Abstract

Introduction: Dietary insulin index and insulin load were developed to quantify the insulinogenice effects of various foods to capture the postprandial insulin response elicited by carbohydrate, protein and fat intake. However, the association between dietary insulin index, dietary insulin load with risk of coronary heart disease is unknown. Methods: Based on the Nurses’ Health Study (NHS) and the Health Professionals Follow-up Study (HPFS), two large prospective cohort studies of US women and men, we included 76,277 women and 42,689 men into our study with dietary information measured every 4 years. We excluded participants with a baseline history of cardiovascular disease, type 2 diabetes, or cancer. Multivariate Cox proportional hazard models were used, adjusting for major risk factors for coronary heart diseases. We modeled dietary insulin index and insulin load using simple update, cumulative average, continue updating and stop updating after intermediate outcomes. Results: The multivariate adjusted hazard ratio (HR) and 95% confidence intervals comparing the highest vs. the lowest quintile of dietary insulin index was 1.08 (95% CI: 0.95-1.23; p for trend=0.66) for women, and 1.07 (95% CI: 0.98-1.17; p for trend =0.02) for men. For dietary insulin load, the adjusted HR was 1.1 (95% CI: 0.97-1.25; p for trend=0.50) for women and 1.05 (95%CI: 0.96-1.14; p for trend=0.10) for men. Results were similar across different analytic methods. Conclusion: In this cohort of US women and men, we did not observe a strong positive between dietary insulin index or dietary load and risk of coronary heart diseases.

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