For middle-aged women in the US, how sugary or starchy your food is overall (glycemic load) matters more for heart disease risk than just how much carbs you eat.

Women in their 40s to 60s who eat a lot of sugary and refined carbs are almost twice as likely to develop heart disease as those who eat fewer of these foods.

Women in their 40s to 60s who eat a lot of foods that spike blood sugar quickly—like white bread, sugary snacks, and refined carbs—are more likely to develop heart disease than those who eat fewer of these foods, with the biggest eaters having almost twice the risk.

Eating a lot of foods that spike your blood sugar quickly may raise your chance of getting heart disease—even if you’re otherwise healthy or don’t smoke or have high blood pressure.

For middle-aged women in the US, how quickly carbs raise blood sugar (glycemic index) might be a better clue about heart disease risk than just whether the carbs are 'simple' or 'complex'.

Women who weigh more or have a BMI of 23 or higher may be more at risk for heart disease if they eat a lot of foods that spike their blood sugar quickly.