CI 1.09 to 1.49), both with evidence of heterogeneity (I(2)>42%, P<0.07). Subgroup analyses revealed only a significant modification by sex, with the female cohorts showing significance for GI RR=1.26 (95% CI 1.12 to 1.41) and for GL RR=1.55 (95% CI 1.18 to 2.03).
  
  
  CONCLUSIONS
  High GI and GL diets were significantly associated with CHD events in women but not in men. Further studies are required to determine the relationship between GI and GL with CHD in men.
authors: Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada.
authors: Arash
authors: A
authors: Mirrahimi
authors: Russell J
authors: RJ
authors: de Souza
authors: Laura
authors: L
authors: Chiavaroli
authors: John L
authors: JL
authors: Sievenpiper
authors: Joseph
authors: J
authors: Beyene
authors: Anthony J
authors: AJ
authors: Hanley
authors: Livia S A
authors: LS
authors: Augustin
authors: Cyril W C
authors: CW
authors: Kendall
authors: David J A
authors: DJ
authors: Jenkins
mesh_terms: D003327:Coronary Disease / Q000503:physiopathology*; D038321:Glycemic Index / Q000502:physiology*; D006801:Humans; D015994:Incidence; D012307:Risk Factors
keywords: coronary heart disease; glycemic index and load; meta-analysis; nutrition; prospective cohort