Carbohydrate Intake and Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Prospective Studies

Abstract

The purpose of this study is to understand the conflicting results from previous studies on the association between carbohydrate intake and cardiovascular disease (CVD) by conducting a systematic review and meta-analysis to summarize the most recent scientific evidence. A systematic review used three electronic databases to gather literature on the association between carbohydrate intake and CVD. Considering the discrepancies, either fixed or random effect models were chosen to determine the effect size, and sensitivity analysis results, as well as publication bias, were also presented. The meta-analysis found that individuals with the highest carbohydrate intake had a 1.15-fold increased risk of CVD compared to those with the lowest intake (hazard ratio, HR: 1.15, 95% confidence interval, CI: 1.07–1.23). Further subgroup analysis revealed that this association was only present in Asia, with a 1.52-fold increased risk (HR: 1.52, 95% CI: 1.17–1.97), while no associations were seen in the Americas, Europe, and Oceania. The relationship between carbohydrate intake and CVD was non-linear, with a marked escalation beyond 60% of total energy from carbohydrates. Our findings suggest that a high-carbohydrate diet may raise the risk of CVD, particularly in Asian populations. This association may be due to the higher carbohydrate consumption and genetic variations found in Asia.

Dietary Guidance for Cardiovascular Health: Consensus and Controversies

“…Sweetened beverages and refined carbohydrates are among the food categories with high pro-inflammatory potential, which may partly account for their harmful effects on cardiovascular health [19]. Furthermore, the dose-response relationship of carbohydrate intake and CV risk has been elucidated by a recent meta-analysis, which showed that the increased CV risk associated with carbohydrate intake was exacerbated when more than 60% of total energy was derived from carbohydrates, especially in Asian populations [20]. Current ESC guidelines for primary prevention recommend the restriction of free sugar consumption, particularly sugar-sweetened beverages, to a maximum of 10% of daily energy intake [14].…”

The impact of poor fetal growth and chronic hyperpalatable diet exposure in adulthood on hippocampal function and feeding patterns in male rats

“…Fetal growth restriction also alters the response to sweet taste at birth (Ayres et al., 2012) and increases the preference for foods that are rich in sugars and fats starting in early life (Silveira et al., 2012) and continuing into adulthood (Barbieri et al., 2009; Kaseva et al., 2013; Lussana et al., 2008; Perala et al., 2012; Stein et al., 2009) in humans. Since alterations in eating habits may be associated with the development of metabolic disorders (Jo & Park, 2023; Layman et al., 2003; Li et al., 2023; Oh et al., 2005), continuous feeding unbalance over the life course of individuals exposed to in utero growth restriction might be a reason for the increased risk of developing these conditions (Portella & Silveira, 2014).…”

“…Since alterations in eating habits may be associated with the development of metabolic disorders (Jo & Park, 2023;Layman et al, 2003;Li et al, 2023;Oh et al, 2005), continuous feeding unbalance over the life course of individuals exposed to in utero growth restriction might be a reason for the increased risk of developing these conditions (Portella & Silveira, 2014).…”