Carbohydrate Quality Research Articles

Correlation between Carbohydrate Consumption Level, Physical Activity and Quality of Sleep with Current Blood Glucose Levels in Patients with Type 2 Diabetes Mellitus at PUSKESMAS Rapak Mahang Tenggarong

The 2018 Riskesdas report states that the prevalence of DM based on the results of blood glucose levels in the province of East Kalimantan, especially in Kutai Kartanegara Regency, is 69.4%. This shows that DM cases in East Kalimantan, especially the Tenggarong area, Kutai Kartanegara Regency, are still a problem. This study aims to determine the relationship between the level of carbohydrate consumption, physical activity and sleep quality with blood glucose levels during type 2 diabetes mellitus at Rapak Mahang Tenggarong Health Center. This research used a cross sectional study design. The results showed that there was a relationship between the level of carbohydrate consumption and blood glucose with a p value = 0.023 (p <0.05). There is no relationship between physical activity and blood glucose with p value = 1.000 (p > 0.05). There is no relationship between sleep quality and blood glucose with p value = 0.957 (p > 0.05).

Dietary protein score and carbohydrate quality index with the risk of chronic kidney disease: Findings from a prospective cohort study.

This study aimed to examine the associations between dietary protein score and carbohydrate quality index (CQI) and the risk of chronic kidney disease (CKD) in Iranian adults. This population-based cohort study was performed within the Tehran Lipid and Glucose Study framework on 6,044 subjects aged ≥18 years old, who were followed up for a mean of 7.7 years. Dietary protein score and CQI were determined using a food frequency questionnaire. CKD was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2. A multivariate Cox proportional hazard regression model was used to estimate the risk of CKD across tertiles of protein score and CQI. The mean (standard deviation) of age and body mass index of participants were 37.9 (12.8) years and 26.8 (4.7) kg/m2, respectively. During the 7.7 ± 2.7 years of follow-up, 1,216 cases (20.1%) of CKD were ascertained. In the final adjusted model, individuals in the highest tertile of protein score had decreased risk of CKD (HR: 0.85, 95% CI: 0.74-0.98, P trend = 0.033). Also, there is a significant association between total carbohydrate score (HR: 0.85, 95% CI: 0.73-0.99, P trend = 0.016), the ratio of whole grain/total grains (HR: 0.81, 95% CI: 0.70-0.94, P trend = 0.004), and glycemic index (HR: 1.30, 95% CI: 1.12-1.51, P trend < 0.001) and risk of CKD. However, no significant association was found between total protein intakes, plant-to-animal ratio, and solid carbohydrate/total carbohydrate with the risk of CKD. Our results revealed a diet with a high protein score and high quality of carbohydrates, characterized by higher intakes of plant proteins, low glycaemic index (GI) carbohydrates, whole grain, fibers, and lower intakes of animal proteins, can be related to reduced CKD risk.

Intake of slow-digesting carbohydrates is related to changes in the microbiome and its functional pathways in growing rats with obesity induced by diet.

The main cause of insulin resistance in childhood is obesity, which contributes to future comorbidities as in adults. Although high-calorie diets and lack of exercise contribute to metabolic disease development, food quality rather than the quantity of macronutrients is more important than food density. The purpose of the present study was to examine the effects of changing the quality of carbohydrates from rapidly to slowly digestible carbohydrates on the composition of the gut microbiota and the profiles of the functional pathways in growing rats with obesity due to a high-fat diet (HFD). During the course of 4 weeks, rats growing on an HFD-containing carbohydrates with different digestive rates were fed either HFD-containing carbohydrates with a rapid digestion rate (OBE group) or HFD-containing carbohydrates with a slow digestion rate (OBE-ISR group). A non-obese group (NOB) was included as a reference, and rats were fed on a rodent standard diet (AIN93G). An analysis of gut microbiota was conducted using 16S rRNA-based metagenomics; a linear mixed-effects model (LMM) was used to determine changes in abundance between baseline and 4 weeks of treatment, and functional pathways were identified. Gut microbiota composition at bacterial diversity and relative abundance, at phylum and genus levels, and functional profiles were analyzed by integrating the Integrated Microbial Genomes (IMG) database. The groups showed comparable gut microbiota at baseline. At the end of the treatment, animals from the ISR group exhibited differences at the phylum levels by decreasing the diversity of Fisher's index and Firmicutes (newly named as Bacillota), and increasing the Pielou's evenness and Bacteroidetes (newly named as Bacteroidota); at the genus level by increasing Alistipes, Bifidobacterium, Bacteroides, Butyricimonas, Lachnoclostridium, Flavonifractor, Ruminiclostridium 5, and Faecalibaculum and decreasing Muribaculum, Blautia, and Ruminiclostridium 9. Remarkably, relative abundances of genera Tyzzerella and Angelakisella were higher in the OBE group compared to NOB and OBE-ISR groups. In addition, some microbiota carbohydrate metabolism pathways such as glycolysis, glucuronic acid degradation, pentose phosphate pathway, methanogenesis, and fatty acid biosynthesis exhibited increased activity in the OBE-ISR group after the treatment. Higher levels of acetate and propionate were found in the feces of the ISR group compared with the NOB and OBE groups. The results of this study demonstrate that replacing rapidly digestible carbohydrates with slowly digestible carbohydrates within an HFD improve the composition of the gut microbiota. Consequently, metabolic disturbances associated with obesity may be prevented.

Quality Specific Associations of Carbohydrate Consumption and Frailty Index.

Background: The quality of carbohydrate consumed may influence the risk of frailty. In this study, we tested the hypothesis that indices of carbohydrate intake are associated with trajectories of frailty in participants of the Baltimore Longitudinal Study of Aging (BLSA). Methods: Cross sectional and longitudinal analyses were conducted in 1024 BLSA participants to examine the association between usual intake of carbohydrate and frailty index. Seven measures of carbohydrate consumption were estimated using data derived from Food Frequency Questionnaires (FFQs) and examined in association with a 43-item Frailty Index (FI). Results: In cross-sectional analyses, there was a significant, positive association between higher tertiles of total carbohydrate, glycemic load, and non-whole grains and FI. Conversely, higher tertiles of fiber-to-carbohydrate ratio was associated with lower FI. These differences persisted over the follow-up period of up to 13.8 years. Women in the highest tertile of the fiber-to-carbohydrate ratio showed a less steep increase in FI over time. Conclusions: Carbohydrate intake was positively associated with increased frailty risk in the BLSA participants, whereas a higher fiber-to-carbohydrate ratio was related to reduced risk for frailty.

The Role of Dietary Glycemic Index and Glycemic Load in Mediating Genetic Susceptibility via MC4R s17782313 Genotypes to Affect Cardiometabolic Risk Factors among Apparently Healthy Obese Individuals.

The association of genetic and dietary factors with occurrence and progression of chronic diseases such as metabolic syndrome (MetS) has long been addressed but there is a lack of evidence for complex interrelationships, including direct and indirect effects of these variables. Hence, this study is aimed at evaluating the mediating role of glycemic indices in the association of melanocortin-4 receptor (MC4R) rs17782313 polymorphism, sociodemographic, and psychological factors with the risk of MetS in obese adults using structural equation modeling. We performed a cross-sectional analysis of data from 287 apparently healthy adults. Dietary glycemic index (GI) and glycemic load (GL) were calculated from a validated 147-item food frequency questionnaire (FFQ). MC4R s17782313 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Structural equation modeling was used to explore direct and indirect effects of genetic and nongenetic factors on MetS. MC4R gene variant was directly associated with the risk of MetS (B = 0.010; P = 0.023). On the other hand, this variant was found to be indirectly and positively associated with LDL-C (B = 6.589; P = 0.042) through mediatory effects of GI and GL. Moreover, GI and GL also mediated indirect positive effects of sex and age on LDL-C (B = 3.970; P ≤ 0.01; B = 0.878; P ≤ 0.01, respectively) and HDL (B = 2.203; P ≤ 0.01; B = 0.129; P ≤ 0.01, respectively). MC4R rs17782313 polymorphism had positive effects on GI (B = 1.577; P ≤ 0.01) and GL (B = 1.235; P ≤ 0.01). Our data may state a hypothesis of the mediating effect of quantity and quality of carbohydrates consumed in relationship between genetic susceptibility to obesity and cardiometabolic risk factors. Further analyses should be carried out in high-quality cohort studies in order to confirm the findings.

Variability of carbohydrate composition and pasting properties of oat flakes and oat flours produced by industrial oat milling process – Comparison to non-heat-treated oat flours

This study characterised the starch and dietary fibre properties and their significance to the pasting characteristics of oat flakes and flours produced from 30 Finnish pure cultivar oats with or without the industrial scale milling process. Large variation in carbohydrate characteristics was observed, the insoluble dietary fibre content of flours was 2.4–5.7 % and soluble dietary fibre was 4.9–8.0 %. The oat milling process induced a significant amount of starch damage (p < 0.05), a fourfold increase from 1 % to 4 % in average was observed. The pasting properties of both flakes and flours were interlinked (p < 0.05) with the chemical composition of oats, i.e., high starch content of flours was connected to higher paste viscosity values. The milling process increased the peak, trough, setback, final and time to peak viscosities of oat flours. These results show the significance of oat milling process, including kilning, to the carbohydrate quality of oats.

Abstract 13226: Low-Carbohydrate Diets and Risk of Type 2 Diabetes in U.S. Men and Women

Introduction: Evidence regarding associations between overall low-carbohydrate diets (LCDs) and the risk of developing type 2 diabetes (T2D) remains to be mixed. In the current analysis, we aimed to prospectively assess associations of various LCDs that emphasize different quality of protein, fat, and carbohydrate with T2D risk in U.S. men and women. Methods: A prospective cohort study was conducted in 203,541 men and women participating in the Nurses’ Health Study (NHS), NHSII, and Health Professionals Follow-Up Study who were free of T2D, cardiovascular disease, and cancer at baseline and were followed for up to &gt;30 years. Five LCD scores based on sources of protein, fat, and carbohydrate differentiated by their qualities were derived every four years based on dietary assessments by a validated food frequency questionnaire. Results: During 5,095,048 person-years of follow-up, 19,675 T2D cases were documented. In the multivariable model, a higher overall LCD score was associated with higher T2D risk in a dose-response manner: the hazard ratio (HR) comparing highest vs. lowest quintile was 1.28 (95% confidence interval: 1.22-1.34; P -trend &lt;0.001). A vegetable-based LCD score that emphasizes vegetable protein and fat intake was associated with 6% lower T2D risk (0.94 [0.90-0.98; P -trend =0.003]), and a healthy LCD score that further de-emphasizes refined carbohydrate intake was associated with 15% lower T2D risk (0.85 [0.81-0.89; P -trend &lt;0.001]). In contrast, LCD scores emphasizing high animal protein and fat intake were associated with higher T2D risk. The HRs (95% CIs) comparing extreme quintiles were 1.35 (1.29-1.42; P -trend &lt;0.001) for an overall animal-based LCD score and 1.39 (1.32-1.46; P -trend &lt;0.001) when such a score that further de-emphasizes whole grain intake. Conclusions: LCDs were not beneficial for the primary prevention of T2D unless they emphasize the quality of the macronutrient compositions.

Prevalence of Class II and III Obesity with Diabetes Type II and Associated Factors

Background: Obesity is related to Type II Diabetes (T2DM), affecting health-related quality of life. Body mass index (BMI) is a standardized screening tool used for Obesity. Gaining weight is highly associated with developing certain metabolic disorders, such as T2DM, which may worsen the quality of life. Among the general Pakistani population prevalence of overweight individuals is 25%, and obesity is 10.3%. Aim: To find out the prevalence of class II and III obesity with T2DM and associated factors Methods: This cross-sectional study was carried out at different clinics of Sindh. The study duration was six months, from February 2022 to July. Through a purposive sampling technique, 200 overweight males and females were selected. BMI was calculated by weight (kg) and Height (inches). Self-structured questionnaire for demographic and related associate factors. Results: The most subjects were fall into the age range above 46 years (67%) majority were male, 143(71.2%), most subjects were lies in class III obesity (65.5%) and 121(60.5%) were chronic smokers. The prevalence of T2DM among people aged ≥46 years was 58.2%. Outcomes on the gender bases showed that T2DM was higher at 73(51.1%) among males than females at 25(43.86%). The incidence of Diabetes was comparatively high among obese class III 81(61.8%) than class II individuals. Practical Implications: The Overweight individuals with type 2 diabetes face a chronic, developing disease that leads to complications that profoundly affect both quality of life and longevity. Diet recommendations to prevent T2DM should focus more on the quality of fat and carbohydrate in the diet than quantity alone, in addition to balancing total energy intake with expenditure to avoid obesity. Conclusion: It is concluded that the high prevalence of T2DM with obesity class III and chronic smokers among participants. Keywords: Associated factors, BMI, Diabetes, Obesity, Prevalence Smokers

Greater Protection of Lower Dietary Carbohydrate to Fiber Ratio (CFR) against Poor Blood Pressure Control in Patients with Essential Hypertension: A Cross-Sectional Study.

(1) Background: Carbohydrate combined with dietary fiber (DF) applied as a surrogate marker of overall carbohydrate quality is a more essential determinant of cardiometabolic health. However, to date, no studies have applied this metric to analyze its associations with poor blood pressure control in hypertensive patients. (2) Methods: A cross-sectional design was implemented in one tertiary hospital and one community hospital in China. Using Feihua Nutrition Software to analyze participants' two-day dietary log, the quantity of carbohydrate and fiber was obtained and the carbohydrate to fiber ratio (CFR) was calculated. The participants were divided into Q1, Q2, Q3, and Q4 groups by quartile method, from low to high according to CFR. The poor systolic and diastolic blood pressure (SBP and DBP) controls were defined as ≥140 mmHg and ≥90 mmHg, respectively. (3) Results: A convenience sample of 459 participants was included and the mean CFR was 29.6. Taking Q1 as reference, after adjusting for covariates, the CFR in Q4 was associated with higher poor SBP-controlled rate (OR, 4.374; 95% CI, 2.236-8.559). Taking Q2 as reference, after adjusting for covariates, the CFRs in Q3 and Q4 were associated with higher poor DBP-controlled rates [(OR = 1.964, 95% CI: 1.016-3.795) and (OR = 4.219, 95% CI: 2.132-8.637), respectively]. The CFR was the stronger protective determinant of SBP and DBP than DF or carbohydrate alone. (4) Conclusions: A higher CFR is a stronger risk factor for blood pressure (BP) control, and low CFR foods or a combination of corresponding food components, should be recommended in the dietary management of hypertensive patients.

Relationship Between Carbohydrate Intake (Quantity, Quality, and Time Eaten) and Mortality (Total, Cardiovascular, and Diabetes): Assessment of 2003-2014 National Health and Nutrition Examination Survey Participants.

In this study we investigated the association of the quantity, quality, and timing of carbohydrate intake with all-cause, cardiovascular disease (CVD), and diabetes mortality. This secondary data analysis included use of National Health and Nutrition Examination Survey (2003-2014) and National Death Index data from adults (n = 27,623) for examination of the association of total daily and differences in carbohydrate intake with mortality. Participants were categorized into four carbohydrate intake patterns based on the median values of daily high- and low-quality carbohydrate intake. The differences (Δ) in carbohydrate intake between dinner and breakfast were calculated (Δ = dinner - breakfast). Cox regression models were used. The participants who consumed more high-quality carbohydrates throughout the day had lower all-cause mortality risk (hazard ratio [HR] 0.88; 95% CI 0.79-0.99), whereas more daily intake of low-quality carbohydrates was related to greater all-cause mortality risk (HR 1.13; 95% CI: 1.01-1.26). Among participants whose daily high- and low-quality carbohydrate intake were both below the median, the participants who consumed more high-quality carbohydrates at dinner had lower CVD (HR 0.70; 95% CI 0.52-0.93) and all-cause mortality (HR 0.82; 95% CI 0.70-0.97) risk; an isocaloric substitution of 1 serving low-quality carbohydrates intake at dinner with high-quality reduced the CVD and all-cause mortality risks by 25% and 19%. There was greater diabetes mortality among the participants who consumed more low-quality carbohydrates at dinner (HR 1.78; 95% CI 1.02-3.11), although their daily high-quality carbohydrate intake was above the median. Consuming more low-quality carbohydrates at dinner was associated with greater diabetes mortality, whereas consuming more high-quality carbohydrates at dinner was associated with lower all-cause and CVD mortality irrespective of the total daily quantity and quality of carbohydrates.

The association of Carbohydrate Quality Index with cardiovascular disease risk factors among women with overweight and obesity: A cross-sectional study.

PurposeDiet is one of the most important factors influencing cardiovascular disease (CVD). The negative relationship between carbohydrate intake with lipid profiles and body weight has been previously investigated. However, this is the first study seeking to assess the association of carbohydrate quality index (CQI) with CVD risk factors.MethodsThis cross-sectional study was conducted on 291 Iranian overweight and obese women, with a body mass index (BMI) ranging between 25 and 40 kg/m2, and aged 18–48 years. CQI scores were calculated by using a validated 168-item semi-quantitative food frequency questionnaire (FFQ). Biochemical and anthropometric measures were assessed using standard methods, and bioelectrical impedance was used to measure body composition.ResultsWe observed that fruits (P < 0.001), vegetables (P < 0.001), and protein (P = 0.002) intake were higher in participants with a higher score of the CQI. When we adjusted for potential confounders, we observed that the CQI was negatively related to systolic blood pressure (SBP) (β = −6.10; 95% CI = −10.11, −2.10; P = 0.003) and DBP (β = −3.11; 95% CI = −6.15, −0.08; P = 0.04). Also, greater adherence to a high CQI dietary pattern, compared to the reference group, was negatively related to HOMA-IR (β = −0.53; 95% CI = −0.94, −0.12) (P for trend = 0.01), WC (β = −3.18; 95% CI = −6.26, −0.10) (P for trend = 0.04), BMI (β = −1.21; 95% CI = −2.50, 0.07) (P for trend = 0.06), and BF (β = −2.06; 95% CI = −3.82, −0.30) (P for trend = 0.02).ConclusionIn line with previous studies, the CQI was inversely associated with blood pressure, WC, BMI, and BF. Further prospective and clinical trial studies are suggested to confirm these data.

Diets differing in carbohydrate cellularity and amount similarly reduced visceral fat in people with obesity - a randomized controlled trial (CARBFUNC)

Visceral adipose tissue (VAT) volume is associated with common lifestyle diseases. Dietary quality, including food matrix and degree of carbohydrate cellularity, as well as the carbohydrate/fat ratio, may influence VAT volume. We aimed to determine the effects of isocaloric diets differing in either "cellularity", a novel marker of dietary carbohydrate quality, or carbohydrate amount on visceral fat volume and anthropometric measures in adults with obesity. In a randomized controlled trial of 193 people with obesity/central adiposity, we compared changes in VAT volume after 6 and 12 months, measured by abdominal computed tomography, on three isocaloric eating patterns based on "acellular" carbohydrate sources (e.g., flour-based whole-grain products; comparator arm), "cellular" carbohydrate sources (minimally processed foods with intact cellular structures such as fruits, potatoes/tubers, and rice), or low-carbohydrate high-fat (LCHF) principles. Outcomes were compared by an intention-to-treat (ITT) analysis using constrained linear mixed-effects modelling (cLMM) providing baseline-adjusted change scores and proper missing data handling without imputation. 78 and 57 participants completed 6 and 12 months, respectively, with similar intakes of energy (females: 1820-2060kcal, males: 2480-2550kcal) and protein (16-17 energy percent, E%) throughout the intervention, and only modest reductions in energy from baseline. Reported dietary intakes were 42-44, 41-42, and 11-15E% carbohydrate and 36-38, 37-38, and 66-70E% fat in the acellular, cellular and LCHF groups, respectively. There were no significant between-group differences in VAT volume after 6 months (cellular vs. acellular [95% CI]:-55cm³ [-545, 436]; LCHF vs. acellular [95% CI]:-225cm³ [-703, 253]) or after 12 months (cellular vs. acellular [95% CI]:-122cm³ [-757, 514]; LCHF vs. acellular [95% CI]:-317cm³ [-943, 309]). VAT volume decreased significantly within all groups by 14-18% and 12-17% after 6 and 12 months, respectively. Waist circumference was reduced to a significantly greater degree in the LCHF vs. acellular group at 6 months (LCHF vs. acellular [95% CI]:-2.78cm [-5.54,-0.017]). Despite modest energy restriction, the three isocaloric eating patterns, differing in carbohydrate cellularity and amount, decreased visceral fat volume significantly and to a similar clinically relevant degree. NCT03401970. https://clinicaltrials.gov/ct2/show/NCT03401970.

Glycemic Index, Glycemic Load, Fiber, and Gluten Intake and Risk of Laparoscopically Confirmed Endometriosis in Premenopausal Women

BackgroundThe etiology of endometriosis is not well understood. Limited evidence suggests that dietary factors influence risk, but prospective data related to carbohydrate, fiber, and gluten consumption are scarce. Despite this, recommendations concerning fiber, gluten intake, and endometriosis are pervasive in the lay literature. ObjectivesWe aimed to investigate the associations of carbohydrate quality [glycemic index (GI) and glycemic load (GL)], fiber intake (total, legume, vegetable, cruciferous vegetable, fruit, cereal), and gluten intake with incident laparoscopically confirmed endometriosis. MethodsThis was a prospective cohort study using data collected from 81,961 premenopausal women in the Nurses’ Health Study II (mean age = 36 y in 1991). Diet was assessed with a validated FFQ every 4 y. Cox proportional hazards models were used to calculate rate ratios (RRs) and 95% CIs. ResultsA total of 3810 incident cases of laparoscopically confirmed endometriosis were reported over 24 y of follow-up. Women in the highest quintile of GI had 12% (95% CI: 1.01, 1.23; Ptrend = 0.03) higher risk of endometriosis diagnosis than those in the lowest quintile. Total vegetable and cruciferous vegetable fiber intakes were also associated with higher risk (highest compared with lowest quintile RR: 1.13; 95% CI: 1.02, 1.24; Ptrend = 0.004 and RR: 1.17; 95% CI: 1.06, 1.29; Ptrend = 0.02, respectively). Higher intake of fruit fiber was associated with lower risk of endometriosis but the association was not significant after adjusting for the Alternative Healthy Eating Index. Gluten intake was also associated with lower risk (highest compared with lowest quintile RR: 0.91; 95% CI: 0.80, 1.02; Ptrend = 0.01), but these results were not consistent in direction nor statistical significance across sensitivity analyses. No association was observed for GL or total, legume, or cereal fiber intake. ConclusionsOur findings suggest that carbohydrate quality and specific types of fiber—total vegetable and cruciferous vegetable fiber—are associated with endometriosis diagnosis in premenopausal women. These results also indicate it is unlikely that gluten intake is a strong factor in the etiology or symptomatology of endometriosis.

A modified standard American diet induces physiological parameters associated with metabolic syndrome in C57BL/6J mice.

Investigations into the causative role that western dietary patterns have on obesity and disease pathogenesis have speculated that quality and quantity of dietary fats and/or carbohydrates have a predictive role in the development of these disorders. Standard reference diets such as the AIN-93 rodent diet have historically been used to promote animal health and reduce variation of results across experiments, rather than model modern human dietary habits or nutrition-related pathologies. In rodents high-fat diets (HFDs) became a classic tool to investigate diet-induced obesity (DIO). These murine diets often relied on a single fat source with the most DIO consistent HFDs containing levels of fat up to 45-60% (kcal), higher than the reported human intake of 33–35% (kcal). More recently, researchers are formulating experimental animal (pre-clinical) diets that reflect mean human macro- and micronutrient consumption levels described by the National Health and Nutrition Examination Survey (NHANES). These diets attempt to integrate relevant ingredient sources and levels of nutrients; however, they most often fail to include high-fructose corn syrup (HFCS) as a source of dietary carbohydrate. We have formulated a modified Standard American Diet (mSAD) that incorporates relevant levels and sources of nutrient classes, including dietary HFCS, to assess the basal physiologies associated with mSAD consumption. Mice proffered the mSAD for 15 weeks displayed a phenotype consistent with metabolic syndrome, exhibiting increased adiposity, fasting hyperglycemia with impaired glucose and insulin tolerance. Metabolic alterations were evidenced at the tissue level as crown-like structures (CLS) in adipose tissue and fatty acid deposition in the liver, and targeted 16S rRNA metagenomics revealed microbial compositional shifts between dietary groups. This study suggests diet quality significantly affects metabolic homeostasis, emphasizing the importance of developing relevant pre-clinical diets to investigate chronic diseases highly impacted by western dietary consumption patterns.

The association of dietary macronutrient quality indices with depression and anxiety symptoms and quality of life in Iranian adults: The LipoKAP study

BackgroundMacronutrients' quality may impact differently on mental health and quality of life (QOL). This study aimed to investigate the potential relationship between the carbohydrate quality index (CQI), fat quality index (FQI), protein quality index (PQI), the affective mental symptoms and QOL among Iranian adults. MethodsThe LipoKAP is a cross-sectional study, conducted with 2456 adults in Iran. A validated food frequency questionnaire was used to evaluate usual dietary intakes. A validated Iranian version of the Hospital Anxiety and Depression Scale was used to assess the severity of anxiety and depression. QOL was assessed by EQ-5D. ResultIn the fully adjusted model, participants in the highest tertile of CQI had lower QOL than those in the lowest tertile (OR = 1.35; 95 % CI: 1.06, 1.73). Individuals in the top tertile of FQI (OR = 0.71; 95 % CI: 0.55, 0.91) and PQI (OR = 0.78; 95 % CI: 0.60; 1.01) were less likely to report lower QOL than those in the bottom tertile. An inverse association was found between PQI and depressive symptoms (OR = 0.72, 95 % CI: 0.55, 0.95), but not for CQI and FQI. LimitationsThe cross-sectional design of the study and the use of a memory-based dietary tool may limit the generalizability of our findings. ConclusionHigher PQI was associated with lower risk of depressive symptoms and having a low-quality life. Although CQI and FQI were not related to depressive and anxiety symptoms, higher values of FQI were associated with better QOL, while CQI showed an inverse association.

Longitudinal association of dietary carbohydrate quality with visceral fat deposition and other adiposity indicators

The quality of dietary carbohydrates rather than total carbohydrate intake may determine the accumulation of visceral fat; however, to date, few studies have examined the impact of diet on adiposity using specific imaging techniques. Thus, the aim of this prospective study was to investigate the association between concurrent changes in carbohydrate quality index (CQI) and objectively-quantified adiposity distribution over a year. We analyzed a cohort of 1476 participants aged 55-75 years with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus randomized controlled trial. Dietary intake information was obtained at baseline, 6- and 12-months from a validated 143-item semi-quantitative food-frequency questionnaire, and CQI (range: 4 to 20) was calculated based on four dietary criteria: total dietary fibre, glycemic index, wholegrain/total grain carbohydrate ratio, and solid/total carbohydrate ratio. Overall and regional adiposity (total body fat, visceral fat and android-to-gynoid fat ratio) was quantified using dual-energy X-ray absorptiometry at all three time points. Multiple adjusted linear mixed-effects models were used to assess associations between concurrent changes in repeatedly measured CQI and adiposity over time. After controlling for potential confounding factors, a 3-point increment in CQI over 12-month follow-up was associated with a decrease in visceral fat (β-0.067 z-score, 95% CI -0.088;-0.046, p<0.001), android-to-gynoid fat ratio (-0.038,-0.059;-0.017, p<0.001), and total fat (-0.064,-0.080;-0.047, p<0.001). Fibre intake and the ratio of wholegrain/total grain showed the strongest inverse associations with all adiposity indicators. In this prospective cohort of older adults with overweight/obesity and MetS, we found that improvements in dietary carbohydrate quality over a year were associated with concurrent favorable changes in visceral and overall fat deposition. These associations were mostly driven by dietary fibre and the wholegrain/total grain ratio. The trial was registered at the International Standard Randomized. CONTROLLED TRIAL: (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.

A diet high in FODMAPs as a novel dietary strategy in diabetes?

Dietary patterns have a profound effect on shaping the gut microbiota. Diverse populations of intestinal bacteria mediate their health-related effects through fermentation of short-chain carbohydrates to produce short-chain fatty acids (SCFAs) which have both pro-inflammatory and anti-inflammatory effects. Type 2 diabetes (T2D) is a disease characterized by chronic inflammation and both microbiota and SCFA have been implicated. Dietary intervention is a cornerstone for controlling body weight, insulin secretion, and postprandial glycemic response. The term FODMAPs stands for poorly-absorbed fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. The health benefits of FODMAPS mainly came from research on gastrointestinal disease where the reduced intake of poorly absorbed FODMAP alleviated symptoms of irritable bowel syndrome albeit with an alteration in gut microbiota. Despite a large amount of literature on dietary intervention in T2D, the health-related effects of FODMAPs have not been explored in this high-risk population. Thus, apart from reducing quantity, modulating the quality of different carbohydrates may reduce glucose absorption and alter the balance of health-related gut microbiota in our pursuit of prevention and treatment of type 2 diabetes. In this review, we summarize the evidence of individual FODMAP contents which influence the pathogenic processes of T2D, especially in the diverse populations of intestinal bacteria. Individual FODMAPs can increase health-promoting bacteria, such as Akkermansia muciniphila and Bifidobacterium. It can mediate the host health-related effects through fermentation of short-chain carbohydrates to produce SCFAs and other metabolic pathways in the management and prevention of T2D.

The Glycemic Index and Human Health with an Emphasis on Potatoes.

Diabetes and obesity are associated with the excessive intake of high-glycemic index (GI) carbohydrates, increased glycemic load (GL) foods, and inactive lifestyles. Carbohydrate-rich diets affect blood glucose levels. GI is an indicator of the impact of a specific food on blood glucose, while GL represents the quantity and quality of carbohydrates in the overall diet and their interactions. There are in vitro and in vivo methods for estimating GI and GL. These values are useful human health markers for conditions such as diabetes, obesity, and pregnancy. Potato is a major starchy vegetable, which is consumed widely and is the fourth most important crop globally. However, the GI of diets rich in starchy vegetables such as potatoes has not been studied in detail. The GI values in potatoes are affected by external and internal factors, such as methods of cooking, methods of processing, resistant starches, cultivation methods, mixed meals and food additions, and hormone levels. This review summarizes how these factors affect the GI and GL associated with diets containing potatoes. Understanding the impacts of these factors will contribute to the development of new and improved potato varieties with low GI values. The consumption of low-GI foods will help to combat obesity. The development of low-GI potatoes may contribute to the development of meal plans for individuals living with diabetes and obesity.

Association between carbohydrate quality index and dietary patterns, sleep quality, anxiety level, and depression symptoms: A cross-sectional study

Association between carbohydrate quality index and dietary patterns, sleep quality, anxiety level, and depression symptoms: A cross-sectional study

Dry Bean: A Protein-Rich Superfood With Carbohydrate Characteristics That Can Close the Dietary Fiber Gap.

Consumer food choices are often focused on protein intake, but the chosen sources are frequently either animal-based protein that has high fat content or plant-based protein that is low in other nutrients. In either case, these protein sources often lack dietary fiber, which is a nutrient of concern in the 2020–2025 Dietary Guide for Americans. Pulse crops, such as dry edible beans (Phaseolus vulgaris L.), are a rich source of dietary protein and contain approximately equal amounts of dietary fiber per 100 kcal edible portion; yet the consumer's attention has not been directed to this important fact. If product labeling were used to draw attention to the similar ratio of dietary protein to dietary fiber in dry bean and other pulses, measures of carbohydrate quality could also be highlighted. Dietary fiber is categorized into three fractions, namely, soluble (SDF), insoluble (IDF), and oligosaccharides (OLIGO), yet nutrient composition databases, as well as food labels, usually report only crude fiber. The objectives of this research were to measure the content of SDF, IDF, and OLIGO in a large genetically diverse panel of bean cultivars and improved germplasm (n = 275) and determine the impact of growing environment on the content of DF. Dietary fiber was evaluated using the American Association of Analytical Chemist 2011.25 method on bean seed grown at two locations. Dry bean cultivars differed for all DF components (P ≤ 0.05). Insoluble dietary fiber constituted the highest portion of total DF (54.0%), followed by SDF (29.1%) and OLIGO (16.8%). Mean total DF and all components did not differ among genotypes grown in two field environments. These results indicate that value could be added to dry bean by cultivar-specific food labeling for protein and components of dietary fiber.