Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Carbohydrate Intake, Glycemic Index, Glycemic Load, and Dietary Fiber in Relation to Risk of Stroke in Women
1 Department of Nutrition, Harvard School of Public Health, Boston, MA.
2 Department of Epidemiology, Harvard School of Public Health, Boston, MA.
3 The Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA.
4 Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA.
The associations of dietary carbohydrate, glycemic index, and glycemic load with stroke risk were examined among 78,779 US women who were free of cardiovascular disease and diabetes in 1980 and completed a food frequency questionnaire. During an 18-year follow-up, 1,020 stroke cases were documented (including 515 ischemic and 279 hemorrhagic). In analyses adjusting for nondietary risk factors and cereal fiber, carbohydrate intake was associated with elevated risk of hemorrhagic stroke when the extreme quintiles were compared (relative risk = 2.05, 95% confidence interval: 1.10, 3.83; ptrend = 0.02), but not with ischemic stroke. The positive association between carbohydrate intake and stroke risk was most evident among women with a body mass index of 
25 kg/m2. Likewise, dietary glycemic load was positively associated with total stroke among only those women whose body mass index was 25 kg/m2. Cereal fiber intake was inversely associated with total and hemorrhagic stroke risk; for total stroke, relative risk = 0.66 (95% confidence interval: 0.52, 0.83; ptrend = 0.001) and for hemorrhagic stroke, relative risk = 0.51 (95% confidence interval: 0.33, 0.78; ptrend = 0.01). Findings suggest that high intake of refined carbohydrate is associated with hemorrhagic stroke risk, particularly among overweight or obese women. In addition, high consumption of cereal fiber was associated with lower risk of total and hemorrhagic stroke.
cerebrovascular accident; dietary carbohydrates; dietary fiber; prospective studies
Abbreviations: BMI, body mass index; CI, confidence interval; RR, relative risk.
Correspondence to Dr. Walter C. Willett, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115 (e-mail: wwillett{at}hsph.harvard.edu).
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T.-P. Tuomainen, J. Mursu, and S. Voutilainen Bold conclusions from inadequate evidence Am. J. Clinical Nutrition, August 1, 2008; 88(2): 477 - 478. [Full Text] [PDF]
|
|
|
|
 |
|
 S. S. Bassuk and J. E. Manson Lifestyle and Risk of Cardiovascular Disease and Type 2 Diabetes in Women: A Review of the Epidemiologic Evidence American Journal of Lifestyle Medicine, June 1, 2008; 2(3): 191 - 213. [Abstract] [PDF]
|
|
|
|
|
|
K. Marsh and J. Brand-Miller State of the Art Reviews: Glycemic Index, Obesity, and Chronic Disease American Journal of Lifestyle Medicine, April 1, 2008; 2(2): 142 - 150. [Abstract] [PDF]
|
|
|
|
|
|
A. W Barclay, P. Petocz, J. McMillan-Price, V. M Flood, T. Prvan, P. Mitchell, and J. C Brand-Miller Glycemic index, glycemic load, and chronic disease risk--a meta-analysis of observational studies Am. J. Clinical Nutrition, March 1, 2008; 87(3): 627 - 637. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J Padayatty and M. Levine Fruit and vegetables: think variety, go ahead, eat! Am. J. Clinical Nutrition, January 1, 2008; 87(1): 5 - 7. [Full Text] [PDF]
|
|
|
|
|
|
G. Livesey, R. Taylor, T. Hulshof, and J. Howlett Glycemic response and health a systematic review and meta-analysis: the database, study characteristics, and macronutrient intakes Am. J. Clinical Nutrition, January 1, 2008; 87(1): 223S - 236S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Riccardi, A. A Rivellese, and R. Giacco Role of glycemic index and glycemic load in the healthy state, in prediabetes, and in diabetes Am. J. Clinical Nutrition, January 1, 2008; 87(1): 269S - 274S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Kan, J. Stevens, G. Heiss, R. Klein, K. M Rose, and S. J London Dietary fiber intake and retinal vascular caliber in the Atherosclerosis Risk in Communities Study Am. J. Clinical Nutrition, December 1, 2007; 86(6): 1626 - 1632. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W.J. Beulens, L. M. de Bruijne, R. P. Stolk, P. H.M. Peeters, M. L. Bots, D. E. Grobbee, and Y. T. van der Schouw High Dietary Glycemic Load and Glycemic Index Increase Risk of Cardiovascular Disease Among Middle-Aged Women: A Population-Based Follow-Up Study J. Am. Coll. Cardiol., July 3, 2007; 50(1): 14 - 21. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. B Levitan, M. A Mittleman, N. Hakansson, and A. Wolk Dietary glycemic index, dietary glycemic load, and cardiovascular disease in middle-aged and older Swedish men Am. J. Clinical Nutrition, June 1, 2007; 85(6): 1521 - 1526. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J S Volek, C E Forsythe, and W J Kraemer Nutritional aspects of women strength athletes Br. J. Sports Med., September 1, 2006; 40(9): 742 - 748. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Fisher, K. Lees, and J. D. Spence Nutrition and Stroke Prevention Stroke, September 1, 2006; 37(9): 2430 - 2435. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Kurth, S. C. Moore, J. M. Gaziano, C. S. Kase, M. J. Stampfer, K. Berger, and J. E. Buring Healthy lifestyle and the risk of stroke in women. Arch Intern Med, July 10, 2006; 166(13): 1403 - 1409. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. W. Small, D. H. S. Silverman, P. Siddarth, L. M. Ercoli, K. J. Miller, H. Lavretsky, B. C. Wright, S. Y. Bookheimer, J. R. Barrio, and M. E. Phelps Effects of a 14-Day Healthy Longevity Lifestyle Program on Cognition and Brain Function. Am J Geriatr Psychiatry, June 1, 2006; 14(6): 538 - 545. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. A. Bischoff, H. B. Staehelin, and W. C. Willett The effect of undernutrition in the development of frailty in older persons. J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2006; 61(6): 585 - 589. [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Ma, Y. Li, D. E. Chiriboga, B. C. Olendzki, J. R. Hebert, W. Li, K. Leung, A. R. Hafner, and I. S. Ockene Association between Carbohydrate Intake and Serum Lipids. J. Am. Coll. Nutr., April 1, 2006; 25(2): 155 - 163. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Lairon, N. Arnault, S. Bertrais, R. Planells, E. Clero, S. Hercberg, and M.-C. Boutron-Ruault Dietary fiber intake and risk factors for cardiovascular disease in French adults Am. J. Clinical Nutrition, December 1, 2005; 82(6): 1185 - 1194. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Ross RE: "Carbohydrate Intake, Glycemic Index, Glycemic Load, and Dietary Fiber in Relation to Risk of Stroke in Women" Am. J. Epidemiol., May 15, 2005; 161(10): 995 - 995. [Full Text] [PDF]
|
|