Association of glycemic load with cardiovascular disease risk factors: The Women's Health Initiative Observational Study

Shikany, James M.; Tinker, Lesley F.; Neuhouser, Marian L.; Ma, Yunsheng; Patterson, Ruth E.; Phillips, Lawrence S.; Liu, Simin; Redden, David T.

doi:10.1016/j.nut.2009.08.014

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Volume 26, Issue 6 , Pages 641-647, June 2010

Association of glycemic load with cardiovascular disease risk factors: The Women's Health Initiative Observational Study

James M. Shikany, Dr.P.H.
- Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
- Corresponding author. Tel.: +205-975-7989; fax: +205-934-7959.
Lesley F. Tinker, Ph.D.
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
Marian L. Neuhouser, Ph.D.
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
Yunsheng Ma, M.D., Ph.D.
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
Ruth E. Patterson, Ph.D.
- Amylin Pharmaceuticals, Inc., San Diego, California, USA
Lawrence S. Phillips, M.D.
- Division of Endocrinology, Emory University School of Medicine, Atlanta, Georgia, USA
Simin Liu, M.D., Sc.D.
- Department of Epidemiology, University of California, Los Angeles School of Public Health, Los Angeles, California, USA
David T. Redden, Ph.D.
- Department of Biostatistics, University of Alabama at Birmingham School of Public Heath, Birmingham, Alabama, USA

Received 21 November 2008; accepted 15 August 2009. published online 06 January 2010.

Abstract

Objective

Associations between dietary glycemic load (GL) and cardiovascular disease risk factors, including plasma lipoprotein/lipid levels, blood pressure, and glucose metabolism factors, in the Women's Health Initiative Observational Study were examined.

Methods

A random sample of 878 Observational Study participants (postmenopausal women 50–79 y of age) with baseline blood measurements (647 white, 104 black, 127 Hispanic) was included. Dietary GL was estimated from baseline food-frequency questionnaires, which assessed dietary intake over the previous 3 mo. At the baseline visit, participants completed demographic and health habit questionnaires, fasting blood samples were collected, anthropometric measurements were completed, and blood pressure was assessed.

Results

In all participants combined, GL was inversely associated with high-density lipoprotein cholesterol (P for trend = 0.004) and positively associated with log₁₀-transformed triacylglycerols (P = 0.008). Although there were no statistically significant interactions of race/ethnicity with associations between GL and cardiovascular disease risk factors, stratified results were suggestive, showing that GL was positively associated with total cholesterol (P = 0.018) and low-density lipoprotein cholesterol (P = 0.038) in Hispanics. In white subjects, there was a trend of reduced high-density lipoprotein cholesterol with higher GL (P = 0.003), whereas GL was positively associated with log₁₀-transformed triacylglycerols (P = 0.015). Associations between GL and high-density lipoprotein cholesterol and between GL and triacylglycerols also differed by body mass index, although the interactions were not statistically significant.

Conclusion

Among these generally healthy postmenopausal women, GL was associated with high-density lipoprotein cholesterol and triacylglycerols. Suggestive effects of race/ethnicity and body mass index on these associations need to be confirmed in larger studies.

Keywords: Glycemic load, Glycemic index, Carbohydrate, Cardiovascular disease, Women's Health Initiative