Association between dietary carbohydrate intake quality and micronutrient intake adequacy in a Mediterranean cohort: the SUN (Seguimiento Universidad de Navarra) Project

Abstract

Epidemiological research confirms that the prevalence of suboptimal micronutrient intakes across Europe is an emerging concern in terms of public health. The aim of the present study was to investigate the association between a new index of carbohydrate (CHO) quality and micronutrient intake adequacy in the 'Seguimiento Universidad de Navarra (SUN)' cohort. The baseline assessment extended from 1999 to March 2012. We assessed 16 841 participants who completed a validated 136-item semi-quantitative FFQ at baseline. We created a new index to evaluate CHO quality for the following four criteria: dietary fibre intake; glycaemic index; whole grains:total grains ratio; solid CHO:total CHO ratio. The subjects were classified into quintiles according to this index. We evaluated the intakes of Zn, I, Se, Fe, Ca, K, P, Mg, Cr and vitamins B 1 , B 2 , B 3 , B 6 , B 12 , C, A, D, E and folic acid. The probability of intake adequacy was evaluated using the estimated average requirement cut-point approach and the probabilistic approach. Logistic regression analysis was used to assess the nutritional adequacy according to the CHO quality index (CQI). Participants in the highest quintile of CQI were found to have the lowest prevalence of inadequacy. A higher quality of CHO intake was found to be associated with a lower risk of nutritional inadequacy in comparison with the lowest quintile of CQI (adjusted OR 0·06, 95 % CI 0·02, 0·16; P for trend ,0·001). A higher CQI was found to be strongly associated with better micronutrient intake adequacy in the young Mediterranean cohort, stressing the importance of focusing nutritional education not only on CHO quantity, but also on quality.

Carbohydrate quality, weight change and incident obesity in a Mediterranean cohort: the SUN Project

“…Furthermore, the robustness of findings in additional sensitivity analyses is other strength. Finally, although the CQI has been previously used to assess micronutrient intake adequacy, 23 to our knowledge it has not been used before in assessing weight change and obesity which could be helpful in dietary advice related to weight management in young adults.…”

“…22 We used baseline dietary intake data to identify a carbohydrate quality index. 23 The carbohydrate quality index (CQI) was defined summing up the following four criteria:…”

Nutritional adequacy according to carbohydrates and fat quality

“…However, only a previous study recently published has reported in a Mediterranean cohort of university graduates, the association of multidimensional indexes of CHO or fat with nutritional adequacy [14]. In the present study, we investigated the association between nutritional quality measured by a CHO quality index (CQI) or a fat quality index (FQI), and overall nutritional adequacy considering 19 micronutrients.…”

“…The CQI was defined summing up the following four criteria: dietary fiber intake (g per day, positively weighted), GI (negatively weighted), ratio whole grains/ total grains (positively weighted), and finally, ratio solid CHO/(solid CHO + liquid CHO) (positively weighted) [14]. For each of these four components, we categorized participants into quintiles and received a value (ranging from 1 to 5) according to each quintile (for GI, those in the fifth quintile received 1 point and those in the first quintile received 5 points).…”

Glycemic index, glycemic load, and common psychological disorders

“…In contrast, high-GL diets can result in rapid late postingestive decreases in blood glucose with a tendency to hypoglycemia, which could be responsible for triggering central dysfunction and depression, thus possibly contributing to the higher prevalence of depression among patients with diabetes (22). In addition, high-GI and high-GL diets may contain lower amounts of fiber, fruit, vegetables, and whole grains (23)(24)(25) and, consequently, provide lower amounts of some key nutrients for the nervous system compared with low-GI and low-GL diets, and, thus, may adversely affect mood disorders. However, findings in this context have been controversial in clinical trials (26)(27)(28)(29)(30)(31) and observational and longitudinal studies (32)(33)(34)(35)(36).…”