GLYCEMIC INDEX/GLYCEMIC LOAD AND BLOOD LIPIDS IN THE WHI

描述(由申请人提供)： 冠心病是绝经后妇女的头号杀手。减少脂肪摄入量通常被推荐用于预防和治疗冠心病。然而，脂肪摄入量的减少通常伴随着碳水化合物摄入量的增加，这本身可能对CHD危险因素产生不良影响。最近的证据表明，富含高淀粉碳水化合物的饮食可能会对血糖和胰岛素浓度产生不利影响，导致血脂变化，从而增加患冠心病的风险。血糖指数(GI)是一种根据餐后血糖反应对含碳水化合物的食物进行排名的方法，也是碳水化合物质量的衡量标准。血糖负荷(GL)是一种综合了两种高碳水化合物的指标。越来越多的观察研究证据表明，高饮食导致高血糖和高血糖，并可能对血脂产生不利影响，包括增加血浆甘油三酯(TG)和降低血浆高密度脂蛋白胆固醇(HDLC)。妇女健康倡议(WHI)是一个多方面的研究计划，旨在研究与绝经后妇女疾病风险相关的因素。这项研究将利用WHI参与者进一步研究GI和GL与血糖、胰岛素和血脂的关系。这项研究的第一个目的是通过对WHI观察性研究中728名基线参与者的横断面分析，研究饮食GI和GL与血糖、胰岛素和血脂(总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯)浓度的关系。第二个目标是量化WHI低脂饮食调整试验中随机抽取的973名参与者在一年时间内饮食GI和GL的变化，并确定这些变化对血糖、胰岛素和血脂浓度的影响。为了实现这些目标，WHI食物频率问卷(FFQ)的营养数据库将扩大到包括目前没有报告的GI和GL。然后将重新分析现有的WHI FFQ，以计算每个参与者的平均饮食GI和GL。这些WHI参与者的现有血糖、胰岛素和血脂数据将用于数据分析。

DESCRIPTION (provided by applicant): Coronary heart disease (CHD) is the number one killer of postmenopausal women. Reduction in fat intake is typically recommended for the prevention and treatment of CHD. However, decreased fat intake is generally accompanied by an increase in carbohydrate intake, which may itself have undesirable effects on CHD risk factors. Recent evidence suggest that diets abundant in high-starch carbohydrates may have an adverse effect on blood glucose and insulin concentrations, resulting in alterations of blood lipids that may increase the risk of developing CHD. Glycemic index (GI) is a way of ranking carbohydrate-containing foods based on their postprandial blood glucose responses and is a measure of carbohydrate quality. Glycemic load (GL) is a measure that incorporates both the high dietary carbohydrates. There is mounting evidence from observational studies that high dietary GI and may adversely affect blood lipids, including increasing plasma triglyceride (TG) and reducing plasma high-density lipoprotein-cholesterol (HDL-C). The Women's Health Initiative (WHI) is a multi-faceted research program examining factors associated with disease risk in postmenopausal women. This study will utilize WHI participants to further investigate the associations of GI and GL with blood glucose, insulin, and lipids. The first aim of this study is to investigate the associations of dietary GI and GL with blood glucose, insulin, and lipid (total cholesterol, low-density lipopretein-cholesterol, HDL-C, and TG) concentrations in a cross-sectional analysis of 728 participants at baseline in the WHI Observational Study. The second aim is to quantify changes, over a one-year period, in dietary GI and GL in 973 participants randomized in the WHI low-fat Dietary Modification trial, and to determine the effects of those changes on blood glucose, insulin, and lipid concentrations. To meet these aims, the nutrient database of the WHI food frequency questionnaire (FFQ) will be expanded to include GI and GL, which are not currently reported. Existing WHI FFQs will then be reanalyzed to calculate each participant's mean dietary GI and GL. Existing blood glucose, insulin, and lipid data for these WHI participants will be used in the data analyses.