CARDIOVASCULAR MEDICINE

Carbohydrates, dietary glycaemic load and glycaemic index, and risk of acute myocardial infarction

A Tavani¹, C Bosetti¹, E Negri¹, L S Augustin², D J A Jenkins³, C La Vecchia⁴

¹ Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
² Servizio di Epidemiologia, Centro di Riferimento Oncologico, Aviano, Italy
³ Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
⁴ Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Milan, Italy

Correspondence to:
Correspondence to:
Dr Alessandra Tavani, Istituto di Ricerche Farmacologiche "Mario Negri", Via Eritrea 62, 20157 Milan, Italy;
tavani{at}marionegri.it

Objectives: To assess the relation between selected carbohydrate foods, dietary glycaemic load and glycaemic index, and the risk of non-fatal acute myocardial infarction in a population with a high intake of refined carbohydrates.

Design and setting: Hospital based case–control study conducted in Milan, Italy, between 1995 and 1999.

Patients: 433 non-diabetic subjects with a first episode of non-fatal acute myocardial infarction, and 448 controls admitted to hospital for a wide spectrum of acute conditions unrelated to known or potential risk factors for acute myocardial infarction.

Methods: Information was collected by interviewer administered questionnaires. Multivariate odds ratios (OR) and 95% confidence intervals (CI) were obtained by multiple logistic regression models.

Results: Compared with patients in the lowest tertile of intake, the multivariate OR for those in the highest tertile was 1.00 for bread, 1.27 for pasta and rice, 1.38 for soups, 0.78 for potatoes, 0.97 for desserts, and 1.00 for sugar. The OR for the highest tertile of score was 1.08 for glycaemic load and 1.38 for glycaemic index. None of the estimates was significant. A significant association with acute myocardial infarction risk was found for glycaemic index in patients aged 60 years (OR 1.81, 95% CI 1.07 to 3.07 for the highest tertile of score compared with the lowest) and in those with a body mass index 25 kg/m² (OR 2.02, 95% CI 1.21 to 3.34).

Conclusions: In this Italian population high glycaemic load and glycaemic index were not strongly associated with acute myocardial infarction risk, but slightly increased odds ratios were observed for glycaemic index in elderly people and in association with overweight.

Keywords: acute myocardial infarction; carbohydrate intake; glycaemic index; glycaemic load

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