Dietary glycemic index in relation to metabolic risk factors and incidence of coronary heart disease: the Zutphen Elderly Study
Open accessAbstract
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.
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Published cohort studies in the last decade have produced mixed results for the associations of GI and GL with CHD.
“Glycemic index (GI) and glycemic load (GL) have been associated with coronary heart disease (CHD) risk in some but not all cohort studies.”
From Associations of Glycemic Index and Load With Coronary Heart Disease Events: A Systematic Review and Meta‐Analysis of Prospective Cohorts (2012) · cites this paper as [29]
No change was found in the overall conclusions with post hoc sensitivity analyses removing the reports with food diaries and interviews.
“Although no change was found in our overall conclusions with post hoc sensitivity analyses removing the 429,35,43 reports with food diaries and interviews”
From Associations of Glycemic Index and Load With Coronary Heart Disease Events: A Systematic Review and Meta‐Analysis of Prospective Cohorts (2012) · cites this paper as [29]
The Insulin Resistance Atherosclerosis Study found GL but not GI to be positively associated with triglycerides.
“the Insulin Resistance Atherosclerosis Study 419 found GL but not GI to be positively associated with triglycerides”
From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [419]
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- Authors
- van Dam, R., Visscher, A., Feskens, E., Verhoef, P., & Kromhout, D.
- Affiliations
- National Institute for Public Health and the Environment (NL)
- Wageningen University & Research (NL)
- ORCID
- Verhoef, P
- Venue
- European Journal of Clinical Nutrition
- Published
- 2000-09-01
- Volume
- 54
- Issue
- 9
- Pages
- 726-731
- ISSN
- 0954-3007 (ISSN-L)
- 1476-5640
- OpenAlex
- W1975546604
- Cited by
- 212
- References
- 25
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 6 · 2022: 3 · 2021: 4 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 6 · 2016: 7 · 2015: 5 · 2014: 5 · 2013: 15 · 2012: 11
- FWCI
- 6.95
- Type
- journal article
- Language
- en
- Open access
- green
- research.wur.nl
- Locations
- European Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Socio-Environmental Systems Modeling (acceptedVersion)
- Rivm Repository (Netherlands National Institute for Public Health and the Environment) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- dietary glycemic index, coronary artery disease, hyperinsulinemia, hyperglycemia, dyslipidemia, metabolic risk factors, older men, myocardial infarction, dietary carbohydrates, wheat bread, sugar consumption, fruit consumption, milk consumption, Zutphen Elderly Study
- MeSH terms
- Aged, Aged, 80 and over, Blood Glucose, Coronary Disease, Cross-Sectional Studies, Diabetes Mellitus, Dietary Carbohydrates, Humans, Longitudinal Studies, Male, Middle Aged, Netherlands, Prospective Studies, Risk Factors, Incidence, Diabetes Complications
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