Dietary glycemic index in relation to metabolic risk factors and incidence of coronary heart disease: the Zutphen Elderly Study

Eur J Clin Nutr. 2000 Sep;54(9):726-31. doi: 10.1038/sj.ejcn.1601086.


Objective: To examine whether a high dietary glycemic index is associated with hyperinsulinemia, hyperglycemia, dyslipidemia and coronary heart disease (CHD) risk in elderly men.

Design: Prospective study of incidence of major CHD (non-fatal myocardial infarction or death due to CHD) between 1985 and 1995 in 646 men, and a cross-sectional analysis of metabolic risk factors in 1990 in 394 men.

Setting: Population based study in the Dutch town Zutphen.

Subjects: Men aged 64-84 y in 1985 without a history of CHD or diabetes, whose diet was assessed with the cross-check dietary history method.

Results: The dietary glycemic index was positively correlated with consumption (g carbohydrate) of wheat bread (r=0.47) and sugar products (r=0.41) and inversely with fruit (r=-0.37) and milk (r=-0.40) consumption. During 4527 person-years of follow-up, 94 cases of CHD were documented. The risk ratio for CHD was 1.11 (95% CI, 0.66-1.87) for the highest as compared to the lowest tertile of glycemic index after correction for age, body mass index, physical activity, cigarette smoking, and dietary factors (P (trend)=0.70). Furthermore, the glycemic index was not appreciably associated with blood concentrations of total cholesterol, HDL-cholesterol, triacylglycerols or (fasting or postload) insulin or glucose.

Conclusions: Our findings do not support the hypothesis that a high-glycemic-index diet unfavorably affects metabolic risk factors or increases risk for CHD in elderly men without a history of diabetes or CHD.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Glucose / metabolism*
  • Coronary Disease / epidemiology*
  • Coronary Disease / etiology
  • Coronary Disease / prevention & control
  • Cross-Sectional Studies
  • Diabetes Complications*
  • Diabetes Mellitus / diet therapy
  • Dietary Carbohydrates / administration & dosage*
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Prospective Studies
  • Risk Factors


  • Blood Glucose
  • Dietary Carbohydrates