Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality

To the Editor: The Prospective Urban Rural Epidemiology (PURE) study investigators (April 8 issue) 1 report that a diet with a high glycemic index and high glycemic load is associated with an increased risk of cardiovascular disease or death, on the basis of an analysis involving more than 137,000 participants from five continents. Their statistical models were adjusted for age, sex, geographic region, study center, urban or rural location, socioeconomic status, education level, physical activity, smoking status, waist-to-hip ratio, history of diabetes, statin use, use of antihypertensive agents, total daily energy intake, and consumption of whole-grain cereals and dietary fiber. We . . .