Dietary Glycemic Index, Dietary Glycemic Load, and Incidence of Heart Failure Events: A Prospective Study of Middle-Aged and Elderly Women

Abstract

Objective Dietary glycemic index (GI) and glycemic load (GL), measures of the propensity of dietary carbohydrate to increase blood glucose, have been associated with risk of coronary heart disease, but their association with incidence of heart failure (HF) is unknown. We therefore assessed whether dietary GI and GL were associated with rates of HF events. Methods We conducted a prospective, observational study of 36,019 women 48-83 years old without baseline HF, diabetes, or myocardial infarction who were participants in the Swedish Mammography Cohort, a prospective cohort study. Diet was measured using food-frequency questionnaires. Women were followed from January 1, 1998 through December 31, 2006 for HF hospitalization or death through the Swedish inpatient and cause-of-death registers. Cox proportional hazards models adjusted for age and other risk factors were used to estimate incidence rate ratios (RR) and 95% confidence intervals (CI). Results Over 9 years of follow-up, 639 of 36,019 women died of HF (n = 54) or were hospitalized for HF for the first time (n = 585). We did not find statistically significant associations between dietary GI and HF events (RR comparing highest to lowest quartile = 1.12, 95% CI 0.87-1.45, p for trend = 0.31) or between dietary GL and HF events (RR comparing highest to lowest quartile = 1.30, 95% CI 0.87-1.93, p for trend = 0.16). Results were not significantly different in normal weight and overweight women. Conclusions In this population, dietary GI did not appear to be associated with incident HF events. There was a suggestion of an association between dietary GL and HF which did not reach statistical significance.

Relevance of the Glycemic Index and Glycemic Load for Body Weight, Diabetes, and Cardiovascular Disease

“…Several prospective studies assessing the relationship between dietary GI or GL and cardiovascular disease risk were identified ( Table 9 ). Those reporting on cardiovascular disease mortality [ 77 , 78 ] or on incident cardiovascular diseases (all combined) [ 79 , 80 ], coronary heart disease [ 81 , 82 , 83 , 84 , 85 ], stroke [ 80 , 82 , 85 ], myocardial infarction [ 80 , 86 ], or heart failure [ 87 ] were included herein. Most studies provided risk estimates that were adjusted for dietary factors, age, body mass index, and other potentially confounding factors.…”

Dietary fiber and the glycemic index: a background paper for the Nordic Nutrition Recommendations 2012

“…No association was found between the estimated GI or GL of the diet and risk for type 2 diabetes (45), ischemic cardiovascular disease (46) or heart failure (55). Out of the three studies on MI, one study did not find an association (47), one study reported a positive association only among obese or physically inactive individuals (56), and the third study reported a lower risk of MI if replacing saturated fatty acids with low GI food instead of high GI food on equal percentage of energy basis (48).…”

High-sugar intake does not exacerbate metabolic abnormalities or cardiac dysfunction in genetic cardiomyopathy

“…A recent epidemiological study found that hospitalization or death from new onset heart failure was not related to sugar intake over a 9 year follow-up in middle age and elderly women [6]. There is less information regarding effects of sugar intake in populations that are at high risk for developing heart failure, such as patients with hypertension, ischemic heart disease or inherited cardiomyopathies.…”