Hsi-Lan Huang1, Sarah Krull Abe2, Norie Sawada2, Ribeka Takachi3, Junko Ishihara4, Motoki Iwasaki2, Taiki Yamaji2, Hiroyasu Iso5, Tetsuya Mizoue6, Mitsuhiko Noda7, Masahiro Hashizume1, Manami Inoue8,9,10, Shoichiro Tsugane2. 1. Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 2. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan. 3. Department of Food Science and Nutrition, Graduate School of Humanities and Sciences, Nara Women's University, Nara, Japan. 4. Department of Food and Life Science, Azabu University, Kanagawa, Japan. 5. Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. 6. Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan. 7. Department of Diabetes, Metabolism and Endocrinology, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan. 8. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan. mnminoue@ncc.go.jp. 9. Department of Cancer Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. mnminoue@ncc.go.jp. 10. Division of Prevention, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. mnminoue@ncc.go.jp.
Abstract
PURPOSE: Long-term associations of dietary glycemic index (GI) and glycemic load (GL) with mortality outcomes remain unclear. METHODS: The present analysis included 72,783 participants of the Japan Public Health Center-based Prospective Study. Participants who responded to the 5-year follow-up questionnaire in 1995-1999 were followed-up until December 2015. We estimated the risk of total and cause-specific mortality associated with GI and GL using Cox proportional hazards regression models. RESULTS: During 1,244,553 person years of follow-up, 7535 men and 4913 women died. GI was positively associated with all-cause mortality. As compared with the lowest quartile, the multivariable HR for those who had the highest quartile of GI was 1.14 (95% CI 1.08-1.20). The HRs for death comparing the highest with the lowest quartile were 1.28 (95% CI 1.14-1.42) for circulatory system diseases, 1.33 (95% CI 1.14-1.55) for heart disease, 1.32 (95% CI 1.11-1.57) for cerebrovascular disease, and 1.45 (95% CI 1.18-1.78) for respiratory diseases. GI was not associated with mortality risks of cancer and digestive diseases. GL showed a null association with all-cause mortality (highest vs lowest quartile; HR 1.04; 95% CI 0.96-1.12). However, among those who had the highest quartile of GL, the HRs for death from circulatory system diseases was 1.24 (95% CI 1.05-1.46), cerebrovascular disease was 1.34 (95% CI 1.03-1.74), and respiratory diseases was 1.35 (95% CI 1.00-1.82), as compared with the lowest quartile. CONCLUSION: In this large prospective cohort study, dietary GI and GL were associated with mortality risks.
PURPOSE: Long-term associations of dietary glycemic index (GI) and glycemic load (GL) with mortality outcomes remain unclear. METHODS: The present analysis included 72,783 participants of the Japan Public Health Center-based Prospective Study. Participants who responded to the 5-year follow-up questionnaire in 1995-1999 were followed-up until December 2015. We estimated the risk of total and cause-specific mortality associated with GI and GL using Cox proportional hazards regression models. RESULTS: During 1,244,553 person years of follow-up, 7535 men and 4913 women died. GI was positively associated with all-cause mortality. As compared with the lowest quartile, the multivariable HR for those who had the highest quartile of GI was 1.14 (95% CI 1.08-1.20). The HRs for death comparing the highest with the lowest quartile were 1.28 (95% CI 1.14-1.42) for circulatory system diseases, 1.33 (95% CI 1.14-1.55) for heart disease, 1.32 (95% CI 1.11-1.57) for cerebrovascular disease, and 1.45 (95% CI 1.18-1.78) for respiratory diseases. GI was not associated with mortality risks of cancer and digestive diseases. GL showed a null association with all-cause mortality (highest vs lowest quartile; HR 1.04; 95% CI 0.96-1.12). However, among those who had the highest quartile of GL, the HRs for death from circulatory system diseases was 1.24 (95% CI 1.05-1.46), cerebrovascular disease was 1.34 (95% CI 1.03-1.74), and respiratory diseases was 1.35 (95% CI 1.00-1.82), as compared with the lowest quartile. CONCLUSION: In this large prospective cohort study, dietary GI and GL were associated with mortality risks.
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