BACKGROUND/ OBJECTIVE: Long-term effects of carbohydrate-restricted diets are unclear. We examined a low-carbohydrate, high-protein (LCHP) score in relation to mortality. SUBJECTS/ METHODS: This is a population-based cohort study on adults in the northern Swedish county of Västerbotten. In 37,639 men (1460 deaths) and 39,680 women (923 deaths) from the population-based Västerbotten Intervention Program, deciles of energy-adjusted carbohydrate (descending) and protein (ascending) intake were added to create an LCHP score (2-20 points). Sex-specific hazard ratios (HR) were calculated by Cox regression. RESULTS: Median intakes of carbohydrates, protein and fat in subjects with LCHP scores 2-20 ranged from 61.0% to 38.6%, 11.3% to 19.2% and 26.6% to 41.5% of total energy intake, respectively. High LCHP score (14-20 points) did not predict all-cause mortality compared with low LCHP score (2-8 points), after accounting for saturated fat intake and established risk factors (men: HR for high vs low 1.03 (95% confidence interval (CI) 0.88-1.20), P for continuous = 0.721; women: HR for high vs low 1.10 (95% CI 0.91-1.32), P for continuous = 0.229). For cancer and cardiovascular disease, no clear associations were found. Carbohydrate intake was inversely associated with all-cause mortality, though only statistically significant in women (multivariate HR per decile increase 0.95 (95% CI 0.91-0.99), P = 0.010). CONCLUSION: Our results do not support a clear, general association between LCHP score and mortality. Studies encompassing a wider range of macronutrient consumption may be necessary to detect such an association.
BACKGROUND/ OBJECTIVE: Long-term effects of carbohydrate-restricted diets are unclear. We examined a low-carbohydrate, high-protein (LCHP) score in relation to mortality. SUBJECTS/ METHODS: This is a population-based cohort study on adults in the northern Swedish county of Västerbotten. In 37,639 men (1460 deaths) and 39,680 women (923 deaths) from the population-based Västerbotten Intervention Program, deciles of energy-adjusted carbohydrate (descending) and protein (ascending) intake were added to create an LCHP score (2-20 points). Sex-specific hazard ratios (HR) were calculated by Cox regression. RESULTS: Median intakes of carbohydrates, protein and fat in subjects with LCHP scores 2-20 ranged from 61.0% to 38.6%, 11.3% to 19.2% and 26.6% to 41.5% of total energy intake, respectively. High LCHP score (14-20 points) did not predict all-cause mortality compared with low LCHP score (2-8 points), after accounting for saturated fat intake and established risk factors (men: HR for high vs low 1.03 (95% confidence interval (CI) 0.88-1.20), P for continuous = 0.721; women: HR for high vs low 1.10 (95% CI 0.91-1.32), P for continuous = 0.229). For cancer and cardiovascular disease, no clear associations were found. Carbohydrate intake was inversely associated with all-cause mortality, though only statistically significant in women (multivariate HR per decile increase 0.95 (95% CI 0.91-0.99), P = 0.010). CONCLUSION: Our results do not support a clear, general association between LCHP score and mortality. Studies encompassing a wider range of macronutrient consumption may be necessary to detect such an association.
Authors: Jibran A Wali; Annabelle J Milner; Alison W S Luk; Tamara J Pulpitel; Tim Dodgson; Harrison J W Facey; Devin Wahl; Melkam A Kebede; Alistair M Senior; Mitchell A Sullivan; Amanda E Brandon; Belinda Yau; Glen P Lockwood; Yen Chin Koay; Rosilene Ribeiro; Samantha M Solon-Biet; Kim S Bell-Anderson; John F O'Sullivan; Laurence Macia; Josephine M Forbes; Gregory J Cooney; Victoria C Cogger; Andrew Holmes; David Raubenheimer; David G Le Couteur; Stephen J Simpson Journal: Nat Metab Date: 2021-06-08
Authors: David G Le Couteur; Samantha Solon-Biet; Victoria C Cogger; Sarah J Mitchell; Alistair Senior; Rafael de Cabo; David Raubenheimer; Stephen J Simpson Journal: Cell Mol Life Sci Date: 2015-12-30 Impact factor: 9.261
Authors: Salome A Rebello; Hiromi Koh; Cynthia Chen; Nasheen Naidoo; Andrew O Odegaard; Woon-Puay Koh; Lesley M Butler; Jian-Min Yuan; Rob M van Dam Journal: Am J Clin Nutr Date: 2014-04-30 Impact factor: 7.045
Authors: Mingyang Song; Teresa T Fung; Frank B Hu; Walter C Willett; Valter D Longo; Andrew T Chan; Edward L Giovannucci Journal: JAMA Intern Med Date: 2016-10-01 Impact factor: 21.873
Authors: Lena Maria Nilsson; Anna Winkvist; Ingegerd Johansson; Bernt Lindahl; Göran Hallmans; Per Lenner; Bethany Van Guelpen Journal: Nutr J Date: 2013-05-07 Impact factor: 3.271