High Dietary Glycemic Load is Associated with Poor Functional Outcome in Patients with Acute Cerebral Infarction
J Clin Neurol 2018;14(2):165-173 https://doi.org/10.3988/jcn.2018.14.2.165
Background and Purpose: Elevated postprandial blood glucose is a critical risk factor for stroke. Te dietary glycemic load (GL) and glycemic index (GI) are frequently used as markers of the postprandial blood glucose response to estimate the overall glycemic efect 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 frst-ever ischemic stroke patients who completed a semiquantitative food-frequency questionnaire. Te dietary GL, GI, and total carbohydrate in-take 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 defned as a score on the modifed Rankin Scale (mRS) of ≥3 at 3 months afer stroke.
Results:Te 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 classifcation, 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% confdence interval=2.82–296.04) and 36.84 (95% confdence 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 shortterm functional outcome afer an acute ischemic stroke.
Key Words:glycemic load, glycemic index, carbohydrate intake, stroke, outcome.