Carbohydrate intake, blood lipids, and diabetes in the Boston Puerto Rican Health Study

Abstract

Puerto Rican adults have prevalent type 2 diabetes (T2D) and dyslipidemia, possibly contributed to by high carbohydrate intake, but this remains understudied. We examined cross-sectional relationships among carbohydrate intake, glycemic index (GI), glycemic load (GL) and fiber with blood lipids in Puerto Ricans aged 45–75 y, with (n=480) and without (n=733) T2D. Dietary intake was compared by T2D status using Pearson's chi-square test, ANCOVA, and tests for linear trend. Consistent with recommendations, individuals with T2D had lower intake of total carbohydrate, GL, and total sugars (all P<0.0001), and greater intake of cereal fiber (P<0.001), relative to those without T2D, which was reflected in lower consumption of sugar (P<0.0001), soft drinks (P<0.0001), and fruit juice (P=0.02), and greater consumption of oatmeal (P<0.001). Low HDL-C was prevalent in both groups (65 vs. 56%, P=0.004, respectively). Higher intakes of carbohydrate and GL were inversely associated with HDL-C (P-trend<0.0001), but not with triacylglycerols, in those without T2D. An inverse association between dietary fiber and HDL-C appeared to be confounded by carbohydrate intake, likely from frequent consumption of legumes with white rice, a refined carbohydrate food. Puerto Rican adults with T2D showed likely dietary modification. Improvement in carbohydrate quality should be emphasized to improve HDL-C status in this population.