Women double their risk of developing coronary heart disease if they have high consumption of carbohydrates, according to research recently published in the Archives of Internal Medicine.
Men’s hearts, however, didn’t seem to be affected by carb consumption. I mention this crucial difference because I see a growing trend to believe that “replacing saturated fat with carbohydrates is a major cause of heart disease.” If true, it seems to apply only to women.
We’ve known for a while that high-glycemic-index eating was linked to heart disease in women but not men. Glycemic index is a measure of how much effect a carbohydrate-containing food has on blood glucose levels. High-glycemic-index foods raise blood sugar higher and for longer duration in the bloodstream.
High-glycemic-index foods include potatoes, white bread, and pasta, for example.
The study at hand includes over 47,000 Italians who were interrogated via questionnaire as to their food intake, then onset of coronary heart disease—the cause of heart attacks—was measured over the next eight years.
Among the 32,500 women, 158 new cases of coronary heart disease were found.
Researchers doing this sort of study typically compare the people eating the least carbs with those eating the most. The highest quartile of carb consumers and glycemic load had twice the rate of heart disease compared to the lowest quartile.
The Cleave-Yudkin theory of the mid-20th century proposed that excessive amounts of refined carbohydrates cause heart disease and certain other chronic systemic diseases. Gary Taubes has also written extensively about this. Theresearch results at hand support that theory in women, but not in men.
Practical Applications
Do these research results apply to non-Italian women and men? Probably to some, but not all. More research is needed.
Women with a family history coronary heart disease—or other CHD risk factors—might be well-advised to put a limit on total carbs, high-glycemic-index foods, and glycemic load. I’d stay out of that “highest quartile.” Don’t forget: heart disease is the No. 1 killer of women.
See NutritionData’s Glycemic Index page for information you can apply today.
Disclaimer: All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status. Always consult your personal physician before making any dietary or exercise changes.
References: Sieri, S., Krogh, V., Berrino, F., Evangelista, A., Agnoli, C., Brighenti, F., Pellegrini, N., Palli, D., Masala, G., Sacerdote, C., Veglia, F., Tumino, R., Frasca, G., Grioni, S., Pala, V., Mattiello, A., Chiodini, P., & Panico, S. (2010). Dietary Glycemic Load and Index and Risk of Coronary Heart Disease in a Large Italian Cohort: The EPICOR Study Archives of Internal Medicine, 170 (7), 640-647 DOI: 10.1001/archinternmed.2010.15
Barclay, Alan, et al. Glycemic index, glycemic load, and chronic disease risk – a meta-analysis of observational studies [of mostly women]. American Journal of Clinical Nutrition, 87 (2008): 627-637.
Diabetic Mediterranean Diet 
Should we really be guided by yet another tedious observational study fraught with confounders and intrinsically unnable to shed light on causes? This conventional wisdom is akin to the state of quantum physics during the Middle Ages.
More refined carbohydrate = less magnesium = more hypertension, higher trigs and more insulin resistance, and 60% of Americans don’t achieve the RDA (http://www.medscape.com/viewarticle/423568) – consistent with Weston Price, Cleave, Yudkin and perhaps the success of the Mediterranian Diet, this suggests food refining contributes to the diseases of civilization. Yet the RCTs focus on statins, not magnesium supplementation, and here we’re giving credence to an epidemiological study which likely asked the wrong question? I’m not so sure “more research is needed”, certainly not this kind of research.
Re “I see a growing trend to replace saturated fat with carbohydrates as a major cause of heart disease,” I thought this from the recent ADA food & nutrition conference interesting:
I remain skeptical that saturated fat is the villain, but at least replacing it with monounsaturated fats is better than replacing it with carbs!
Beth-
Walter Willett, who participated in that ADA debate, has written that replacing saturated fats with polyunsaturated fats is helpful in terms of reducing cardiovascular disease. I don’t think he’s changed his mind. I agree with your monounsaturated fat comment, especially if you are referring to refined carbs.
Jonathan-
I’m not familiar with magnesium connection – will have to look into it when time allows. Magnesium supplements seem to be less expensive than statins.