J Clin Neurol.  2018 Apr;14(2):165-173. 10.3988/jcn.2018.14.2.165.

High Dietary Glycemic Load is Associated with Poor Functional Outcome in Patients with Acute Cerebral Infarction

• Song TJ
• Chang Y
• Chun MY
• Lee CY
• Kim AR
• Kim Y
• Kim YJ

• KMID: 2407942
• DOI: http://doi.org/10.3988/jcn.2018.14.2.165

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.

Keyword

glycemic load; glycemic index; carbohydrate intake; stroke; outcome

MeSH Terms

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
Blood Glucose
Lipoproteins
Triglycerides

Figure

• 

  Fig. 1 Flow chart depicting the participation of subjects in this study.

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