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Dietary glycemic index, glycemic load and mortality: Japan Public Health Center-based prospective study

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Abstract

Purpose

Long-term associations of dietary glycemic index (GI) and glycemic load (GL) with mortality outcomes remain unclear.

Methods

The present analysis included 72,783 participants of the Japan Public Health Center-based Prospective Study. Participants who responded to the 5-year follow-up questionnaire in 1995–1999 were followed-up until December 2015. We estimated the risk of total and cause-specific mortality associated with GI and GL using Cox proportional hazards regression models.

Results

During 1,244,553 person years of follow-up, 7535 men and 4913 women died. GI was positively associated with all-cause mortality. As compared with the lowest quartile, the multivariable HR for those who had the highest quartile of GI was 1.14 (95% CI 1.08–1.20). The HRs for death comparing the highest with the lowest quartile were 1.28 (95% CI 1.14–1.42) for circulatory system diseases, 1.33 (95% CI 1.14–1.55) for heart disease, 1.32 (95% CI 1.11–1.57) for cerebrovascular disease, and 1.45 (95% CI 1.18–1.78) for respiratory diseases. GI was not associated with mortality risks of cancer and digestive diseases. GL showed a null association with all-cause mortality (highest vs lowest quartile; HR 1.04; 95% CI 0.96–1.12). However, among those who had the highest quartile of GL, the HRs for death from circulatory system diseases was 1.24 (95% CI 1.05–1.46), cerebrovascular disease was 1.34 (95% CI 1.03–1.74), and respiratory diseases was 1.35 (95% CI 1.00–1.82), as compared with the lowest quartile.

Conclusion

In this large prospective cohort study, dietary GI and GL were associated with mortality risks.

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Availability of data and materials

For information on how to submit an application for gaining access to JPHC data and/or biospecimens, please follow the instructions at http://epi.ncc.go.jp/en/jphc/805/8155.html.

Abbreviations

BMES:

Blue Mountains Eye study

CIs:

Confidence intervals

FFQ:

Food Frequency Questionnaire

GI:

Glycemic index

GL:

Glycemic load

HbA1c:

Glycated hemoglobin

HRs:

Hazard ratios

JPHC study:

Japan Public Health Center-based Prospective Study

PHCs:

Public health centers

PREDIMED study:

PREvención con DIeta MEDiterránea

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Acknowledgements

The authors would like to thank Rieko Kanehara and Dr. Utako Murai of the Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan for her advice on the nutritional aspects of the study. Research group members are listed at the following site (as of Oct, 2020): https://epi.ncc.go.jp/en/jphc/781/8510.html.

Funding

This study was supported by the National Cancer Centre Research and Development Fund (since 2011), and a Grant in Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010).

Author information

Authors and Affiliations

  1. Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Hsi-Lan Huang & Masahiro Hashizume

  2. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan

    Sarah Krull Abe, Norie Sawada, Motoki Iwasaki, Taiki Yamaji, Manami Inoue & Shoichiro Tsugane

  3. Department of Food Science and Nutrition, Graduate School of Humanities and Sciences, Nara Women’s University, Nara, Japan

    Ribeka Takachi

  4. Department of Food and Life Science, Azabu University, Kanagawa, Japan

    Junko Ishihara

  5. Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

    Hiroyasu Iso

  6. Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan

    Tetsuya Mizoue

  7. Department of Diabetes, Metabolism and Endocrinology, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan

    Mitsuhiko Noda

  8. Department of Cancer Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Manami Inoue

  9. Division of Prevention, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Manami Inoue

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  1. Hsi-Lan Huang
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  2. Sarah Krull Abe
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  3. Norie Sawada
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  11. Masahiro Hashizume
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  12. Manami Inoue
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Contributions

MI and H-LH designed the study. H-LH performed the analysis and wrote the manuscript. H-LH, SKA, NS, RT, JI, MI, TY, HI, TM, MN, MH, MI, and ST revised the manuscript critically for important intellectual content. All authors approved the final version before submission.

Corresponding author

Correspondence to Manami Inoue.

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Conflict of interest

All authors declare no competing interests.

Ethics approval and consent to participate

The study was conducted in compliance with the provisions of the Declaration of Helsinki. The study protocol was approved by the Institutional Review Board of the National Cancer Center, Japan. The participants were informed of the study objectives, and those who completed the survey questionnaire were regarded as consenting to participation.

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Huang, HL., Abe, S.K., Sawada, N. et al. Dietary glycemic index, glycemic load and mortality: Japan Public Health Center-based prospective study . Eur J Nutr 60, 4607–4620 (2021). https://doi.org/10.1007/s00394-021-02621-0

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