Introduction:
Diets with a high carbohydrate content, especially the refined carbohydrates, and diets with a high glycemic index (GI) or glycemic load (GL) have been shown to have adverse metabolic effects and may increase the risk of cardiovascular disease. We tested the hypothesis that dietary carbohydrates, GI, and GL may be associated with increased risk of stroke among a cohort of middle-aged and older Chinese women, who typically consume a high-carbohydrate diet.
Methods:
This study included 64,328 women (40-70 years of age) who are participants of the Shanghai Women’s Health Study and were free of cardiovascular disease, cancer, and diabetes at enrollment (1997-2000). Habitual dietary intakes were assessed by a validated food-frequency questionnaire. Incident cases of stroke were identified through follow-up interviews and confirmed by medical records. Multivariate Cox regression was used to estimate hazard ratio (HR) of stroke with 95% confidence interval (CI).
Results:
During a mean follow-up of 10 years, we ascertained 3,075 incident stroke cases, including 2,815 ischemic stroke and 260 hemorrhagic stroke. Compared with those in the lowest quintile, women in the highest quintile of GI had a HR of 1.16 for stroke (95% CI: 1.01-1.33) and women in the highest quintile of GL had a HR of 1.30 (95% CI: 1.04-1.62), P for trend <0.05 for both. High dietary GI and GL were associated with increased risks of both ischemic and hemorrhagic stroke, with stronger associations observed for GL and for hemorrhagic stroke. However, no significant associations were found for total carbohydrate intake after adjustment for potential confounders.
Conclusions:
High dietary GI and GL may be associated with elevated risk of stroke in middle-aged and older Chinese women.
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