Dietary glycemic load and glycemic index and risk of cerebrovascular disease in the EPICOR cohort

PLoS One. 2013 May 23;8(5):e62625. doi: 10.1371/journal.pone.0062625. Print 2013.

Abstract

Background: Studies on the association of stroke risk to dietary glycemic index (GI) and glycemic load (GL) have produced contrasting results.

Objective: To investigate the relation of dietary GI and GL to stroke risk in the large EPIC-Italy cohort (EPICOR) recruited from widely dispersed geographic areas of Italy.

Design: We studied 44099 participants (13,646 men and 30,453 women) who completed a dietary questionnaire. Multivariable Cox modeling estimated adjusted hazard ratios (HRs) of stroke with 95% confidence intervals (95%CI). Over 11 years of follow-up, 355 stroke cases (195 ischemic and 83 hemorrhagic) were identified.

Results: Increasing carbohydrate intake was associated with increasing stroke risk (HR = 2.01, 95%CI = 1.04-3.86 highest vs. lowest quintile; p for trend 0.025). Increasing carbohydrate intake from high-GI foods was also significantly associated with increasing stroke risk (HR 1.87, 95%CI = 1.16-3.02 highest vs. lowest, p trend 0.008), while increasing carbohydrate intake from low-GI foods was not. Increasing GL was associated with significantly increasing stroke risk (HR 2.21, 95%CI = 1.16-4.20, highest vs. lowest; p trend 0.015). Dietary carbohydrate from high GI foods was associated with increased both ischemic stroke risk (highest vs. lowest HR 1.92, 95%CI = 1.01-3.66) and hemorrhagic stroke risk (highest vs. lowest HR 3.14, 95%CI = 1.09-9.04). GL was associated with increased both ischemic and hemorrhagic stroke risk (HR 1.44, 95%CI = 1.09-1.92 and HR 1.56, 95%CI = 1.01-2.41 respectively, continuous variable).

Conclusions: In this Italian cohort, high dietary GL and carbohydrate from high GI foods consumption increase overall risk of stroke.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Brain Ischemia / etiology*
  • Brain Ischemia / mortality
  • Cohort Studies
  • Diet
  • Dietary Carbohydrates / adverse effects*
  • Female
  • Glycemic Index
  • Humans
  • Incidence
  • Intracranial Hemorrhages / etiology*
  • Intracranial Hemorrhages / mortality
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Proportional Hazards Models
  • Risk Factors
  • Surveys and Questionnaires

Substances

  • Dietary Carbohydrates

Grant support

EPICOR is supported by Compagnia di San Paolo. The Italian EPIC collaboration is supported by Associazione Italiana per la Ricerca sul Cancro (AIRC). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.