Carbohydrate Intake and Hyperlipidemia among Population with High‐Carbohydrate Diets: The Health Examinees Gem Study

Abstract

ScopeThe association between carbohydrate intake from low‐, medium‐, and high‐glycemic index (GI) foods and hyperlipidemia among population with a high‐carbohydrate diet is examined.Methods and resultsA total of 93,870 participants of the Health Examinees Study (HEXA) are included in this cross‐sectional study. The odds ratio (ORs) and 95% confidence interval (CIs) are estimated using the logistic regression model. The mean (interquartile range) of % energy from carbohydrate intake is 72.05 (67.73–77.18)% per day. Increasing intake of carbohydrate replacing fat is associated with increasing prevalence of high triglyceride (TG) and low HDL‐cholesterol, with stronger association for high‐GI carbohydrates than low‐ or med‐GI carbohydrates. ORs (95% CIs) comparing the highest with the lowest quintiles of high‐GI carbohydrates are 1.27 (1.09, 1.48) among men and 1.51 (1.31, 1.74) among women for high TG; and 1.50 (1.24, 1.82) among men and 1.73 (1.54, 1.93) among women for low‐HDL‐cholesterol. High‐GI carbohydrate intake replacing fat is inversely associated with the prevalence of high LDL‐ and total cholesterol. More pronounced associations in body mass index (BMI) <25 kg m−2 than higher BMI are found.ConclusionsIncreasing low‐quality carbohydrate intake is associated with increasing prevalence of high TGs and low HDL‐cholesterol.

Low-Carbohydrate Diets in Korea: Why Does It Matter, and What Is Next?

“…Table 2 presents a summary of previous observational studies evaluating dietary carbohydrate intakes as percentages of total energy. Most studies evaluated carbohydrate intake as quantiles (e.g., quintiles, quartiles, tertiles), 7,9,[14][15][16][17][18][19] whereas some studies categorized carbohydrate intakes into several specific ranges. [20][21][22][23] Based on cross-sectional studies using data acquired by the Korea National Health and Nutrition Examination Survey (KNHANES), carbohydrate intake levels were 50%-56% of energy in the lowest quintile groups and 79%-83% of energy in the highest quintile groups among Korean adults.…”

“…9,15,17 When the highest and lowest quintile groups were compared, high carbohydrate intake was associated with an increased risk of metabolic syndrome in men 9,15 and women. 9 In addition, people with high carbohydrate intakes had an increased risk of elevated triglyceride levels 9,17,19 and lower HDLcholesterol levels, 9,14,17,19 whereas they had a reduced risk of elevated total and LDL-cholesterol levels. 17,19 Several cross-sectional studies examining specific ranges of dietary carbohydrates found similar associations.…”

“…9 In addition, people with high carbohydrate intakes had an increased risk of elevated triglyceride levels 9,17,19 and lower HDLcholesterol levels, 9,14,17,19 whereas they had a reduced risk of elevated total and LDL-cholesterol levels. 17,19 Several cross-sectional studies examining specific ranges of dietary carbohydrates found similar associations. [20][21][22] Lee et al 21 categorized 13,106 adults aged 20 years or older into seven groups based on their carbohydrate intake, ranging from <55% to >80% of energy from carbohydrates.…”

“…Table 2 presents a summary of previous observational studies evaluating dietary carbohydrate intakes as percentages of total energy. Most studies evaluated carbohydrate intake as quantiles (e.g., quintiles, quartiles, tertiles), 7 , 9 , 14 - 19 whereas some studies categorized carbohydrate intakes into several specific ranges. 20 - 23 …”

“… 9 In addition, people with high carbohydrate intakes had an increased risk of elevated triglyceride levels 9 , 17 , 19 and lower HDL cholesterol levels, 9 , 14 , 17 , 19 whereas they had a reduced risk of elevated total and LDL cholesterol levels. 17 , 19 …”