Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index
Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index
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DOI：
10.3945/ajcn.2009.29099
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发表时间：
2010-06-01
影响因子：
7.1
通讯作者：
Overvad, Kim
中科院分区：
文献类型：
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作者：
Jakobsen, Marianne U.;Dethlefsen, Claus;Overvad, Kim
背景：研究表明，用碳水化合物替代饱和脂肪酸（SFA）与缺血性心脏病的较高风险有一定关系，而用多不饱和脂肪酸替代 SFA 则与较低的缺血性心脏病风险相关。然而，碳水化合物的影响可能取决于消耗的类型。 目标：通过使用替代模型，我们旨在研究与碳水化合物能量摄入较高和相应的 SFA 能量摄入较低相关的心肌梗死 (MI) 风险。还对具有不同血糖指数 (GI) 值的碳水化合物进行了研究。设计：我们的前瞻性队列研究纳入了 53,644 名基线时未患 MI 的女性和男性。结果：在平均 12 年的随访期间，发生了 1943 例 MI 病例。用低GI值的碳水化合物替代SFA与心肌梗死风险之间存在不显着的负相关关系[碳水化合物能量摄入量每增加5%，心肌梗死的风险比(HR)：0.88； 95% CI：0.72，1.07）。相比之下，用高升糖指数碳水化合物替代 SFA 与 MI 风险之间存在统计学上显着的正相关关系（HR：1.33；95% CI：1.08，1.64）。碳水化合物与中等 GI 值没有关联（FIR：0.98；95% CI：0.80，1.21）。没有观察到性别的影响。结论：这项研究表明，用低 GI 值的碳水化合物替代 SFA 与较低的 MI 风险相关，而用高 GI 值的碳水化合物替代 SFA 与较高的 MI 风险相关。临床营养杂志 2010；91：1764-8。
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 (FIR: 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. J Clin Nutr 2010;91: 1764-8.