Abstract
BackgroundCarbohydrate quality influences major health outcomes; however, the best criteria to assess carbohydrate quality remain unknown.ObjectiveThe objectives were to: i) evaluate whether a diet that meets a carbohydrate ratio (simple, modified or dual ratio) is associated with higher nutrient intakes and diet quality, and ii) model the impact of substituting carbohydrate foods that meet the proposed ratios in place of foods that do not, on nutrient intakes.DesignA secondary analysis of cross-sectional data from the 2011–12 Australian National Nutrition and Physical Activity Survey.Participants/SettingNational data from participants aged 2 years and older (n = 12,153).Main outcome measuresRatios were defined as (i) simple ratio, 10:1 (10g carbohydrate:≥1g dietary fiber); (ii) modified ratio, 10:1:2 (10g carbohydrate:≥1g dietary fiber:≤2g free sugars); and (iii) dual ratio, 10:1 & 1:2 (10g carbohydrate:≥1g dietary fiber & ≤2g free sugars per 1g dietary fiber). Ratios were compared to nutrient intakes obtained via automated multiple-pass 24-hour dietary recall and diet quality calculated using the Australian Healthy Eating Index.Statistical analyses performedSubstitution dietary modelling was performed. Data were analyzed using paired and independent sample t-tests.ResultsRatio adherence was highest for simple (50.2% adults; 28.6% children), followed by dual (40.6% adults; 21.7% children), then modified (32.7% adults; 18.6% children) ratios. Participants who met any ratio reported higher nutrient intake and diet quality compared to those who failed to meet the respective ratio (P < .001 for all), with the greatest nutrient intakes found for those who met modified or dual ratios. Dietary modelling improved nutrient intakes for all ratios, with the greatest improvement found for the dual ratio.ConclusionsAll carbohydrate ratios were associated with higher diet quality, with a free sugars constraint in the dual ratio providing the greatest improvements.
Highlights
Carbohydrate (CHO) quality is known to highly influence major health outcomes [1]
All carbohydrate ratios were associated with higher diet quality, with a free sugars constraint in the dual ratio providing the greatest improvements
Reflecting the importance of CHO quality for human health, as well as a high prevalence of diets characterized by low CHO quality internationally [9,10,11,12,13,14], in 2015 the World Health Organization (WHO) recommended diets contain less than 10% of total energy from free sugars, with greater health benefits achievable when free sugars are reduced to less than 5% of total energy [15]
Summary
Compelling evidence from randomized controlled trials, prospective studies, and dose-response effects suggest a causal relationship between high dietary fiber and a reduced risk of non-communicable diseases [1]. High intakes of dietary fiber, which is the non-digestible edible component of plants, can reduce the risk of cardiometabolic risk factors, including obesity, high cholesterol, high blood pressure and insulin resistance [1,2,3,4]. High dietary intake of free sugars promotes adverse health outcomes including dental carries and weight gain [8]. Developing a metric to assess dietary CHO quality may be an important strategy to monitor nutritional-related health risk for populations and assist in identifying, guiding and promoting healthier CHO food choices and products. Carbohydrate quality influences major health outcomes; the best criteria to assess carbohydrate quality remain unknown
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
