Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality

This multinational cohort study from the PURE trial examines the relationship between dietary glycemic index (GI) and glycemic load (GL) with cardiovascular disease (CVD) and mortality across diverse populations. Encompassing 137,851 individuals aged 35–70 from 20 countries, the study found that a high GI diet was consistently associated with elevated risks of major cardiovascular events and all-cause mortality over a median 9.5-year follow-up. Specifically, individuals with preexisting CVD had a 51% increased risk (HR: 1.51) and those without had a 21% increased risk (HR: 1.21) when comparing highest to lowest GI quintiles. Higher GL showed a similar pattern in participants with prior CVD but lacked significance among those without. The adverse association between GI and outcomes was especially pronounced in individuals with BMI ≥25. Regionally, China, Africa, and Southeast Asia had the highest mean GI and GL values. The study reinforces GI as a relevant measure of carbohydrate quality and supports lower-GI diets for primary and secondary cardiovascular prevention, especially in high-risk groups.

This multinational cohort study from the PURE trial examines the relationship between dietary glycemic index (GI) and glycemic load (GL) with cardiovascular disease (CVD) and mortality across diverse populations. Encompassing 137,851 individuals aged 35–70 from 20 countries, the study found that a high GI diet was consistently associated with elevated risks of major cardiovascular events and all-cause mortality over a median 9.5-year follow-up. Specifically, individuals with preexisting CVD had a 51% increased risk (HR: 1.51) and those without had a 21% increased risk (HR: 1.21) when comparing highest to lowest GI quintiles. Higher GL showed a similar pattern in participants with prior CVD but lacked significance among those without. The adverse association between GI and outcomes was especially pronounced in individuals with BMI ≥25. Regionally, China, Africa, and Southeast Asia had the highest mean GI and GL values. The study reinforces GI as a relevant measure of carbohydrate quality and supports lower-GI diets for primary and secondary cardiovascular prevention, especially in high-risk groups.