Shamima Akter1, Tetsuya Mizoue2, Akiko Nanri3, Atsushi Goto4, Mitsuhiko Noda5, Norie Sawada4, Taiki Yamaji4, Motoki Iwasaki4, Manami Inoue4, Shoichiro Tsugane4. 1. Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan. Electronic address: sakter@hosp.ncgm.go.jp. 2. Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan. 3. Department of Food and Health Sciences, Fukuoka Women's University, Fukuoka, Japan. 4. Center for Public Health Sciences, National Cancer Center, Tokyo, Japan. 5. Department of Diabetes Metabolism and Endocrinology, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan.
Abstract
BACKGROUND: Evidence is limited regarding the association between low-carbohydrate diet (LCD) score and mortality among Asians, a population that consumes a large amount of carbohydrates. OBJECTIVE: The present study examined the association between low-carbohydrate diet (LCD) score (based on percentage of energy as carbohydrate, fat, and protein) and the risk of total and cause-specific mortality among Asians. DESIGN: This study was a prospective cohort study in Japan with follow-up for a median of 16.9 years involving 43008 men and 50646 women aged 45-75 years. Association of LCD score, LCD score based on animal sources of protein and fat, and LCD score based on plant sources of protein and fat with risk of mortality was assessed using Cox proportional hazards model. RESULTS: A U-shaped association was observed between LCD score and total mortality: the multivariable-adjusted hazard ratios (HRs) (95% CI) of total mortality for lowest through highest scores were 1.00, 0.95 (0.91, 1.01), 0.93 (0.88, 0.98), 0.93 (0.88, 0.98), and 1.01 (0.95, 1.07) (P-non-linearity <0.01). A similar association was found for mortality from cardiovascular disease (CVD) and heart disease. LCD score based on carbohydrate, animal protein, and animal fat also showed a U-shaped association for total mortality (P-non-linearity <0.01). In contrast, LCD score based on carbohydrate, plant protein, and plant fat was linearly associated with lower total (HR, 0.89; 95% CI: 0.83, 0.94 for highest versus lowest quintile), CVD [0.82 (0.73, 0.92)], heart disease [0.83 (0.71, 0.98)], and cerebrovascular disease [0.75 (0.62, 0.91) mortality. CONCLUSIONS: Both LCD with high animal protein and fat and high-carbohydrate diet with low animal protein and fat were associated with higher risk of mortality. Meanwhile, LCD high in plant-based sources of protein and fat was associated with a lower risk of total and CVD mortality.
BACKGROUND: Evidence is limited regarding the association between low-carbohydrate diet (LCD) score and mortality among Asians, a population that consumes a large amount of carbohydrates. OBJECTIVE: The present study examined the association between low-carbohydrate diet (LCD) score (based on percentage of energy as carbohydrate, fat, and protein) and the risk of total and cause-specific mortality among Asians. DESIGN: This study was a prospective cohort study in Japan with follow-up for a median of 16.9 years involving 43008 men and 50646 women aged 45-75 years. Association of LCD score, LCD score based on animal sources of protein and fat, and LCD score based on plant sources of protein and fat with risk of mortality was assessed using Cox proportional hazards model. RESULTS: A U-shaped association was observed between LCD score and total mortality: the multivariable-adjusted hazard ratios (HRs) (95% CI) of total mortality for lowest through highest scores were 1.00, 0.95 (0.91, 1.01), 0.93 (0.88, 0.98), 0.93 (0.88, 0.98), and 1.01 (0.95, 1.07) (P-non-linearity <0.01). A similar association was found for mortality from cardiovascular disease (CVD) and heart disease. LCD score based on carbohydrate, animal protein, and animal fat also showed a U-shaped association for total mortality (P-non-linearity <0.01). In contrast, LCD score based on carbohydrate, plant protein, and plant fat was linearly associated with lower total (HR, 0.89; 95% CI: 0.83, 0.94 for highest versus lowest quintile), CVD [0.82 (0.73, 0.92)], heart disease [0.83 (0.71, 0.98)], and cerebrovascular disease [0.75 (0.62, 0.91) mortality. CONCLUSIONS: Both LCD with high animal protein and fat and high-carbohydrate diet with low animal protein and fat were associated with higher risk of mortality. Meanwhile, LCD high in plant-based sources of protein and fat was associated with a lower risk of total and CVDmortality.
Authors: Deyang Yu; Nicole E Richardson; Cara L Green; Alexandra B Spicer; Michaela E Murphy; Victoria Flores; Cholsoon Jang; Ildiko Kasza; Maria Nikodemova; Matthew H Wakai; Jay L Tomasiewicz; Shany E Yang; Blake R Miller; Heidi H Pak; Jacqueline A Brinkman; Jennifer M Rojas; William J Quinn; Eunhae P Cheng; Elizabeth N Konon; Lexington R Haider; Megan Finke; Michelle Sonsalla; Caroline M Alexander; Joshua D Rabinowitz; Joseph A Baur; Kristen C Malecki; Dudley W Lamming Journal: Cell Metab Date: 2021-04-21 Impact factor: 27.287
Authors: Jeff S Volek; Stephen D Phinney; Ronald M Krauss; Richard J Johnson; Laura R Saslow; Barbara Gower; William S Yancy; Janet C King; Frederick M Hecht; Nina Teicholz; Bruce R Bistrian; Osama Hamdy Journal: Nutrients Date: 2021-09-22 Impact factor: 5.717