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Amount, type, and sources of carbohydrates in relation to ischemic heart disease mortality in a Chinese population: a prospective cohort study1234

Identifieur interne : 000789 ( Pmc/Curation ); précédent : 000788; suivant : 000790

Amount, type, and sources of carbohydrates in relation to ischemic heart disease mortality in a Chinese population: a prospective cohort study1234

Auteurs : Salome A. Rebello ; Hiromi Koh ; Cynthia Chen ; Nasheen Naidoo ; Andrew O. Odegaard ; Woon-Puay Koh ; Lesley M. Butler ; Jian-Min Yuan ; Rob M. Van Dam

Source :

RBID : PMC:4144114

Abstract

Background: The relation between carbohydrate intake and risk of ischemic heart disease (IHD) has not been fully explored in Asian populations known to have high-carbohydrate diets.

Objective: We assessed whether intakes of total carbohydrates, different types of carbohydrates, and their food sources were associated with IHD mortality in a Chinese population.

Design: We prospectively examined the association of carbohydrate intake and IHD mortality in 53,469 participants in the Singapore Chinese Health Study with an average follow-up of 15 y. Diet was assessed by using a semiquantitative food-frequency questionnaire. HRs and 95% CIs were calculated by using a Cox proportional hazards analysis.

Results: We documented 1660 IHD deaths during 804,433 person-years of follow-up. Total carbohydrate intake was not associated with IHD mortality risk [men: HR per 5% of energy, 0.97 (95% CI: 0.92, 1.03); women: 1.06 (95% CI: 0.99, 1.14)]. When types of carbohydrates were analyzed individually, starch intake was associated with higher risk [men: 1.03 (95% CI: 0.99, 1.08); women: 1.08, (95% CI: 1.02, 1.14)] and fiber intake with lower risk of IHD mortality [men: 0.94 (95% CI: 0.82, 1.08); women: 0.71 (95% CI: 0.60, 0.84)], with stronger associations in women than men (both P-interaction < 0.01). In substitution analyses, the replacement of one daily serving of rice with one daily serving of noodles was associated with higher risk (difference in HR: 26.11%; 95% CI: 10.98%, 43.30%). In contrast, replacing one daily serving of rice with one of vegetables (−23.81%; 95% CI: −33.12%, −13.20%), fruit (−11.94%; 95% CI: −17.49%, −6.00%), or whole-wheat bread (−19.46%; 95% CI: −34.28%, −1.29%) was associated with lower risk of IHD death.

Conclusions: In this Asian population with high carbohydrate intake, the total amount of carbohydrates consumed was not substantially associated with IHD mortality. In contrast, the shifting of food sources of carbohydrates toward a higher consumption of fruit, vegetables, and whole grains was associated with lower risk of IHD death.


Url:
DOI: 10.3945/ajcn.113.076273
PubMed: 24787492
PubMed Central: 4144114

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<name sortKey="Yuan, Jian Min" sort="Yuan, Jian Min" uniqKey="Yuan J" first="Jian-Min" last="Yuan">Jian-Min Yuan</name>
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<p>
<bold>Background: </bold>
The relation between carbohydrate intake and risk of ischemic heart disease (IHD) has not been fully explored in Asian populations known to have high-carbohydrate diets.</p>
<p>
<bold>Objective:</bold>
We assessed whether intakes of total carbohydrates, different types of carbohydrates, and their food sources were associated with IHD mortality in a Chinese population.</p>
<p>
<bold>Design:</bold>
We prospectively examined the association of carbohydrate intake and IHD mortality in 53,469 participants in the Singapore Chinese Health Study with an average follow-up of 15 y. Diet was assessed by using a semiquantitative food-frequency questionnaire. HRs and 95% CIs were calculated by using a Cox proportional hazards analysis.</p>
<p>
<bold>Results: </bold>
We documented 1660 IHD deaths during 804,433 person-years of follow-up. Total carbohydrate intake was not associated with IHD mortality risk [men: HR per 5% of energy, 0.97 (95% CI: 0.92, 1.03); women: 1.06 (95% CI: 0.99, 1.14)]. When types of carbohydrates were analyzed individually, starch intake was associated with higher risk [men: 1.03 (95% CI: 0.99, 1.08); women: 1.08, (95% CI: 1.02, 1.14)] and fiber intake with lower risk of IHD mortality [men: 0.94 (95% CI: 0.82, 1.08); women: 0.71 (95% CI: 0.60, 0.84)], with stronger associations in women than men (both
<italic>P</italic>
-interaction < 0.01). In substitution analyses, the replacement of one daily serving of rice with one daily serving of noodles was associated with higher risk (difference in HR: 26.11%; 95% CI: 10.98%, 43.30%). In contrast, replacing one daily serving of rice with one of vegetables (−23.81%; 95% CI: −33.12%, −13.20%), fruit (−11.94%; 95% CI: −17.49%, −6.00%), or whole-wheat bread (−19.46%; 95% CI: −34.28%, −1.29%) was associated with lower risk of IHD death.</p>
<p>
<bold>Conclusions: </bold>
In this Asian population with high carbohydrate intake, the total amount of carbohydrates consumed was not substantially associated with IHD mortality. In contrast, the shifting of food sources of carbohydrates toward a higher consumption of fruit, vegetables, and whole grains was associated with lower risk of IHD death.</p>
</div>
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<subject>Cardiovascular Disease Risk</subject>
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<article-title>Amount, type, and sources of carbohydrates in relation to ischemic heart disease mortality in a Chinese population: a prospective cohort study
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
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<sup>2</sup>
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<name>
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<aff id="aff1">
<label>1</label>
From the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore (SAR, HK, CC, NN, W-PK, and RMvD); the Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN (AOO), the Duke-National University of Singapore Graduate Medical School, Singapore (W-PK); the Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute and Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA (J-MY and LMB); the Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (RMvD); and the Department of Nutrition, Harvard School of Public Health, Boston, MA (RMvD).</aff>
</contrib-group>
<author-notes>
<fn id="fn1">
<label>2</label>
<p>Study sponsors had no role in the design of the analytical plan, data interpretation, or manuscript preparation and approval.</p>
</fn>
<fn id="fn2">
<label>3</label>
<p>Supported by the
<funding-source>NIH</funding-source>
(grants
<award-id>NCI RO1 CA055069</award-id>
,
<award-id>R35 CA053890</award-id>
,
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,
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, and
<award-id>R01 CA144034</award-id>
).</p>
</fn>
<corresp id="cor1">
<label>4</label>
Address reprint requests and correspondence to SA Rebello, Saw Swee Hock School of Public Health, 16 Medical Drive, Block MD3, Singapore 117597. E-mail:
<email xlink:type="simple">ephsar@nus.edu.sg</email>
.</corresp>
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<pmc-comment>Fake ppub date generated by PMC from publisher pub-date/@pub-type='epub-ppub' </pmc-comment>
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<lpage>64</lpage>
<history>
<date date-type="received">
<day>25</day>
<month>9</month>
<year>2013</year>
</date>
<date date-type="accepted">
<day>31</day>
<month>3</month>
<year>2014</year>
</date>
</history>
<permissions>
<copyright-statement>© 2014 American Society for Nutrition</copyright-statement>
<copyright-year>2014</copyright-year>
</permissions>
<abstract>
<p>
<bold>Background: </bold>
The relation between carbohydrate intake and risk of ischemic heart disease (IHD) has not been fully explored in Asian populations known to have high-carbohydrate diets.</p>
<p>
<bold>Objective:</bold>
We assessed whether intakes of total carbohydrates, different types of carbohydrates, and their food sources were associated with IHD mortality in a Chinese population.</p>
<p>
<bold>Design:</bold>
We prospectively examined the association of carbohydrate intake and IHD mortality in 53,469 participants in the Singapore Chinese Health Study with an average follow-up of 15 y. Diet was assessed by using a semiquantitative food-frequency questionnaire. HRs and 95% CIs were calculated by using a Cox proportional hazards analysis.</p>
<p>
<bold>Results: </bold>
We documented 1660 IHD deaths during 804,433 person-years of follow-up. Total carbohydrate intake was not associated with IHD mortality risk [men: HR per 5% of energy, 0.97 (95% CI: 0.92, 1.03); women: 1.06 (95% CI: 0.99, 1.14)]. When types of carbohydrates were analyzed individually, starch intake was associated with higher risk [men: 1.03 (95% CI: 0.99, 1.08); women: 1.08, (95% CI: 1.02, 1.14)] and fiber intake with lower risk of IHD mortality [men: 0.94 (95% CI: 0.82, 1.08); women: 0.71 (95% CI: 0.60, 0.84)], with stronger associations in women than men (both
<italic>P</italic>
-interaction < 0.01). In substitution analyses, the replacement of one daily serving of rice with one daily serving of noodles was associated with higher risk (difference in HR: 26.11%; 95% CI: 10.98%, 43.30%). In contrast, replacing one daily serving of rice with one of vegetables (−23.81%; 95% CI: −33.12%, −13.20%), fruit (−11.94%; 95% CI: −17.49%, −6.00%), or whole-wheat bread (−19.46%; 95% CI: −34.28%, −1.29%) was associated with lower risk of IHD death.</p>
<p>
<bold>Conclusions: </bold>
In this Asian population with high carbohydrate intake, the total amount of carbohydrates consumed was not substantially associated with IHD mortality. In contrast, the shifting of food sources of carbohydrates toward a higher consumption of fruit, vegetables, and whole grains was associated with lower risk of IHD death.</p>
</abstract>
<counts>
<page-count count="12"></page-count>
</counts>
</article-meta>
</front>
</pmc>
</record>

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