Dietary carbohydrates, glycemic load and serum high-density lipoprotein cholesterol concentrations among South Indian adults

Abstract

Objective: To examine the relationship between dietary carbohydrates, glycemic load and high-density lipoprotein cholesterol (HDL-C) concentrations in Asian Indians, a high-risk group for diabetes and premature coronary artery disease. Subjects/methods: The study population comprised of 2043 individuals aged ≥20 years randomly selected from Chennai Urban Rural Epidemiological Study (CURES), an ongoing population-based study on a representative population of Chennai (formerly Madras) city in southern India. Participants with self-reported history of diabetes or heart disease or on drug therapy for dyslipidemia were excluded from the study. Dietary carbohydrates, glycemic index and glycemic load were assessed using a validated interviewer administered semiquantitative Food Frequency Questionnaire (FFQ). Results: Both dietary glycemic load (P<0.0001) and total dietary carbohydrate intake (P<0.001) were significantly associated with higher serum triglyceride levels and lower serum HDL-C levels. For the lowest to highest quintile of glycemic load, the multivariate-adjusted mean HDL-C values were 44.1 mg per 100 ml and 41.2 mg per 100 ml (6.6% difference, P for trend<0.001), while for total carbohydrate it was less (5% difference, P for trend=0.016). The pattern of decrease in HDL-C for the lowest to highest quintile of glycemic load was more pronounced among men (1st vs 5th quintile: adjusted HDL-C: 4.3 mg per 100 ml decrease (10.3%)) than women (1st vs 5th quintile: adjusted HDL-C: 3.2 mg per 100 ml decrease (6.9%)). Conclusion: Our findings indicate that both total carbohydrates and dietary glycemic load intake are inversely associated with plasma HDL-C concentrations among Asian Indians, with dietary glycemic load having a stronger association.