February 26, 2024

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NEJM: Low-quality carbohydrate diet will shorten lifespan!

NEJM: Low-quality carbohydrate diet will shorten lifespan!


NEJM: Low-quality carbohydrate diet will shorten lifespan! 

NEJM analyzes the eating habits of 20 countries on five continents: low-quality carbohydrate diet will shorten lifespan!


For diabetics, diet control is the top priority in life; for others, diet should also be controlled to avoid diabetes.

Because diabetes is closely related to cardiovascular disease and the high-risk mortality caused by it.


When it comes to diet, in addition to the obvious high-sugar, high-fat and high-calorie foods, there is also an unhealthy diet that has been popular around the world for many years, that is, low-quality carbohydrate foods with high glycemic index (GI), also called high-glycemic index foods.


That is, after eating, it enters the gastrointestinal tract and digests quickly, the absorption rate is high, and the glucose release is fast, resulting in a rapid increase in blood sugar; this corresponds to low glycemic index foods, that is, the food stays in the gastrointestinal for a long time after eating, and the absorption rate is low.

The slow release can prevent blood sugar from rising after a meal.


On February 25, in a new study published in the top medical journal “New England Journal of Medicine (NEJM)”, a research team led by McMaster University in Canada conducted a survey of more than 137,000 people in 20 countries on five continents.

Eating habits surveys found that low-quality carbohydrate diets, that is, high-glycemic index foods, greatly increase the risk of cardiovascular disease and all-cause death.

Because the participants involved in the study have a wide range of carbohydrate intake and diverse eating habits, it has a high reference value.


NEJM: Low-quality carbohydrate diet will shorten lifespan!



Currently, most studies on the relationship between the glycemic index and cardiovascular disease come from high-income Western countries, and there is a lack of data from non-Western low-income or middle-income countries.

To fill this gap, the McMaster University Population Health Research Institute (PHRI) and Hamilton Health Sciences conducted an epidemiological study (PURE) on 137,851 urban and rural residents living in 20 countries on five continents.


These countries include 4 high-income countries (Canada, Sweden, Saudi Arabia and the UAE), 11 middle-income countries (China, Argentina, Brazil, Chile, Colombia, Iran, Malaysia, Palestine, Poland, South Africa and Turkey) and 5 Low-income countries (Bangladesh, India, Pakistan, Tanzania and Zimbabwe).

Participants were 35 to 70 years old, and the average follow-up time was 9.5 years.


NEJM: Low-quality carbohydrate diet will shorten lifespan!


The researchers used 28 food questionnaires to record detailed information about the participants’ habitual food intake (ie food frequency), and obtained the glycemic index of carbohydrate foods from food databases such as the international glycemic index table.

The intake of major carbohydrate foods is used to estimate the glycemic index and glycemic load to assess their association with cardiovascular disease and all-cause mortality.


The glycemic index (GI) of these seven categories of carbohydrate-containing foods are: beans 42, non-legume starch 93, non-starchy vegetables 54, fruit 69, fruit juice 68, dairy products 38, and sugar-sweetened beverages 87.


Generally speaking, GI is calculated based on 100g food, GI<55 is low GI food; 55-70 is medium GI food; GI>70 is high GI food.


Most fruits, vegetables, legumes and whole-grain foods have a low glycemic index, while white steamed bread, white bread, rice and potatoes have a high glycemic index.

For example, the GI of 100g rice, the staple food of us Chinese, is about 83, and the GI of 100g rich steamed bun is about 88.


Glycemic load is calculated by multiplying the average net carbohydrate intake (in grams/day) by the glycemic index and dividing by 100.


During the average follow-up period of 9.5 years (3.2 to 11.9 years), there were 8780 deaths and 8252 major cardiovascular events (3579 myocardial infarction, 3840 stroke and 923 heart failure).


The analysis found that among participants with previous cardiovascular disease, a high-glycemic index diet was associated with a 50% increase in the risk of major cardiovascular events (non-fatal myocardial infarction, stroke, or heart failure) or death; people without a history of heart disease, this One proportion will also increase by 20%. Participants with obesity (BMI≥25) had a significantly stronger correlation with the above results than those with normal weight.


NEJM: Low-quality carbohydrate diet will shorten lifespan!


In addition, this impact relevance varies by geographic region. Among 44,845 Chinese participants, the impact of a high-glycemic index diet was even more significant.

Researchers found similar effects among participants in the Middle East.


The study’s first author, Professor of Nutritional Science and Medicine at the University of Toronto School of Medicine, David Jenkins, said: “I have been studying the effects of high-glycemic diets for decades.

This study confirms that eating a lot of low-quality carbohydrates is a worldwide phenomenon A common problem. PURE research has shown that not all carbohydrate foods are the same.

A diet rich in low-quality carbohydrates can shorten lifespan, while a diet rich in high-quality carbohydrates such as fruits, vegetables and legumes is beneficial health.”


This study also clearly shows that in a diverse population, a diet with a low glycemic index and glycemic load can help reduce the risk of cardiovascular disease and death.


Salim Yusuf, the corresponding author of the study, a professor of medicine at McMaster University and the executive director of PHRI, said: “This study, as well as from the PURE study and several other previous studies, have emphasized that low-quality carbohydrate intake may be better than dietary intake.

Most of the fat in it is more unfavorable. This requires us to fundamentally change our thinking about what kind of diet may be harmful and what kind of diet is neutral or healthy.”



NEJM: Low-quality carbohydrate diet will shorten lifespan!

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