Carbohydrate-, sugar-rich diets up risk of coronary heart disease

A diet that stimulates a high glucose response, such as one rich in carbohydrates or sugar, may increase the risk of coronary heart disease (CHD), according to a large pan-European study.

The European Prospective Investigation into Cancer and Nutrition included a total of 338,325 participants who completed a dietary questionnaire. Covariate-adjusted Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95 percent confidence intervals (CIs) for a CHD event, in relation to intake of glycaemic index (GI), glycaemic load (GL), and carbohydrates.

Of the participants, 6,378 had experienced a CHD event over a median of 12.8 years. An association was found between high GL and greater CHD risk (HR, 1.16, 95 percent CI, 1.02–1.31; highest vs lowest quintile: p_trend=0.035; HR per 50 g/day of GL intake, 1.18, 95 percent CI, 1.07–1.29).

This association was prominent in patients with body mass index (BMI) ≥25 kg/m² (HR, 1.22, 95 percent CI, 1.11–1.35) but not in those with BMI <25 kg/m² (HR, 1.09, 95 percent CI, 0.98–1.22; p_interaction=0.022). In addition, such association did not differ between men (HR, 1.19, 95 percent CI, 1.08–1.30) and women (HR, 1.22, 95 percent CI, 1.07–1.40; test for interaction was nonsignificant).

GI also correlated with CHD risk in the continuous model (HR per 5 units/day, 1.04, 95 percent CI, 1.00–1.08). Moreover, high available carbohydrate (HR per 50 g/day, 1.11, 95 percent CI, 1.03–1.18) and high sugar intake (HR per 50 g/day, 1.09, 95 percent CI, 1.02–1.17) were associated with increased CHD risk.

“High carbohydrate intake raises blood triglycerides, glucose, and insulin; reduces high-density lipoproteins; and may increase risk of CHD,” the authors noted. “Epidemiological studies indicate that high dietary GI and GL are associated with increased CHD risk.”