Dietary glycemic load and index and risk of coronary heart disease in a large Italian cohort: The EPICOR study

Sabina Sieri, Vittorio Krogh, Franco Berrino, Alberto Evangelista, Claudia Agnoli, Furio Brighenti, Nicoletta Pellegrini, Domenico Palli, Giovanna Masala, Carlotta Sacerdote, Fabrizio Veglia, Rosario Tumino, Graziella Frasca, Sara Grioni, Valeria Pala, Amalia Mattiello, Paolo Chiodini, Salvatore Panico

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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 CHDin 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). Conclusion: In this Italian cohort, high dietary GL and carbohydrate intake from high-GI foods increase the over-all risk of CHD in women but not men.

Original languageEnglish
Pages (from-to)640-647
Number of pages8
JournalArchives of Internal Medicine
Volume170
Issue number7
DOIs
Publication statusPublished - Apr 12 2010

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ASJC Scopus subject areas

  • Internal Medicine

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Sieri, S., Krogh, V., Berrino, F., Evangelista, A., Agnoli, C., Brighenti, F., Pellegrini, N., Palli, D., Masala, G., Sacerdote, C., Veglia, F., Tumino, R., Frasca, G., Grioni, S., Pala, V., Mattiello, A., Chiodini, P., & Panico, S. (2010). Dietary glycemic load and index and risk of coronary heart disease in a large Italian cohort: The EPICOR study. Archives of Internal Medicine, 170(7), 640-647. https://doi.org/10.1001/archinternmed.2010.15