Carbohydrates, dietary glycaemic load and glycaemic index, and risk of acute myocardial infarction.

OBJECTIVES To assess the relation between selected carbohydrate foods, dietary glycaemic load and glycaemic index, and the risk of non-fatal acute myocardial infarction in a population with a high intake of refined carbohydrates. DESIGN AND SETTING Hospital based case-control study conducted in Milan, Italy, between 1995 and 1999. PATIENTS 433 non-diabetic subjects with a first episode of non-fatal acute myocardial infarction, and 448 controls admitted to hospital for a wide spectrum of acute conditions unrelated to known or potential risk factors for acute myocardial infarction. METHODS Information was collected by interviewer administered questionnaires. Multivariate odds ratios (OR) and 95% confidence intervals (CI) were obtained by multiple logistic regression models. RESULTS Compared with patients in the lowest tertile of intake, the multivariate OR for those in the highest tertile was 1.00 for bread, 1.27 for pasta and rice, 1.38 for soups, 0.78 for potatoes, 0.97 for desserts, and 1.00 for sugar. The OR for the highest tertile of score was 1.08 for glycaemic load and 1.38 for glycaemic index. None of the estimates was significant. A significant association with acute myocardial infarction risk was found for glycaemic index in patients aged > or = 60 years (OR 1.81, 95% CI 1.07 to 3.07 for the highest tertile of score compared with the lowest) and in those with a body mass index > or = 25 kg/m2 (OR 2.02, 95% CI 1.21 to 3.34). CONCLUSIONS In this Italian population high glycaemic load and glycaemic index were not strongly associated with acute myocardial infarction risk, but slightly increased odds ratios were observed for glycaemic index in elderly people and in association with overweight.