Glycemic load and coronary heart disease in a Mediterranean population: The EPIC Greek cohort study

F. Turati, V. Dilis, M. Rossi, P. Lagiou, V. Benetou, M. Katsoulis, A. Naska, D. Trichopoulos, C. La Vecchia, A. Trichopoulou

Research output: Contribution to journalArticlepeer-review


Background and aims: High glycemic load (GL) has been associated with increased coronary heart disease (CHD) risk. We evaluated whether preference of low-GL foods conveys incremental benefits with respect to CHD, especially to people adhering to the traditional Mediterranean diet (MD). Methods and results: We analyzed data from the Greek European Prospective Investigation into Cancer and Nutrition, including 20,275 participants free of cardiovascular diseases, cancer, or diabetes at baseline and without incident diabetes. Subjects completed a validated, semi-quantitative food frequency questionnaire at enrollment. We calculated a 10-point MD adherence score and the dietary GL, and estimated hazard ratios (HRs) for CHD incidence and mortality through Cox proportional hazard regression. After a median follow-up of 10.4 years, 417 participants developed CHD, and 162 died from the disease. A significant positive association of GL with CHD incidence emerged (HR for the highest versus the lowest tertile=1.41, 95% confidence interval, CI: 1.05-1.90). HRs for CHD mortality exceeded unity but were not statistically significant. The association with GL was stronger among subjects with higher body mass index. High adherence to MD with low/moderate GL was associated with lower risk of CHD incidence (HR = 0.61, CI: 0.39-0.95) and mortality (HR = 0.47, 95% CI: 0.23-96). Conclusion: High dietary GL increases the risk of CHD. Compared to a high GL diet with suboptimal adherence to the traditional Mediterranean pattern, a low/moderate GL diet that also conforms to the traditional MD principles could lead to a 40% reduced risk for CHD, and over 50% reduced risk for death from CHD.

Original languageEnglish
Pages (from-to)336-342
Number of pages7
JournalNutrition, Metabolism and Cardiovascular Diseases
Issue number3
Publication statusPublished - 2015


  • Cohort study
  • Coronary heart diseases
  • Diet
  • Glycemic load
  • Mediterranean diet

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine
  • Medicine(all)


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