Dietary Glycemic Load and Glycemic Index and Risk of Coronary Heart Disease and Stroke in Dutch Men and Women: The EPIC-MORGEN Study

Published on Oct 5, 2011in PLOS ONE 2.77
· DOI :10.1371/journal.pone.0025955
Koert N.J. Burger34
Estimated H-index: 34
(Utrecht University),
Joline W.J. Beulens46
Estimated H-index: 46
(Utrecht University)
+ 2 AuthorsDaphne L. van der A40
Estimated H-index: 40
Background The associations of glycemic load (GL) and glycemic index (GI) with the risk of cardiovascular diseases (CVD) are not well-established, particularly in men, and may be modified by gender. Objective To assess whether high dietary GL and GI increase the risk of CVD in men and women. Methods A large prospective cohort study (EPIC-MORGEN) was conducted within the general Dutch population among 8,855 men and 10,753 women, aged 21–64 years at baseline (1993–1997) and free of diabetes and CVD. Dietary intake was assessed with a validated food-frequency questionnaire and GI and GL were calculated using Foster-Powell's international table of GI. Information on morbidity and mortality was obtained through linkage with national registries. Cox proportional hazards analysis was performed to estimate hazard ratios (HRs) for incident coronary heart disease (CHD) and stroke, while adjusting for age, CVD risk factors, and dietary factors. Results During a mean follow-up of 11.9 years, 581 CHD cases and 120 stroke cases occurred among men, and 300 CHD cases and 109 stroke cases occurred among women. In men, GL was associated with an increased CHD risk (adjusted HR per SD increase, 1.17 [95% CI, 1.02–1.35]), while no significant association was found in women (1.09 [0.89–1.33]). GI was not associated with CHD risk in both genders, while it was associated with increased stroke risk in men (1.27 [1.02–1.58]) but not in women (0.96 [0.75–1.22]). Similarly, total carbohydrate intake and starch intake were associated with a higher CHD risk in men (1.23 [1.04–1.46]; and 1.24 [1.07–1.45]), but not in women. Conclusion Among men, high GL and GI, and high carbohydrate and starch intake, were associated with increased risk of CVD.
  • References (53)
  • Citations (50)
Published on Jan 1, 1991in European Journal of Clinical Nutrition 2.95
Gail R. Goldberg36
Estimated H-index: 36
Alison E. Black31
Estimated H-index: 31
+ 4 AuthorsAndrew M. Prentice79
Estimated H-index: 79
This paper uses fundamental principles of energy physiology to define minimum cut-off limits for energy intake below which a person of a given sex, age and body weight could not live a normal life-style. These have been derived from whole-body calorimeter and doubly-labelled water measurements in a wide range of healthy adults after due statistical allowance for intra- and interindividual variance. The tabulated cut-off limits, which depend on sample size and duration of measurements, identify m...
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Published on Apr 1, 1997in The American Journal of Clinical Nutrition 6.55
Barry M. Popkin317
Estimated H-index: 317
(Harvard University),
Geoffrey R. Howe1
Estimated H-index: 1
(Harvard University),
Lawrence H. Kushi75
Estimated H-index: 75
(Harvard University)
In epidemiologic studies, total energy intake is often related to disease risk because of associations between physical activity or body size and the probability of disease. In theory, differences in disease incidence may also be related to metabolic efficiency and therefore to total energy intake. Because intakes of most specific nutrients, particularly macronutrients, are correlated with total energy intake, they may be noncausally associated with disease as a result of confounding by total en...
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Published on Mar 1, 2007in The American Journal of Clinical Nutrition 6.55
Kevin C. Maki42
Estimated H-index: 42
Tia M. Rains18
Estimated H-index: 18
+ 2 AuthorsMichael Davidson107
Estimated H-index: 107
Background: Lowering the dietary glycemic load and increasing protein intake may be advantageous for weight management. Objective: This randomized controlled trial was designed to evaluate the effects of an ad libitum reduced-glycemic-load (RGL) diet on body weight, body composition, and cardiovascular disease (CVD) risk markers in overweight and obese adults during an initial weight-loss phase (12 wk) and a weight-loss maintenance phase (weeks 24-36). Design: Subjects were assigned to RGL (n = ...
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Published on Mar 1, 2001in The American Journal of Clinical Nutrition 6.55
Simin Liu100
Estimated H-index: 100
(Harvard University),
JoAnn E. Manson230
Estimated H-index: 230
(Harvard University)
+ 4 AuthorsBarry M. Popkin317
Estimated H-index: 317
(Harvard University)
Background: In metabolic studies, both greater carbohydrate intakes and higher glycemic indexes (GIs) raise fasting triacylglycerol concentrations. In epidemiologic studies, dietary glycemic load (GL) is positively associated with risk of coronary artery disease and type 2 diabetes. Objective: We examined both the physiologic relevance of GI and GL and the ability of dietary questionnaires to measure these variables. Design: In the Nurses' Health Study, we measured plasma triacylglycerol concent...
386 Citations Source Cite
Published on Jun 1, 2000in The American Journal of Clinical Nutrition 6.55
Simin Liu100
Estimated H-index: 100
Barry M. Popkin317
Estimated H-index: 317
+ 5 AuthorsJoAnn E. Manson230
Estimated H-index: 230
Background: Little is known about the effects of the amount and type of carbohydrates on risk of coronary heart disease (CHD). Objective: The objective of this study was to prospectively evaluate the relations of the amount and type of carbohydrates with risk of CHD. Design: A cohort of 75 521 women aged 38-63 y with no previous diagnosis of diabetes mellitus, myocardial infarction, angina, stroke, or other cardiovascular diseases in 1984 was followed for 10 y. Each participant's dietary glycemi...
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Published on Apr 1, 2009in European Journal of Clinical Nutrition 2.95
Emily B. Levitan36
Estimated H-index: 36
Murray A. Mlttleman86
Estimated H-index: 86
Alicja Wolk109
Estimated H-index: 109
Dietary glycemic index, dietary glycemic load and mortality among men with established cardiovascular disease
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Published on Sep 1, 2000in European Journal of Clinical Nutrition 2.95
R. M. van Dam1
Estimated H-index: 1
A. W. J. Visscher1
Estimated H-index: 1
+ 2 AuthorsD. Kromhout1
Estimated H-index: 1
Dietary glycemic index in relation to metabolic risk factors and incidence of coronary heart disease: the Zutphen Elderly Study
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Published on Apr 12, 2010in JAMA Internal Medicine 19.99
Sabina Sieri58
Estimated H-index: 58
V. Krogh77
Estimated H-index: 77
+ 15 AuthorsCarlotta Sacerdote76
Estimated H-index: 76
(University of Turin)
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 1...
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Published on Sep 1, 2010in American Journal of Cardiology 3.17
Steven G. Chrysant25
Estimated H-index: 25
(University of Oklahoma),
George S. Chrysant6
Estimated H-index: 6
(University of Oklahoma)
The concept of the J-curve effect has been around for a long time and is a subject of contention among various investigators. The J-curve effect describes an inverse relation between low blood pressure (BP) and cardiovascular complications. Because the coronary arteries are perfused during diastole, this effect is seen mostly with low diastolic BP in the range of 70 to 80 mm Hg, depending on preexisting coronary artery disease, hypertension, or left ventricular hypertrophy. Although national and...
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Published on Feb 1, 2011in Nutrition Metabolism and Cardiovascular Diseases 3.32
Jaakko Mursu30
Estimated H-index: 30
Jyrki K. Virtanen28
Estimated H-index: 28
+ 5 AuthorsSari Voutilainen39
Estimated H-index: 39
Background and aim: The role of dietary glycemic index (GI) and glycemic load (GL) in coronary heart disease (CHD) is unclear. Our aim was to study the association between the dietary GI and GL and the risk of acute myocardial infarction (AMI). Methods and results: The study population consisted of 1981 Finnish men from the prospective population-based Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study, aged 42e60 years and free of CHD at baseline. During an average follow-up time of 16.1 y...
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Alba Garcimartín6
Estimated H-index: 6
(Complutense University of Madrid),
Juana Benedí23
Estimated H-index: 23
(Complutense University of Madrid)
+ 1 AuthorsF. J. Sánchez Muniz33
Estimated H-index: 33
(Complutense University of Madrid)
Abstract Seaweed antidiabetic properties have been linked to changes in carbohydrate digestion and absorption. The effect of aqueous extracts and suspensions of restructured pork (RP) with 5 g/100 g of Porphyra umbilicalis (Nori), Undaria pinnatifida (Wakame) or Himanthalia elongata (Sea spaghetti) on α-glucosidase activity and glucose diffusion were in vitro tested. α-Glucosidase inhibition type was also assayed. Sea spaghetti-RP suspensions displayed, through a competitive mechanism, the highe...
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Published on Oct 1, 2014in International Journal of Public Health
Ivana Kulhánová12
Estimated H-index: 12
(Erasmus University Rotterdam),
Rasmus Hoffmann19
Estimated H-index: 19
(Erasmus University Rotterdam)
+ 2 AuthorsJohan P. Mackenbach92
Estimated H-index: 92
(Erasmus University Rotterdam)
Objectives Using new facilities for linking large databases, we aimed to evaluate for the first time the magnitude of relative and absolute educational inequalities in mortality by sex and cause of death in the Netherlands.
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Published on Aug 1, 2012in Atherosclerosis 4.47
Xiang-yu Ma2
Estimated H-index: 2
(Third Military Medical University),
Jian-ping Liu2
Estimated H-index: 2
(Third Military Medical University),
Zhi-yuan Song2
Estimated H-index: 2
(Third Military Medical University)
Abstract Objective The objective of this study was to assess the relations between glycemic load (GL), glycemic index (GI) and the risk of fatal or nonfatal cardiovascular diseases (CVDs). Methods Prospective studies were identified by a comprehensive search of Pubmed, ISI web of Science, the Cochrane Library and EMBASE database, supplemented with manual searches through the reference lists of original publications and review articles. Relative risks (RRs) and 95% confidence intervals (CIs) were...
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Published on Jun 1, 2015in European Journal of Nutrition 4.42
Susan E. Power4
Estimated H-index: 4
(University College Cork),
Eibhlís M. O’Connor3
Estimated H-index: 3
(University College Cork)
+ 4 AuthorsIan B. Jeffery20
Estimated H-index: 20
(University College Cork)
Purpose Ageing is associated with loss of cognitive function and an increased risk of dementia which is expected to place growing demands on health and long-term care providers. Among multiple causative factors, evidence suggests that cognitive impairment in older subjects may be influenced by diet. The objective of this study was to examine the association between dietary patterns, dietary glycaemic load (GL) and cognition in older Irish adults.
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Published on Jan 1, 2013in Nutrition Research and Practice 1.64
Fernanda R. de O. Penaforte1
Estimated H-index: 1
(University of São Paulo),
Camila Cremonezi Japur5
Estimated H-index: 5
(University of São Paulo)
+ 2 AuthorsRosa Wanda Diez-Garcia6
Estimated H-index: 6
(University of São Paulo)
The hypothesis of this study was that greater sugar consumption at breakfast promotes a stronger sensation of hunger and a later increase in energy consumption. The objective was to assess the relation between sugar consumption in a meal and the subsequent sensations of hunger and ad libitum food consumption. Sixteen women consumed a breakfast accompanied by 2 drinks sweetened ad libitum with sugar. After 3 h, a lunch was offered to evaluate ad libitum food consumption. During the period from br...
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Published on Dec 20, 2012in PLOS ONE 2.77
Jingyao Fan3
Estimated H-index: 3
(Peking Union Medical College),
Yiqing Song3
Estimated H-index: 3
(Peking University)
+ 2 AuthorsWeili Zhang17
Estimated H-index: 17
(Peking Union Medical College)
Background The relationship between dietary glycemic index, glycemic load and risk of coronary heart disease (CHD), stroke, and stroke-related mortality is inconsistent.
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Published on Jan 1, 2014in Current Atherosclerosis Reports 2.56
Arash Mirrahimi21
Estimated H-index: 21
(University of Toronto),
Laura Chiavaroli21
Estimated H-index: 21
(University of Toronto)
+ 4 AuthorsDavid J.A. Jenkins89
Estimated H-index: 89
(University of Toronto)
A number of meta-analyses of cohort studies have assessed the impact of glycemic load (GL) and glycemic index (GI) on cardiovascular outcomes. The picture that emerges is that for women, a significant association appears to exist between the consumption of high GL/GI diets and increased cardiovascular disease (CVD) risk. This association appears to be stronger in those with greater adiposity and possibly in those with diabetes, although these findings are not uniform. There is also an indication...
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Federica Turati26
Estimated H-index: 26
Vardis Dilis29
Estimated H-index: 29
+ 7 AuthorsCarlo La Vecchia122
Estimated H-index: 122
(University of Milan)
Abstract 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 basel...
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Published on Sep 24, 2014in PLOS ONE 2.77
Itandehui Castro-Quezada6
Estimated H-index: 6
Almudena Sánchez-Villegas41
Estimated H-index: 41
+ 20 AuthorsEmilio Ros70
Estimated H-index: 70
Objective: Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. Material and Methods: The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based o...
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