Pasta meal intake in relation to risks of type 2 diabetes and atherosclerotic cardiovascular disease in postmenopausal women : findings from the Women's Health Initiative

Mengna Huang; Kenneth Lo; Jie Li; Matthew Allison; Wen-Chih Wu; Simin Liu

doi:10.1136/bmjnph-2020-000198

Pasta meal intake in relation to risks of type 2 diabetes and atherosclerotic cardiovascular disease in postmenopausal women : findings from the Women's Health Initiative

BMJ Nutr Prev Health. 2021 Apr 30;4(1):195-205. doi: 10.1136/bmjnph-2020-000198. eCollection 2021.

Authors

Mengna Huang^#^{1

2

3}, Kenneth Lo^#^{2

4}, Jie Li^{1

2

5}, Matthew Allison⁶, Wen-Chih Wu⁷, Simin Liu^{1

2

8}

Affiliations

¹ Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.
² Center for Global Cardiometabolic Health, Brown University, Providence, Rhode Island, USA.
³ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
⁴ Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
⁵ Center for International Health, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
⁶ Department of Family Medicine and Public Health, San Diego School of Medicine, University of California San Diego, La Jolla, California, USA.
⁷ Center for Long term Services and Support, Providence VA Medical Center, Alpert Medical School, Brown University School of Public Health and the Miriam Hospital Center for Cardiac Fitness, Providence, Rhode Island, USA.
⁸ Division of Endocrinology, Department of Medicine, and Division of Cardiothoracic Surgery, Department of Surgery, The Warren Alpert School of Medicine and Rhode Island Hospital, Providence, Rhode Island, USA.

^# Contributed equally.

Abstract

Objective: To evaluate the association between pasta meal intake and long-term risk of developing diabetes or atherosclerotic cardiovascular disease (ASCVD, including coronary heart disease (CHD) and stroke) in postmenopausal women.

Design: Prospective cohort study.

Setting: Women's Health Initiative (WHI) in the USA.

Participants: 84 555 postmenopausal women aged 50-79 in 1994, who were free of diabetes, ASCVD and cancer at baseline who were not in the dietary modification trial of the WHI, completed a validated food frequency questionnaire, and were evaluated for incident diabetes and ASCVD outcomes during the follow-up until 2010.

Main outcome measure: Diabetes and ASCVD.

Results: Cox proportional hazards models were used to estimate the association (HR) between quartiles of pasta meal consumption (residuals after adjusting for total energy) and the risk of incidence diabetes, CHD, stroke or ASCVD, accounting for potential confounding factors, with testing for linear trend. We then statistically evaluated the effect of substituting white bread or fried potato for pasta meal on disease risk. When comparing the highest to the lowest quartiles of residual pasta meal intake, we observed significantly reduced risk of ASCVD (HR=0.89, 95% CI 0.83 to 0.96, p trend=0.002), stroke (HR=0.84, 95% CI 0.75 to 0.93, p trend=0.001), CHD (HR=0.91, 95% CI 0.83 to 1.00, p trend=0.058) and no significant alteration in diabetes risk (HR=1.02, 95% CI 0.96 to 1.07, p trend=0.328). Replacing white bread or fried potato with pasta meal was statistically associated with decreased risk of stroke and ASCVD.

Conclusions: Pasta meal intake did not have adverse effects on long-term diabetes risk and may be associated with significant reduced risk of stroke and ASCVD. The potential benefit of substituting pasta meal for other commonly consumed starchy foods on cardiometabolic outcomes warrants further investigation in additional high-quality and large prospective studies of diverse populations.

Keywords: diabetes mellitus; nutrition assessment.

Abstract

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