Dose response association of glycemic index with CHD risk: a systematic review and meta‐analysis of prospective cohorts

Coronary Heart Disease (CHD) events are responsible for about a third of all deaths in developed countries. Glycemic index (GI) and glycemic load (GL) have been associated with CHD risk in some cohort studies but a dose response has not been established. Aims To conduct a meta‐analysis of GI and GL dose response association with CHD risk in cohort studies. Methods We searched MEDLINE, EMBASE, and CINAHL for prospective cohorts of GI and GL associations with primary incidence of CHD events. Measures of risk estimation with their respective GI and GL exposure doses were pooled using random effects generalized least squares linear models and linear spline piecewise regression models to investigate dose response trends. Data were expressed as change in percent risk of CHD per unit GI with 95% confidence intervals (CI). Results 9 studies were eligible, 7 had complete data for dose response analyses. No significant linear trends were observed for GI or GL dose, but in female cohorts the gradient of GI versus CHD risk was 0.15% [95%CI; 0.008–0.284] up to a GI of 78 and significantly increased to 3.82% [95%CI; 0.621–7.021] thereafter. Conclusion These results suggest a threshold effect may exist for the association of GI with CHD events in women. Funding: Canadian Institutes of Health Research. Grant Funding Source : ASN