Abstract
BackgroundBecause a moderate-carbohydrate diet reportedly has minimal risks, the substitution of carbohydrate for protein has been emphasized. Few studies have explored the effect of moderate-carbohydrate diets with higher protein intake in Asians, who typically consume a high-carbohydrate low-fat diet. Therefore, this study evaluated the associations of moderate- versus high- carbohydrate diets with cardiovascular risk factors among Korean adults by protein source.MethodsThis study included 7965 adults (3196 men, 4769 women) aged ≥ 19 years who participated in the 2013–2017 Korea National Health and Nutrition Examination Survey. Dietary intake was assessed by a 24-h recall method and four types of diet were defined: a moderate-carbohydrate diet with plant protein (MCP) or animal protein (MCA) and a high-carbohydrate diet with plant protein (HCP) or animal protein (HCA).ResultsCompared with the MCP group, men in the other three groups had significantly higher odds ratios (ORs) for elevated total cholesterol, reduced high-density lipoprotein (HDL)-cholesterol, and metabolic syndrome. Among women, only the HCP group had an increased OR for reduced HDL-cholesterol, compared with the MCP group. Similar associations were observed in younger adults (19–49 years). In addition, younger adults in the MCA group exhibited higher ORs for elevated triglycerides in men and elevated total cholesterol in women, compared with those in the MCP group.ConclusionsA moderate-carbohydrate diet with a high intake of plant protein was inversely associated with cardiovascular risk factors, especially among younger Korean adults. Further intervention studies are required to confirm this relationship and develop the optimal diet for cardiovascular health in the Korean population.
Highlights
Because a moderate-carbohydrate diet reportedly has minimal risks, the substitution of carbohydrate for protein has been emphasized
This study evaluated associations of cardiovascular risk factors with moderate- and high-carbohydrate diets according to protein source among Korean adults
Education level and household income tended to be lower in the high than the moderate carbohydrate diet groups (p < 0.0001 for all); they were lowest in participants with a highcarbohydrate diet with plant protein (HCP)
Summary
Because a moderate-carbohydrate diet reportedly has minimal risks, the substitution of carbohydrate for protein has been emphasized. Few studies have explored the effect of moderate-carbohydrate diets with higher protein intake in Asians, who typically consume a high-carbohydrate low-fat diet. This study evaluated the associations of moderate- versus high- carbohydrate diets with cardiovascular risk factors among Korean adults by protein source. A low-fat diet has been long emphasized to prevent and manage cardiovascular diseases, while a low-carbohydrate diet has an effect on weight loss comparable to a low-fat diet [1, 2]. In terms of cardiovascular risk factors, a low-carbohydrate diet has been associated with a decreased triglyceride level and increased high-density lipoprotein (HDL)-cholesterol level in meta-analyses of randomized controlled trials [3, 4]. A lowcarbohydrate diet is typically regarded as a carbohydrate intake of less than 45% [11] or 40% [5] of the total energy
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