Dietary Carbohydrate Quality Research Articles

Associations of nutrition education with diet quality indexes and chronotype: a cross-sectional study

ABSTRACT This study examined the impact of nutrition education on chronotype, sleep quality, and dietary quality among university students. Participants included 317 students with nutrition education and 280 without. Data were collected through questionnaires assessing demographic characteristics, chronotype (using the Morning-Evening Questionnaire), sleep quality (via the Pittsburgh Sleep Quality Index), and dietary habits. Anthropometric measurements and 24-hour food recalls were also recorded. Dietary quality was evaluated using the Healthy Eating Index (HEI)-2020, while dietary fat and carbohydrate quality were assessed with the Fat Quality Index (FQI) and Carbohydrate Quality Index (CQI), respectively. Results indicated that students who received nutrition education had significantly lower body weight, height, and waist circumference compared to those without. Of the students, 8.9% had a morning, 7% had an evening and the rest had an intermediate chronotype. HEI-2020, CQI, and FQI scores were significantly higher in the nutrition education group. Although no significant relationship was found between nutrition education and chronotype, improved dietary and sleep quality were observed in the group with education. This suggested that enhancing nutritional knowledge can positively impact health by improving dietary quality and sleep.

Effect of dietary carbohydrate quality index on the severity of premenstrual symptoms

The objective of the researchers of this study is to evaluate the effect of the Carbohydrate Quality Index (CQI) in the diet of university students living in dormitories on the severity of premenstrual symptoms. The researchers applied a survey to the students, including questions about their sociodemographic characteristics and eating habits, Food Frequency Questionnaire (FFQ), and Premenstrual Symptom Scale (PMSS). A total of 606 female students were included as participants in the study. CQI value of students with PMS was found to be lower (p < 0.05). It was observed that increasing the CQI could reduce the PMSS score [β (−0.228 (0.18–0.007) 95%CI] (p < 0.05).

Dietary carbohydrate quality index and incidence of obesity-related cancers in the “Seguimiento Universidad De Navarra” (SUN) prospective cohort

SummaryPurposeThe quality, rather than the quantity, of carbohydrate intake may play a major role in the etiology of obesity-related cancers (ORCs). We assessed the association between a previously defined carbohydrate quality index (CQI) and the risk of developing ORCs in the “Seguimiento Universidad de Navarra” (SUN) cohort.MethodsA total of 18,446 Spanish university graduates [mean age 38 years (SD 12 years), 61% women, mean BMI 23.5 kg/m2 (SD 3.5 kg/m2)], with no personal history of cancer, were followed-up. Baseline CQI was assessed summing quintiles of four previously defined criteria: high dietary fiber intake, low glycemic index (GI), high whole-grain: total-grain carbohydrates ratio and high solid carbohydrates: total carbohydrates ratio. Participants were classified into tertiles of their total CQI. Incident ORCs were confirmed by an oncologist using medical records and by querying the National Death Index blindly to dietary exposures.ResultsDuring a median follow-up of 13.7 years, 269 incident cases of ORC were confirmed. A higher CQI was inversely associated with ORC incidence [multivariable-adjusted hazard ratio (HR) for the upper (T3) versus the lowest tertile (T1) of 0.68 (95% CI: 0.47–0.96), p for trend = 0.047]. Particularly, higher dietary fiber intake was inversely associated with ORC, HRT3 vs. T1=0.57 (95% CI 0.37–0.88 p for trend = 0.013).ConclusionIn this prospective Mediterranean cohort, an inverse association between a better global quality of carbohydrate intake and the risk of ORCs was found. Strategies for cancer prevention should promote a higher quality of carbohydrate intake.

Dietary fat consumption frequency and body mass index of middle-age adults in Mumbai city, India during COVID-19 pandemic

Obesity and COVID-19 are global pandemics listed by World Health Organization, which need urgent attention. Obesity involves low grade chronic inflammation, which is characterised by sustained pro-inflammatory innate immune responses mediated through activation of the NLR family pyrin domain-containing 3 (NLRP3) inflammasome/IL-1 axis, and is a strong risk factor for Diabetes and Heart diseases(1). Dietary fats provide energy, satiety, source of fat-soluble vitamins and essential fatty acids – Omega 3 (n-3) and Omega 6 (n-6) fatty acids, but must be consumed in right amounts and ratios. Essential fatty acids (EFA) deficiency and n-6/n-3 imbalance is linked with chronic illnesses such as, heart attacks, cancer, insulin resistance, stroke, obesity, and diabetes(2). Excess dietary fat intake and imbalance of fatty acids, contribute to obesity, inflammation, comorbidities and faster disease progression. A cross-sectional survey aimed to understand the fatty food frequency of overweight and obese middle age adults from Mumbai, India during the COVID-19 outbreak. Using purposive sampling, 100 adults (30-60 years), a questionnaire (demographics, anthropometrics and fat food frequency questionnaire) was administered. Data was analysed using SPSS 26.0. As per BMI standards, 60.2% participants were overweight, 12.6% were obese and 27.1% had normal BMI. For visible fat consumption, sunflower oil (47.6%), ghee (38.8%), rice bran oil (34%) groundnut oil (11.7%) and invisible fats – milk (100%). Other dairy products, nuts and oilseeds were consumed weekly. twice a week, majority (92.3%) consumed packaged high fat foods as compared to eating deep-fried items (58.9%). We concluded that excess dietary fat intake is high risk factor for obesity and related comorbidities diabetes, and hypertension. High BMI increases the risk for non-communicable diseases (NCDs) such as obesity, cardiovascular disease (CVD), insulin resistance and type 2 diabetes. People with co-morbidities are high risk groups for COVID-19 infection susceptibility. Hence, managing weight could be a cost-effective preventive strategy to help in delaying the onset and progression of NCDs, thereby lowering the susceptibility to COVID-19. Our findings have important implications in working towards adopting healthy fats and reducing mortality and reducing the global burden of pandemic. High dietary fat intake is a modifiable risk factor for overweight and obesity. Comorbidities increased risk for COVID-19 infection, disease severity and mortality. Hence, there is a need to understand the dietary fat consumption patterns in obesity and COVID-19. Dietary carbohydrate, sugar and fat quality in relation to obesity and pandemic such as, COVID-19 could be explored in future studies.

The association of dietary carbohydrate quality and quantity with obesity among Iranian adolescents: a case-control study

BackgroundAdolescent obesity is considered as a major health concern worldwide which is closely linked to the quality of diet. The purpose of the present study was to assess the carbohydrate quality and quantity in relation to odds of overweight and obesity in adolescents.MethodsThis case-control study with a 1:1 ratio was conducted on 406 adolescents (14 to 18 years old) matched for age and gender. Participants were selected by multistage cluster random sampling method from March to October 2019 in Shiraz, Iran. Dietary intakes of the study population were assessed by a validated semi-quantitative food frequency questionnaire. Also anthropometric indices were measured using standard methods and demographic information was recorded via face to face interview. The relation between low carbohydrate diet score (LCDS) and carbohydrate quality index (CQI), and odds of obesity was evaluated by multiple Logistic regression.ResultsAfter adjusting the role of potential confounders, the participants in the third tertiles of LCDS (OR = 0.443, 95% CI = (0.260 to 0.755)) and CQI (OR = 0.005, 95% CI = (0.001 to 0.025)) had less odds of being overweight and obese compared to the first tertile.ConclusionThe present study found an inverse relationship between dietary quantity and quality of carbohydrate intake and the odds of overweight and obesity in a sample of Iranian adolescents.

INTEGRATING ANIMAL MODEL, HUMAN SUBJECTS, AND SOCIAL SYSTEMS IN NUTRITION AND AGING RESEARCH

Abstract This symposium will bring together speakers who will present cutting-edge research on nutrition and aging from interdisciplinary perspectives using complementary methods. Nutrition plays an important role in understanding the biology of aging, promoting healthy aging, preventing age-related diseases, and supporting aging populations at risks. This symposium will present innovative studies using animal models, population surveys, and nutrition programs to inform future research and promote nutrition security and diet quality. Lee et al. examine sex-specific differences in gut homeostasis and host metabolism in female and male mice fed different rodent diets. Shea et al. and Ardisson Korat et al. focus on dietary quality and patterns in older populations. Using a novel network analysis, Shea et al. examine similarities and differences in the manner in which food groups are consumed in a nationally representative sample from the National Health and Nutrition Examination Survey. Ardisson Korat et al. utilize data from the Nurse’s Health Study and evaluate the long-term role of dietary carbohydrate quality in promoting healthy aging. Borth &amp; Whitmire and El-Abbadi et al. investigate food insecurity and nutrition programs among older adults during and after the COVID-19 pandemic. Using data from US Census Bureau’s Household Pulse Survey (April 2020 to December 2022), El-Abbadi et al. explore the differences in food insecurity by age-groups, gender, and race and ethnicity. Borth &amp; Whitmire conduct research on congregate nutrition programs to identify successful practices of nutrition programs during the pandemic and discuss challenges and directions in future congregate nutrition programs. This is a Nutrition Interest Group Sponsored Symposium.

Different dietary carbohydrate component intakes and long-term outcomes in patients with NAFLD: results of longitudinal analysis from the UK Biobank

BackgroundThis study aimed to investigate the association between the intake of different dietary carbohydrate components and the long-term outcomes of non-alcoholic fatty liver disease (NAFLD).MethodsWe used prospective data from 26,729 NAFLD participants from the UK Biobank cohort study. Dietary information was recorded by online 24-hour questionnaires (Oxford WebQ). Consumption of different carbohydrate components was calculated by the UK Nutrient Databank Food Composition Table. Cox proportional hazards models were used to estimate the adjusted hazard ratio (HR) and 95% confidence interval (CI). A substitution model was used to estimate the associations of hypothetical substitution for free sugars.ResultsDuring a median of 10.5 (IQR: 10.2–11.2) years and a total of 280,135 person-years of follow-up, 310 incident end-stage liver disease (ESLD) and 1750 deaths were recorded. Compared with the lowest quartile, the multi-adjusted HRs (95% CI) of incident ESLD in the highest quartile were 1.65 (1.14–2.39) for free sugars, 0.51 (0.35–0.74) for non-free sugars, and 0.55 (0.36–0.83) for fiber. For overall mortality, the multi-adjusted HRs (95% CI) in the highest quartile were 1.21 (1.04–1.39) for free sugars, 0.79 (0.68–0.92) for non-free sugars, and 0.79 (0.67–0.94) for fiber. Substituting free sugars with equal amounts of non-free sugars, starch or fiber was associated with a lower risk of incident ESLD and overall mortality.ConclusionsA lower intake of free sugars and a higher intake of fiber are associated with a lower incidence of ESLD and overall mortality in NAFLD patients. These findings support the important role of the quality of dietary carbohydrates in preventing ESLD and overall mortality in NAFLD patients.

Dietary carbohydrate quality index and cardio-metabolic risk factors.

Introduction: Improving the quality of diet is known as one of the practical ways to reduce cardio-metabolic risk factors (CMRFs). The carbohydrate quality index (CQI) is a relatively new index to evaluate diet quality. It is calculated based on the ratio of solid carbohydrates to total carbohydrates, dietary fibre intake, glycemic index and the ratio of whole grains to total grains. This systematic review and meta-analysis was designed to investigate the association between dietary CQI and CMRFs. Methods: In this systematic review, some international databases, including Scopus, PubMed, EMBASE, Web of Science, and Google Scholar up to July 2022, were searched according to appropriate keywords. All observational studies with an English full text assessing the association between the dietary CQI and CMRFs were included. Two researchers independently extracted the data and assessed the quality of the articles with the Newcastle-Ottawa Scale. Random/fixed-effect meta-analysis was used to pool standardized mean difference (SMD) as an effect size. Results: 11 studies with a total of 63962 subjects were found to be eligible and included in the qualitative synthesis; only BMI, WC and metabolic syndrome reached the threshold of 3 reports with the same effect size and thus only 5 were included in the meta-analysis. The main finding of the included studies was that there were inverse associations between CQI and CMRFs, mainly obesity, glucose metabolism indices, and blood pressure. In the five studies included in the random effect meta-analysis, the association between CQI and body mass index (SMD: 0.45, 95%CI: -0.12, 1.01), waist circumference (SMD: -0.09, 95%CI: -0.34, 0.15) and metabolic syndrome (SMD: 0.63, 95%CI: -0.01, 1.28) was not statistically significant. Conclusion: Although the qualitative findings support the positive association of CQI with CMRFs, the evidence is insufficient to conclude robust findings. Further observational and interventional studies are needed to clearly elucidate this association.

Changes in dietary carbohydrate and lipid quality indices between 2008 and 2018: Analysis of the Brazilian dietary surveys.

The aim of the study was to evaluate characteristics and changes over a decade in dietary carbohydrate and lipid quality according to socio-demographic variables. Data was obtained from two Brazilian National Dietary Surveys 2008-2009 (n = 34 003) and 2017-2018 (n = 46 164) examining a nationwide representative sample of individuals ≥10 years old. Food intake was assessed by means of two non-consecutive diet records (2008-2009) and 24 h diet recalls (2017-2018). Carbohydrate Quality Index is a score ranging from 4 to 20 calculated from fibre intake, global dietary glycaemic index, solid/total carbohydrate (CHO) and whole grains/total grains CHO. Lipid Quality Index was estimated by dividing the sum of the dietary content of monounsaturated and polyunsaturated fatty acids by the sum of saturated and trans fatty acids. Indices were categorised into five categories (1 for lowest and 5 for highest quality). Socio-demographic variables were sex, age, income, urban/rural area and place of food consumption. The estimates (95% CI) were generated separately for each survey and then compared to identify changes in time. Our main findings refer to changes in diet quality according to income. At the lowest income level, the proportions of individuals in the best carbohydrate and lipid quality categories reduced from 26.9% to 20.6% and from 30.0% to 24.9%, respectively. Alternatively, at the highest income level, these proportions increased from 22.9% to 26.6% and from 11.9% to 15.7%, respectively. Furthermore, the quality of lipids improved in women and among individuals reporting some away-from-home food consumption, while the quality of carbohydrates was reduced among adolescents and in rural areas.

Association between the Carbohydrate Quality Index (CQI) and Nutritional Adequacy in a Pediatric Cohort: The SENDO Project.

Suboptimal micronutrient intake in children remains a public health concern around the world. This study examined the relationship between a previously defined dietary carbohydrate quality index (CQI) and the risk of micronutrient intake inadequacy in a pediatric cohort of Spanish preschoolers. Children aged 4-5 years old were recruited at their medical center or at school, and information on sociodemographic, dietary, and lifestyle variables were collected through a self-administered online questionnaire. Dietary information was obtained from a validated 147-item semi-quantitative food frequency questionnaire. We calculated the CQI and categorized participants into quartiles according to their scores. We assessed the intakes of 20 micronutrients and evaluated the probability of intake inadequacy by using the estimated average requirement cut-off point. Generalized estimating equations were used to adjust for potential confounders and account for the intra-cluster correlations between siblings. The adjusted proportions of children with an inadequate intake of ≥three micronutrients were 23%, 12%, 11%, and 9% in the first, second, third, and fourth quartiles of the CQI, respectively. Children in the highest quartile of the CQI had 0.22-fold lower odds (95% CI 0.10-0.48) of having ≥three inadequate micronutrient intakes than their peers in the lowest quartile. These findings reinforce the relevance of carbohydrate quality in children's diets.

Higher diet quality relates to better cardiac function in cancer survivors: The multi-ethnic study of atherosclerosis

BackgroundCancer therapies induce cardiac injury and increase cardiovascular disease (CVD) risk. In non-cancer populations, higher diet quality is associated with protection against CVD, but the relationship between diet and cardiac function in cancer survivors is unknown. MethodsThis cross-sectional analysis from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort included 113 cancer survivors (55 breast, 53 prostate, three lung, and three blood) and 4233 non-cancer controls. Dietary intake was reported via validated food frequency questionnaire. Alternate healthy eating index (AHEI) was calculated as a measure of quality. Cardiac function, determined as left ventricular ejection fraction (LVEF), was assessed by cardiac magnetic resonance. ResultsCancer survivors had a lower LVEF compared to controls (61.3 ± 6.5% v 62.4 ± 6.1%, p = 0.04). In all participants, total fat (β ± SE: −0.04 ± 0.01, p = 0.004), saturated fat (−0.11 ± 0.03, p < 0.001), and trans-fat (−0.36 ± 0.12, p = 0.002) intake were inversely associated with LVEF while AHEI (0.03 ± 0.01, p < 0.001) was positively associated with LVEF. Among cancer survivors only, sucrose intake was negatively related to LVEF (−0.15 ± 0.06, p = 0.02), and the ratio of unsaturated fat to saturated fat (2.7 ± 1.1, p = 0.01) and fiber intake (0.42 ± 0.14, p = 0.003) were positively related to LVEF. DiscussionIn cancer survivors, improved dietary fat and carbohydrate quality (i.e., greater consumption of unsaturated fatty acids and fiber) was associated with favorable cardiac function, while higher sucrose was associated with worse cardiac function. Further research is needed to confirm these findings and test whether changes in the identified dietary factors will modulate cardiac function in cancer survivors.

Dietary carbohydrate quality index (CQI), cardio-metabolic risk factors and insulin resistance among adults with obesity

BackgroundMetabolic syndrome (MetS), as a cluster of cardiometabolic risk factors, is a global public health concern due to its increasing prevalence. Considering the previous evidence of the association between carbohydrate quality and cardiometabolic risk factors, our study was aimed to evaluate any possible association between carbohydrate quality index (CQI) and cardiometabolic risk factors among obese adults.MethodsIn this cross-sectional study, 336 apparently healthy individuals with obesity were participated. Dietary intake was assessed by a semi-quantitative Food Frequency Questionnaire (FFQ), including 168 food items validated for the Iranian population. CQI was calculated with three components of solid carbohydrates to total carbohydrates ratio, dietary fiber intake, and dietary glycemic index (GI). Body composition was determined by bioelectrical impedance analysis (BIA). Blood pressure was measured by sphygmomanometer and enzymatic methods were used to evaluate serum lipid, glucose, and insulin concentrations.ResultsSubjects in the third quartile of CQI had significantly lower systolic blood pressure (SBP) (P = 0.03) and diastolic blood pressure (DBP) (P = 0.01). Participants in the higher quartiles of CQI had more intake of energy, carbohydrates, fat, saturated fatty acid (SFA), and mono-saturated fatty acid (MUFA) (P < 0.05). Moreover, the homeostasis model assessment of insulin resistance (HOMA-IR) was decreased in the second quartile of CQI [odds ratio (OR) = 0.146, P = 0.01) after adjustment for age, body mass index (BMI), sex, physical activity, socioeconomic status (SES) and energy intake.ConclusionAccording to our findings, a higher quality of dietary carbohydrates, determined by CQI, could be associated with a lower risk of hypertension.

P29-003-23 Dietary Carbohydrate Intake and Carbohydrate Quality in Relation to Healthy Aging in Women

P29-003-23 Dietary Carbohydrate Intake and Carbohydrate Quality in Relation to Healthy Aging in Women

114-OR: Genetic Variants in GIPR and Effects of Dietary Carbohydrate Quantity and Quality on Glycemic Responses to an Oral Glucose Load—The OmniCarb Trial

The gut incretin hormone, glucose-dependent insulinotropic polypeptide (GIP), may play a pivotal role in mediating adverse effects of high glycemic index (GI) foods on metabolic diseases. GIP exerts its effects by binding to a receptor, GIPR; genome-wide association studies have identified variants in the GIPR region related to type 2 diabetes (T2D) and glycemic/GIP responses to glucose tolerance tests. We examined whether GIPR variants were related to impaired glycemic responses during oral glucose tolerance tests (OGTTs) after consuming 4 diets (each for 5 weeks) with different carbohydrate (Carb) content and GI levels in the OmniCarb randomized crossover feeding trial. A genetic risk score (GRS) was calculated by counting T2D-risk alleles of SNPs rs1800437, rs11671664, and rs2238689 at GIPR (n=146). We found that GRS was related to greater glycemic responses after consuming a high GI/high Carb diet, regardless of baseline glycemic status (Fig). When testing diet replacement effects, combined effects of high GI and high Carb (vs. low GI/low Carb) on glycemic responses were significantly modified by GRS (Pinteraction&amp;lt;0.05). In conclusion, T2D-risk-related GIPR variants modified the effects of dietary carbohydrates on glucose tolerance. GIPR variants may be related to deteriorating glucose tolerance after eating a high GI, high Carb diet. Disclosure Y.Heianza: None. X.Wang: None. Q.Xue: None. L.J.Appel: None. F.Sacks: None. L.Qi: None. Funding National Institutes of Health (2P20GM109036-06A1-7233, DK091718, DK100383, DK115679)

New metrics of dietary carbohydrate quality.

The aim of this study was to introduce novel metrics of dietary carbohydrates quality relevant for products and diets. Carbohydrate quality has long been associated with a low glycemic index. More recently, novel metrics of carbohydrate quality featuring variations of total carbohydrates-fibers-free sugars ratios have been applied to carbohydrate-rich foods, including grains, beans, vegetables, and fruit. High scoring products had higher levels of health-promoting nutrients (protein, dietary fiber, iron, magnesium, zinc, potassium, selenium, and various B-vitamins) and lower levels of nutrients of public health concern (total sugar, added/free sugars, and fat profile). Cross-sectional studies also found variants of carbohydrate quality metrics to be associated with better markers of cardiometabolic disease, including lower levels of blood triglycerides:high-density lipoprotein cholesterol ratio, homeostatic model assessment of insulin resistance, and SBP. New ratio-based carbohydrate quality metrics are built around high fiber and whole grain content, combined with a low free sugar content. Such metrics allow the identification of food products of higher overall nutritional quality, and are associated with improved diet quality and certain health outcomes.

Associations between Conventional and Emerging Indicators of Dietary Carbohydrate Quality and New-Onset Type 2 Diabetes Mellitus in Chinese Adults.

Dietary glycemic index (GI), carbohydrate to fiber ratio (CF) and carbohydrate quality index (CQI) are conventional and emerging indicators for carbohydrate quality. We aimed to investigate the associations between these indicators and new-onset type 2 diabetes mellitus (T2DM) risk among Chinese adults. This prospective cohort study included 14,590 adults from the China Health and Nutrition Survey without cardiometabolic diseases at baseline. The associations between dietary GI, CF and CQI and T2DM risk were assessed using Cox proportional hazard regression analysis and dose-response relationships were explored using restricted cubic spline and threshold analysis. After a mean follow-up duration of 10 years, a total of 1053 new-onset T2DM cases occurred. There were U-shaped associations between dietary GI and CF and T2DM risk (both P-nonlinear < 0.0001), and T2DM risk was lowest when dietary GI was 72.85 (71.40, 74.05) and CF was 20.55 (17.92, 21.91), respectively (both P-log likelihood ratio < 0.0001). Inverse associations between CQI and T2DM risk specifically existed in participants < 60 y or attended middle school or above (both P-trend < 0.05). These findings indicated that moderate dietary GI and CF range and a higher dietary CQI score may be suggested for T2DM prevention in Chinese adults.

Measures of carbohydrate quality and their association with diet quality and cardiometabolic health outcomes in Singapore middle-aged and older adults

Background and aimsCarbohydrate quality may play a key role in cardiometabolic health and disease risk. This study aimed to assess the dietary carbohydrate quality of the free-living middle-aged and older adults in Singapore, and its association with overall diet quality and cardiometabolic health. Methods and resultsThis cross-sectional study examined the diet and cardiometabolic disease risk indicators of middle-aged and older adults in Singapore (n = 104). Dietary carbohydrate quality was assessed as the pass and fail rate of the population to four measures of carbohydrate quality: (i) dietary fiber recommended daily allowance (RDA), (ii) whole-grain recommendation, (iii) free sugar recommendation, and (iv) carbohydrate metrics. The association between each carbohydrate quality measure and diet quality, as well as cardiometabolic health, was assessed. Except for free sugar recommendation, the carbohydrate quality of the population was found to be poor with a low adherence (20–36%) to three measures. Subjects meeting these measures had generally higher intakes of fiber, protein, and most micronutrients compared with subjects who failed. Meeting different variants of the carbohydrate metrics was associated with 60% lower odds of pre-hypertensive blood pressure (p = 0.037; p = 0.047), and meeting the dietary fiber RDA was associated with lower waist circumference (p = 0.021). ConclusionAn improvement in carbohydrate quality is warranted among free-living middle-aged and older adults in Singapore. Not all measures of carbohydrate quality were equally effective in preserving overall diet quality; the carbohydrate metrics and dietary fiber RDA can be identified as effective measures in relation to cardiometabolic disease risk. Clinical trial registrationhttps://clinicaltrials.gov/ Clinical trial registrationNCT03554954, 13 Sept. 2018.

Contrasting Carbohydrate Quantity and Quality and the Effects on Plasma Saturated and Monounsaturated Fatty Acids in Healthy Adults: A Randomized Controlled Trial

BackgroundIt is unclear whether moderate differences in dietary carbohydrate quantity and quality influence plasma FAs in the lipogenic pathway in healthy adults. ObjectivesWe investigated the effects of different carbohydrate quantities and quality on plasma palmitate concentrations (primary outcome) and other saturated and MUFAs in the lipogenic pathway. MethodsTwenty healthy participants were randomly assigned, and 18 (50% women; age: 22–72 y; BMI: 18.2–32.7 kg/m2 and BMI was measured in kg/m2) started the cross-over intervention. During each 3-wk period (separated by a 1-wk washout period), 3 diets were consumed (all foods provided) in random order: low-carbohydrate (LC) (38% energy (E) carbohydrates, 25–35 g fiber/d, 0% E added sugars); high-carbohydrate/high-fiber (HCF) (53% E carbohydrates, 25–35 g fiber/d, 0% E added sugars); and high-carbohydrate/high-sugar (HCS) (53% E carbohydrates, 19–21 g fiber/d, 15% E added sugars). Individual FAs were measured proportionally to total FAs by GC in plasma cholesteryl esters, phospholipids, and TGs. False discovery rate–adjusted repeated measures ANOVA [ANOVA-false discovery rate (FDR)] was used to compare outcomes. ResultsThe self-reported intakes of carbohydrates and added- and free sugars were; 30.6% E and 7.4% E in LC, 41.4% E and 6.9% E in HCF, and 45.7% E and 10.3% in HCS. Plasma palmitate did not differ between the diet periods (ANOVA FDR P > 0.43, n = 18). After HCS, myristate concentrations in cholesterol esters and phospholipids were ≥19% higher than LC and ≥22% higher than HCF (P = 0.005). After LC, palmitoleate in TG was 6% lower compared with HCF and 7% compared with HCS (P = 0.041). Body weight differed (≤0.75 kg) between diets before FDR correction. ConclusionsDifferent carbohydrate quantity and quality do not influence plasma palmitate concentrations after 3 wk in healthy Swedish adults, whereas myristate increased after the moderately higher intake of carbohydrate/high-sugar, but not carbohydrate/high-fiber. Whether plasma myristate is more responsive than palmitate to differences in carbohydrate intake requires further study, especially considering that participants deviated from the planned dietary targets. J Nutr 20XX;xx:xx–xx.This trial was registered at clinicaltrials.gov as NCT03295448.

Dietary carbohydrate quantity and quality and risk of cardiovascular disease, all-cause, cardiovascular and cancer mortality: A systematic review and meta-analysis

Evidence remains conflicted on the association between dietary carbohydrate quantity and quality and risk of cardiovascular disease, all-cause, cardiovascular and cancer mortality, and such meta-analyses are lacking. The study aimed to conduct a systematic review and meta-analysis to synthesize the knowledge about their associations and to explore the dose-response relations. We comprehensively searched PubMed, EMBASE, and Web of Science up to March 2022 for observational studies investigating the associations in adults. Random effect model was used to estimate the summary relative risks (RRs) and 95% confidence intervals (CIs) and the dose-response association was explored by restricted cubic splines. We obtained the data from 41 eligible studies. Compared with participants with lowest dietary carbohydrate intake, those with highest intake had an RR of 1.10 (95% CI 1.03-1.17, I2=52.8%) for cardiovascular disease, 1.10 (0.98-1.24, I2=65.5%) for coronary heart disease (CHD), 1.20 (1.08-1.34, I2=0) for stroke, 1.07 (1.00-1.14, I2=61.9%) for all-cause mortality, 1.02 (0.92-1.14, I2=51.3%) for cardiovascular mortality, and 1.01 (0.89-1.13, I2=56.7%) for cancer mortality. For each 5 %E increase in dietary carbohydrate intake, the summary RR was 1.02 (1.00-1.04, I2=66.8%) for cardiovascular disease, 1.04 (1.01-1.06, I2=0) for stroke but not significant for other outcomes. Restricted cubic splines showed linear associations with risk of cardiovascular disease (Pnon-linearity=0.143), CHD (Pnon-linearity=0.508), stroke (Pnon-linearity=0.654) and non-linear associations with all-cause mortality (Pnon-linearity=0.008) and cardiovascular mortality (Pnon-linearity=0.055). Limited studies were found on the association of cardiovascular disease and mortality with dietary carbohydrate quality using a multidimensional and integrated indicator. Increased consumption of dietary carbohydrate intake is associated with increased risk of cardiovascular disease, stroke, and all-cause mortality. Linear relation was found for cardiovascular disease and stroke but non-linear relation for all-cause mortality. More studies are warranted to investigate the association of dietary carbohydrate quality using a combined indicator and cardiovascular disease and mortality.

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.