Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index

Abstract

Background: Studies have suggested that replacing saturated fatty acids (SFAs) with carbohydrates is modestly associated with a higher risk of ischemic heart disease, whereas replacing SFAs with polyunsaturated fatty acids is associated with a lower risk of ischemic heart disease. The effect of carbohydrates, however, may depend on the type consumed. Objectives: By using substitution models, we aimed to investigate the risk of myocardial infarction (MI) associated with a higher energy intake from carbohydrates and a concomitant lower energy intake from SFAs. Carbohydrates with different glycemic index (GI) values were also investigated. Design: Our prospective cohort study included 53,644 women and men free of MI at baseline. Results: During a median of 12 y of follow-up, 1943 incident MI cases occurred. There was a nonsignificant inverse association between substitution of carbohydrates with low-GI values for SFAs and risk of MI [hazard ratio (HR) for MI per 5% increment of energy intake from carbohydrates: 0.88; 95% CI: 0.72, 1.07). In contrast, there was a statistically significant positive association between substitution of carbohydrates with high-GI values for SFAs and risk of MI (HR: 1.33; 95% CI: 1.08, 1.64). There was no association for carbohydrates with medium-GI values (HR: 0.98; 95% CI: 0.80, 1.21). No effect modification by sex was observed. Conclusion: This study suggests that replacing SFAs with carbohydrates with low-GI values is associated with a lower risk of MI, whereas replacing SFAs with carbohydrates with high-GI values is associated with a higher risk of MI.

Carbohydrate substitution for fat or protein and risk of type 2 diabetes in male smokers

“…To our knowledge, no previous studies have separately reported the associations of low-, medium-or high-GI carbohydrate intake and type 2 diabetes risk, while recently analyses on risk of coronary heart disease have been published. 21,22 The main contributor foods of low-GI carbohydrates were milk and fruits, vegetables and legumes, of medium-GI carbohydrates added sugar and sugary foods and of high-GI carbohydrates wheat bread and bakeries, rye bread and potatoes. 20 The inverse association between medium-GI carbohydrate intake and diabetes risk is in keeping with the findings from some previous cohort studies, suggesting inverse association between sugar intake and diabetes risk.…”

Saturated Fatty Acids and Cardiovascular Disease: Replacements for Saturated Fat to Reduce Cardiovascular Risk

“…Similarly, in the EPIC-Netherlands cohort replacing 5% of energy from SFA with carbohydrate was associated with an increased risk of IHD [31]. In contrast, replacing 5% of calories from SFA with carbohydrate was not associated with a reduction in risk of MI in a Danish cohort [101].…”

“…Replacing SFA with low GI carbohydrates (GI<53) was not associated with a change in IHD risk [31]. Similarly, Jakobsen et al found no significant change in MI risk when 5% of energy from SFA was replaced by low GI (median GI 82) or medium GI (median GI 88) carbohydrates [101].…”

Misvisende om kosthold i ny nasjonal retningslinje for forebygging av hjerte- og karsykdommer

“…Derved blir «grove» og «raffinerte» kilder til karbohydrater satt sammen til en kategori, noe som er problematisk. Derimot ser utskifting av mettet fett med lavglykemiske karbohydratkilder med mye fiber ut til å vaere gunstig 206,207 . Tabell I tillegg til metaanalysene i tabell 25 fant både Ramsden og Hooper og medarbeidere at et høyere inntak av flerumettet fett på bekostning av mettet fett reduserte risikoen for hjerte-og kar-hendelser (se kapittel 7C) 126,148,149 .…”

“…En reduksjon av mettet fett til fordel for kostfiber kan også vaere gunstig, blant annet for energitettheten 206,207 .…”