Examinando por Autor "Jenkins, David"

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  • Publicación
    Acceso abierto
    Associations of cereal grains intake with cardiovascular disease and mortality across 21 countries in prospective urban and rural epidemiology study
    (BMJ, 2021-02-03) Dehghan, Mahshid; Raj, John Michael; Thomas, Tinku; Rangarajan, Sumathy; Jenkins, David; Mony, Prem; Mohan, Viswanathan; Lear, Scott A.; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Rosengren, Annika; Lanas, Fernando; AlHabib, Khalid F.; Dans, Antonio; Keskinler, Mirac Vural; Puoane, Thandi; Soman, Biju; Wei, Li; Zatonska, Katarzyna; Diaz, Rafael; Ismail, Noorhassim; Chifamba, Jephat; Kelishadi, Roya; Yusufali, Afzalhussein; Khatib, Rasha; Xiaoyun, Liu; Bo, Hu; Iqbal, Romaina; Yusuf, Rita; Yeates, Karen; Teo, Koon; Yusuf, Salim; Masira
    Objective. To evaluate the association between intakes of refined grains, whole grains, and white rice with cardiovascular disease, total mortality, blood lipids, and blood pressure in the Prospective Urban and Rural Epidemiology (PURE) study. Design. Prospective cohort study. Setting PURE study in 21 countries. Participants 148858 participants with median follow-up of 9.5 years. Exposures Country specific validated food frequency questionnaires were used to assess intakes of refined grains, whole grains, and white rice. Main outcome measure Composite of mortality or major cardiovascular events (defined as death from cardiovascular causes, nonfatal myocardial infarction, stroke, or heart failure). Hazard ratios were estimated for associations of grain intakes with mortality, major cardiovascular events, and their composite by using multivariable Cox frailty models with random intercepts to account for clustering by centre. Results Analyses were based on 137130 participants after exclusion of those with baseline cardiovascular disease. During follow-up, 9.2% (n=12668) of these participants had a composite outcome event. The highest category of intake of refined grains (≥350 g/day or about 7 servings/day) was associated with higher risk of total mortality (hazard ratio 1.27, 95% confidence interval 1.11 to 1.46; P for trend=0.004), major cardiovascular disease events (1.33, 1.16 to 1.52; P for trend<0.001), and their composite (1.28, 1.15 to 1.42; P for trend<0.001) compared with the lowest category of intake (<50 g/day). Higher intakes of refined grains were associated with higher systolic blood pressure. No significant associations were found between intakes of whole grains or white rice and health outcomes. Conclusion High intake of refined grains was associated with higher risk of mortality and major cardiovascular disease events. Globally, lower consumption of refined grains should be considered.
  • Publicación
    Acceso abierto
    Glycemic index, glycemic load, and cardiovascular disease and mortality
    (The New England Journal of Medicine, 2021-04-08) Jenkins, David; Dehghan, Mahshid; Mente, Andrew; Bangdiwala, Shrikant I.; Rangarajan, Sumathy; Srichaikul, Kristie; Mohan, Viswanathan; Avezum, Alvaro; Díaz, Rafael; Rosengren, Annika; Lanas, Fernando; Lopez-Jaramillo, Patricio; Li, Wei; Oguz, Aytekin; Khatib, Rasha; Poirier, Paul; Mohammadifard, Noushin; Pepe, Andrea; Alhabib, Khalid F.; Chifamba, Jephat; Yusufali, Afzal Hussein; Iqbal, Romaina; Yeates, Karen; Yusoff, Khalid; Ismail, Noorhassim; Teo, Koon; Swaminathan, Sumathi; Liu, Xiaoyun; Zatońska, Katarzyna; Yusuf, Rita; Yusuf, Salim; The PURE Study Investigators; Masira
    BACKGROUND Most data regarding the association between the glycemic index and cardiovascular disease come from high-income Western populations, with little information from non-Western countries with low or middle incomes. To fill this gap, data are needed from a large, geographically diverse population. METHODS This analysis includes 137,851 participants between the ages of 35 and 70 years living on five continents, with a median follow-up of 9.5 years. We used countryspecific food-frequency questionnaires to determine dietary intake and estimated the glycemic index and glycemic load on the basis of the consumption of seven categories of carbohydrate foods. We calculated hazard ratios using multivariable Cox frailty models. The primary outcome was a composite of a major cardiovascular event (cardiovascular death, nonfatal myocardial infarction, stroke, and heart failure) or death from any cause. RESULTS In the study population, 8780 deaths and 8252 major cardiovascular events occurred during the follow-up period. After performing extensive adjustments comparing the lowest and highest glycemic-index quintiles, we found 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 results with respect to glycemic load were similar to the findings regarding the glycemic index among the participants with cardiovascular disease at baseline, but the association was not significant among those without preexisting cardiovascular disease. CONCLUSIONS In this study, a diet with a high glycemic index was associated with an increased risk of cardiovascular disease and death. (Funded by the Population Health Research Institute and others.)