TABLE 3.
HRs (95% CIs) of ischemic heart disease mortality across quintiles of carbohydrates, starch, monosaccharides and disaccharides, and dietary fiber1
| Quintiles of intake |
|||||||
| 1 (low) | 2 | 3 | 4 | 5 (high) | P-trend | Per 5% of energy2 | |
| Carbohydrates | |||||||
| Men (n) | 4688 | 4560 | 4572 | 4613 | 5068 | — | — |
| Median (range) intake (% of energy) | 49.64 (28.14, 53.04) | 55.33 (53.04, 57.32) | 59.18 (57.32, 61.03) | 63.05 (61.03, 65.39) | 68.80 (65.39, 86.14) | — | — |
| Age-adjusted HR3 | 1.00 | 0.94 (0.77, 1.15) | 0.82 (0.67, 1.01) | 0.82 (0.67, 1.00) | 0.84 (0.69, 1.02) | 0.19 | 0.97 (0.93, 1.01) |
| Multivariable HR4 | 1.00 | 0.95 (0.78, 1.16) | 0.82 (0.67, 1.01) | 0.82 (0.67, 1.00) | 0.83 (0.68, 1.02) | 0.19 | 0.97 (0.93, 1.01) |
| Additional adjustment for diet5 | 1.00 | 0.98 (0.80, 1.20) | 0.86 (0.69, 1.07) | 0.85 (0.68, 1.07) | 0.82 (0.64, 1.05) | 0.36 | 0.97 (0.92, 1.03) |
| Women (n) | 6005 | 6134 | 6122 | 6081 | 5626 | — | — |
| Median (range) intake (% of energy) | 50.01 (29.17, 53.04) | 55.38 (53.04, 57.32) | 59.17 (57.32, 61.03) | 63.01 (61.03, 65.39) | 68.47 (65.39, 83.10) | — | — |
| Age-adjusted HR3 | 1.00 | 0.92 (0.69, 1.21) | 0.92 (0.70, 1.21) | 1.13 (0.87, 1.46) | 1.03 (0.79, 1.34) | 0.34 | 1.03 (0.97, 1.09) |
| Multivariable HR4 | 1.00 | 0.91 (0.69, 1.21) | 0.91 (0.69, 1.20) | 1.10 (0.85, 1.43) | 1.01 (0.78, 1.31) | 0.47 | 1.02 (0.96, 1.08) |
| Additional adjustment for diet5 | 1.00 | 0.96 (0.72, 1.29) | 0.99 (0.74, 1.33) | 1.22 (0.91, 1.63) | 1.17 (0.85, 1.61) | 0.12 | 1.06 (0.99, 1.14) |
| Starch | |||||||
| Men (n) | 4128 | 4470 | 4601 | 4760 | 5542 | — | — |
| Median (range) intake (% of energy) | 30.40 (4.41, 33.80) | 36.58 (33.80, 39.03) | 41.47 (39.04, 43.88) | 46.65 (43.88, 49.82) | 54.70 (49.83, 83.00) | — | — |
| Age-adjusted HR3 | 1.00 | 1.01 (0.81, 1.26) | 1.09 (0.88, 1.35) | 1.08 (0.88, 1.34) | 1.14 (0.93, 1.39) | 0.14 | 1.02 (0.99, 1.06) |
| Multivariable HR4 | 1.00 | 1.01 (0.81, 1.26) | 1.05 (0.85, 1.31) | 1.05 (0.84, 1.31) | 1.09 (0.88, 1.34) | 0.30 | 1.02 (0.98, 1.05) |
| Additional adjustment for diet5 | 1.00 | 1.04 (0.83, 1.30) | 1.11 (0.88, 1.39) | 1.13 (0.89, 1.43) | 1.17 (0.91, 1.51) | 0.16 | 1.03 (0.99, 1.08) |
| Women (n) | 6565 | 6224 | 6093 | 5934 | 5152 | — | — |
| Median (range) intake (% of energy) | 30.01 (5.97, 33.80) | 36.61 (33.81, 39.04) | 41.45 (39.04, 43.87) | 46.51 (43.88, 49.82) | 54.21 (49.82, 80.62) | — | — |
| Age-adjusted HR3 | 1.00 | 1.29 (0.95, 1.76) | 1.34 (0.99, 1.81) | 1.68 (1.26, 2.25) | 1.76 (1.32, 2.36) | <0.01 | 1.09 (1.05, 1.14) |
| Multivariable HR4 | 1.00 | 1.24 (0.91, 1.70) | 1.24 (0.91, 1.68) | 1.57 (1.17, 2.10) | 1.61 (1.20, 2.16) | <0.01 | 1.08 (1.03, 1.13) |
| Additional adjustment for diet5 | 1.00 | 1.25 (0.91, 1.72) | 1.24 (0.91, 1.71) | 1.56 (1.14, 2.15) | 1.60 (1.13, 2.26) | 0.01 | 1.08 (1.02, 1.14) |
| Monosaccharides and disaccharides6 | |||||||
| Men (n) | 5224 | 4962 | 4740 | 4542 | 4033 | — | — |
| Median (range) intake (% of energy) | 7.28 (0, 9.20) | 10.68 (9.20, 12.05) | 13.37 (12.05, 14.79) | 16.39 (14.79, 18.41) | 21.34 (18.41, 50.43) | — | — |
| Age-adjusted HR3 | 1.00 | 0.81 (0.68, 0.97) | 0.76 (0.63, 0.91) | 0.83 (0.70, 1.00) | 0.64 (0.52, 0.79) | <0.01 | 0.90 (0.85, 0.95) |
| Multivariable HR4 | 1.00 | 0.82 (0.69, 0.98) | 0.79 (0.66, 0.95) | 0.86 (0.72, 1.04) | 0.67 (0.54, 0.82) | <0.01 | 0.91 (0.86, 0.96) |
| Additional adjustment for diet5 | 1.00 | 0.82 (0.68, 0.98) | 0.78 (0.64, 0.94) | 0.84 (0.68, 1.02) | 0.64 (0.50, 0.81) | <0.01 | 0.90 (0.84, 0.96) |
| Women (n) | 5469 | 5732 | 5954 | 6152 | 6661 | — | — |
| Median (range) intake (% of energy) | 7.20 (0, 9.20) | 10.71 (9.20, 12.05) | 13.40 (12.05, 14.79) | 16.41 (14.79, 18.41) | 21.61 (18.41, 49.11) | — | — |
| Age-adjusted HR3 | 1.00 | 0.94 (0.76, 1.17) | 0.71 (0.56, 0.90) | 0.71 (0.55, 0.90) | 0.70 (0.55, 0.90) | <0.01 | 0.86 (0.80, 0.92) |
| Multivariable HR4 | 1.00 | 0.96 (0.77, 1.20) | 0.73 (0.57, 0.93) | 0.74 (0.58, 0.95) | 0.75 (0.58, 0.96) | <0.01 | 0.87 (0.81, 0.94) |
| Additional adjustment for diet5 | 1.00 | 1.03 (0.82, 1.29) | 0.82 (0.64, 1.06) | 0.88 (0.68, 1.14) | 0.95 (0.72, 1.27) | 0.08 | 0.93 (0.86, 1.01) |
| Dietary fiber | |||||||
| Men (n) | 7097 | 4765 | 4131 | 3802 | 3706 | — | — |
| Median (range) intake (g/d) | 7.83 (0, 9.46) | 10.40 (9.46, 11.29) | 12.13 (11.30, 13.09) | 14.18 (13.09, 15.59) | 17.77 (15.59, 50.68) | — | — |
| Age-adjusted HR3 | 1.00 | 0.72 (0.60, 0.87) | 0.85 (0.71, 1.02) | 0.78 (0.64, 0.94) | 0.74 (0.61, 0.90) | <0.01 | 0.82 (0.72, 0.93) |
| Multivariable HR4 | 1.00 | 0.78 (0.65, 0.93) | 0.96 (0.80, 1.15) | 0.90 (0.74, 1.09) | 0.88 (0.72, 1.08) | 0.34 | 0.94 (0.82, 1.07) |
| Additional adjustment for diet5 | 1.00 | 0.78 (0.65, 0.93) | 0.96 (0.80, 1.16) | 0.91 (0.74, 1.10) | 0.89 (0.72, 1.10) | 0.39 | 0.94 (0.82, 1.08) |
| Women (n) | 3596 | 5929 | 6563 | 6892 | 6988 | — | — |
| Median (range) intake (g/d) | 8.50 (1.54, 9.46) | 10.46 (9.46, 11.30) | 12.15 (11.30, 13.09) | 14.18 (13.09, 15.59) | 17.81 (15.59, 49.00) | — | — |
| Age-adjusted HR3 | 1.00 | 0.90 (0.71, 1.15) | 0.76 (0.59, 0.98) | 0.63 (0.49, 0.82) | 0.56 (0.42, 0.74) | <0.01 | 0.67 (0.57, 0.78) |
| Multivariable HR4 | 1.00 | 0.95 (0.74, 1.21) | 0.81 (0.63, 1.04) | 0.69 (0.53, 0.90) | 0.64 (0.48, 0.84) | <0.01 | 0.72 (0.61, 0.85) |
| Additional adjustment for diet5 | 1.00 | 0.91 (0.72, 1.17) | 0.78 (0.61, 1.01) | 0.66 (0.51, 0.86) | 0.62 (0.46, 0.82) | <0.01 | 0.71 (0.60, 0.84) |
1
Data were analyzed by using Cox proportional hazards regression. P-interactions by sex in fully adjusted models were as follows: carbohydrates, 0.066; starch, 0.005; fiber, 0.001; and monosaccharides and disaccharides, 0.106.
2
Dietary fiber was modeled as 5 g/1000 kcal.
3
Adjusted for age, year of interview, father's dialect, and total energy intake.
4
Additional adjustment for cigarette smoking, alcohol consumption, physical activity, sleep duration, education level, BMI, history of hypertension, and, for women only, menopausal status and hormone-replacement therapy use.
5
Multivariable model with additional adjustment for dietary cholesterol, ratio of polyunsaturated to saturated fat, and fiber intake.
6
Persons with negative values for monosaccharide and disaccharide consumption were given a consumption value of 0 (n = 22).