Application of the ≤ 10:1 carbohydrate to fiber ratio to identify healthy grain foods and its association with cardiometabolic risk factors.

Abstract

Optimal metrics to assess healthfulness of carbohydrate-rich products are not well established. We investigated how the content per 10g of carbohydrate of at least 1g of fiber (≤ 10:1-ratio) related to nutritional quality in grain foods as well as cardiometabolic risk factors in São Paulo, Brazil. Data were from the cross-sectional population-based study 2015 Health Survey of São Paulo, including a probabilistic sample of urban residents in the city. Participants (n = 1188) aged 20 + years completed a 24-h dietary recall and a subsample of 603 participants had blood samples, anthropometrics, and blood pressure measurements collected, and answered a second 24-h recall. Energy and nutrient contents of grain foods meeting or not meeting the ≤ 10:1-ratio were evaluated using linear regression models. The association between consumption (percent energy, %E) of grain foods meeting the ≤ 10:1-ratio and cardiometabolic risk factors were investigated using linear regression models. Foods meeting the ≤ 10:1-ratio had less available carbohydrate (-3.0g/serving), total sugar (-7.4g/serving), added sugar (-7.2g/serving) and saturated fat (-0.7g/serving), and more dietary fiber (+ 3.5g/serving), protein (+ 2.1g/serving), potassium (+ 100.1mg/serving), iron (+ 0.9mg/serving), selenium (+ 4.2µg/serving), magnesium (+ 38.7mg/serving), and zinc (+ 1.1mg/serving). Each increase in 1%E consumption of grain foods meeting the ≤ 10:1-ratio was associated with lower levels of blood triacylglycerol (-10.7%), the triacylglycerol/high-density lipoprotein cholesterol ratio (-14.9%), fasting insulin (-13.6%), and homeostasis model assessment for insulin resistance (-14.0%). The ≤ 10:1-ratio identified grain foods with higher nutritional quality and higher intakes of these foods were associated with cardiometabolic risk factors related to atherogenic dyslipidemia and insulin resistance.