Carbohydrate Quality of a Middle-aged and Older Population in Singapore and Its Association with Cardiometabolic Health

Abstract

Abstract Objectives Carbohydrate quality plays a key role in cardiometabolic health, though this has not been well investigated in Asian populations. This study aimed to assess the carbohydrate quality of middle-aged and older adults in Singapore, and its association with various cardiometabolic health-related markers. Methods A secondary data analysis of a cross-sectional study consisting of 104 adults (59 ± 6 years, mean ± SD) was conducted. Carbohydrate quality was evaluated by their adherence to: (i) Singapore recommended daily allowance (RDA) for dietary fiber intake, (ii) Singapore recommended daily whole grain intake, (iii) World Health Organization free sugars limit and (iv) the balanced carbohydrate metrics (BCM). The BCM was reflected by a ratio of at least 1g of fiber per 10g of carbohydrates (10:1, simple ratio), or variations including free sugars criteria. Food intake was collected using 3-day food record. Measurements of cardiometabolic health-related markers were body mass index, waist circumference, blood pressure, blood lipid-lipoprotein markers (total, low-density lipoprotein and high-density lipoprotein cholesterol and triglycerides) and glucose and 10-year risk to coronary heart disease. The association between dietary carbohydrate quality and cardiometabolic health-related markers, as well as associations amongst the 4 measures of carbohydrate quality were evaluated using Fisher's exact test. Results 36%, 20%, 87% and 34% of the population met the fiber RDA, whole grain recommendation, free sugars limit and BCM respectively. A significant association in adherence to each measure of carbohydrate quality was found across all 4 measures (P < 0.05), except for between the whole grain recommendation and free sugars limit. The simple ratio was associated with a lower systolic blood pressure (P = 0.04) while no association was observed with other cardiometabolic health-related markers. Conclusions Consuming a diet adhering to the simple ratio of at least 1g of fiber for every 10g of carbohydrates may improve blood pressure and subsequently lower cardiometabolic disease risk. Funding Sources National University of Singapore, Singapore Economic Development Board and Société des Produits Nestlé SA