High Dietary Glycemic Load is Associated with Poor Functional Outcome in Patients with Acute Cerebral Infarction.
10.3988/jcn.2018.14.2.165
- Author:
Tae Jin SONG
1
;
Yoonkyung CHANG
;
Min Young CHUN
;
Chan Young LEE
;
A Ram KIM
;
Yuri KIM
;
Yong Jae KIM
Author Information
1. Stroke Center, Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea. brain930@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
glycemic load;
glycemic index;
carbohydrate intake;
stroke;
outcome
- MeSH:
Blood Glucose;
Body Mass Index;
Cerebral Infarction*;
Classification;
Diabetes Mellitus;
Diet;
Glycemic Index;
Glycemic Load*;
Humans;
Hyperlipidemias;
Lipoproteins;
Male;
Marital Status;
Multivariate Analysis;
National Institutes of Health (U.S.);
Odds Ratio;
Prospective Studies;
Risk Factors;
Stroke;
Triglycerides
- From:Journal of Clinical Neurology
2018;14(2):165-173
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND PURPOSE: Elevated postprandial blood glucose is a critical risk factor for stroke. The dietary glycemic load (GL) and glycemic index (GI) are frequently used as markers of the postprandial blood glucose response to estimate the overall glycemic effect of diets. We hypothesized that high dietary GL, GI, or total carbohydrate intake is associated with a poor functional outcome in patients with acute ischemic stroke. METHODS: We prospectively included 263 first-ever ischemic stroke patients who completed a semiquantitative food-frequency questionnaire. The dietary GL, GI, and total carbohydrate intake were investigated by examining the average frequency of intake during the previous year based on reference amounts for various food items. Poor functional outcome was defined as a score on the modified Rankin Scale (mRS) of ≥3 at 3 months after stroke. RESULTS: The patients were aged 65.4±11.7 years (mean±standard deviation), and 58.2% of them were male. A multivariate analysis adjusted for age, sex, marital status, prestroke mRS score, diabetes mellitus, hyperlipidemia, body mass index, triglycerides, low-density lipoprotein, hemoglobin A1c, stroke classification, and National Institutes of Health Stroke Scale score, early neurological deterioration, and high-grade white-matter hyperintensities revealed that the dietary GL and total carbohydrate intake were associated with a poor functional outcome, with odds ratios for the top quartile relative to the bottom quartile of 28.93 (95% confidence interval=2.82–296.04) and 36.84 (95% confidence interval=2.99–453.42), respectively (p for trend=0.002 and 0.002, respectively). In contrast, high dietary GI was not associated with a poor functional outcome (p for trend=0.481). CONCLUSIONS: Increased dietary GL and carbohydrate intake were associated with a poor short-term functional outcome after an acute ischemic stroke.
