The association between the intake of carbohydrates, body mass index (BMI), and the 4-y incidence of impaired glucose tolerance and diabetes mellitus (glucose intolerance) was investigated in elderly men and women aged 64-87 y. In 1971 the baseline population consisted of 175 normoglycemic subjects. During the follow-up period (1972-1975) an oral glucose-tolerance test (OGTT) was carried out annually. In univariate analyses, baseline BMI and the habitual intake of carbohydrates and pastries, as determined from a cross-check dietary history, were positively associated with the incidence of glucose intolerance. The habitual intake of legumes was inversely related to the incidence of glucose intolerance. These results could not be explained by potential confounding factors such as age, gender, alcohol use, energy intake, prescribed diet, medication use, and comorbidity. These results suggest that energy balance and the use of carbohydrate-rich foods are related to the development of glucose intolerance in an elderly population.