The data from the PURE study published in the New England Journal of Medicine shows that a diet with a high glycemic index or loaded with poor carbohydrates will increase the risk of CVD and mortality.

    The investigatory team analyzed 137,851 participants between the ages of 35 and 70 years from five continents who were followed for a median of 9.5 years. Country-specific food-frequency questionnaires were used by the researchers to calculate the dietary intake for each participant and to determine the glycemic index and glycemic load of each participant’s diet based on the consumption of seven categories of carbohydrate foods. Hazard ratios were calculated using multivariable Cox frailty models. The primary outcome was all-cause mortality or a major CV event, defined as CV death, nonfatal MI, stroke or HF.

During the follow-up period, there occurred 8780 deaths and 8252 major cardiovascular events. After implementing extensive adjustments comparing the lowest and highest glycemic-index quintiles, the team observed that a diet with a high glycemic index was associated with an increased risk of a major cardiovascular event or death, both among participants with preexisting cardiovascular disease (hazard ratio, 1.51; 95% confidence interval [CI], 1.25 to 1.82) and among those without such disease (hazard ratio, 1.21; 95% CI, 1.11 to 1.34). Among the components of the primary outcome, a high glycemic index was also associated with an increased risk of death from cardiovascular causes. The study concluded that a diet with a high glycemic index was associated with an increased risk of cardiovascular disease and death.

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