A prospective cohort study
American Journal of Clinical Nutrition, 05/16/2014
Rebello SA, et al. – In this study, researchers assessed whether intakes of total carbohydrates, different types of carbohydrates, and their food sources were associated with IHD mortality in a Chinese population. They concluded that 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.
- Authors 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
- They 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.