The objective of this study was to examine the impact of substituting a higher percentage of energy intake of saturated fatty acids (SFAs) by carbohydrates on the risk of myocardial infarction (MI) and to compare carbohydrates with different glycemic index (GI) values. This prospective cohort study included 53,644 women and men free of MI at baseline who were followed-up for a median of 12 years. A non significant inverse association was observed between substitution of carbohydrates with low-GI values for SFAs and risk of MI. However, a significant positive association was noted between substitution of carbohydrates with high-GI values for SFAs and risk of MI. These results suggest that the effect of substituting SFAs for carbohydrates on the risk of MI depends on the type of carbohydrates. In his editorial comment, Frank B Hu underlined the uniqueness of this study by its specific examination of the impact of the quality of carbohydrates on MI risk.
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