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.
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.
Authors: Arne Astrup; Jørn Dyerberg; Peter Elwood; Kjeld Hermansen; Frank B Hu; Marianne Uhre Jakobsen; Frans J Kok; Ronald M Krauss; Jean Michel Lecerf; Philippe LeGrand; Paul Nestel; Ulf Risérus; Tom Sanders; Andrew Sinclair; Steen Stender; Tine Tholstrup; Walter C Willett Journal: Am J Clin Nutr Date: 2011-01-26 Impact factor: 7.045
Authors: E E Blaak; J-M Antoine; D Benton; I Björck; L Bozzetto; F Brouns; M Diamant; L Dye; T Hulshof; J J Holst; D J Lamport; M Laville; C L Lawton; A Meheust; A Nilson; S Normand; A A Rivellese; S Theis; S S Torekov; S Vinoy Journal: Obes Rev Date: 2012-07-11 Impact factor: 9.213
Authors: Sonia S Anand; Corinna Hawkes; Russell J de Souza; Andrew Mente; Mahshid Dehghan; Rachel Nugent; Michael A Zulyniak; Tony Weis; Adam M Bernstein; Ronald M Krauss; Daan Kromhout; David J A Jenkins; Vasanti Malik; Miguel A Martinez-Gonzalez; Dariush Mozaffarian; Salim Yusuf; Walter C Willett; Barry M Popkin Journal: J Am Coll Cardiol Date: 2015-10-06 Impact factor: 24.094