Low carbohydrate diet and all cause and cause-specific mortality

Abstract

Background: Evidence is limited regarding the association between low-carbohydrate diet (LCD) score and mortality among Asians, a population that consumes a large amount of carbohydrates. Objective: The present study examined the association between low-carbohydrate diet (LCD) score (based on percentage of energy as carbohydrate, fat, and protein) and the risk of total and cause-specific mortality among Asians. Design: This study was a prospective cohort study in Japan with follow-up for a median of 16.9 years involving 43008 men and 50646 women aged 45e75 years. Association of LCD score, LCD score based on animal sources of protein and fat, and LCD score based on plant sources of protein and fat with risk of mortality was assessed using Cox proportional hazards model. Results: A U-shaped association was observed between LCD score and total mortality: the multivariableadjusted hazard ratios (HRs) (95% CI) of total mortality for lowest through highest scores were 1.00, 0.95 (0.91, 1.01), 0.93 (0.88, 0.98), 0.93 (0.88, 0.98), and 1.01 (0.95, 1.07) (P-non-linearity <0.01). A similar association was found for mortality from cardiovascular disease (CVD) and heart disease. LCD score based on carbohydrate, animal protein, and animal fat also showed a U-shaped association for total mortality (P-nonlinearity <0.01). In contrast, LCD score based on carbohydrate, plant protein, and plant fat was linearly associated with lower total (HR, 0.89; 95% CI: 0.83, 0.94 for highest versus lowest quintile), CVD [0.82 (0.73, 0.92)], heart disease [0.83 (0.71, 0.98)], and cerebrovascular disease [0.75 (0.62, 0.91) mortality. Conclusions: Both LCD with high animal protein and fat and high-carbohydrate diet with low animal protein and fat were associated with higher risk of mortality. Meanwhile, LCD high in plant-based sources of protein and fat was associated with a lower risk of total and CVD mortality.

Alternative Dietary Patterns for Americans: Low-Carbohydrate Diets

“…A search of Pubmed.gov yielded 14 such papers. Studies were excluded if there was no clear definition for "low-carbohydrate" [146][147][148] or if the paper did not isolate the link between a low-carbohydrate diet and health outcomes but instead reported on a score that combined intake measures of carbohydrate, fat and protein [149,150]. One systematic review was also identified, but that paper also did not report on the isolated link between a "low-carbohydrate" diet and health outcomes [151].…”

Which Diets Are Effective in Reducing Cardiovascular and Cancer Risk in Women with Obesity? An Integrative Review

“…Previous meta-analyses of cohort studies have investigated the relationship between carbohydrate intake and all-cause mortality, and also mortality related to other outcomes, such as CVD and cancer, in the general population [ 42 , 43 , 44 , 45 ]. Some meta-analyses have found an association of LCD or low-carbohydrate, high-protein diets with increased all-cause mortality [ 42 , 43 ].…”

“…A meta-analysis observed that the risk of CVD mortality and incidence were not significantly increased, while another meta-analysis showed that CVD, cerebrovascular and cancer mortality were greater for higher scores of LCD evaluated as quartiles with the highest quartile related to the lowest carbohydrate intake [ 43 ]. Two meta-analyses observed that both LCD (HR 1.20; 95% CI 1.09–1.32) and high-carbohydrate diets (HR 1.23; 95% CI 1.11–1.36) were associated with an increased mortality risk [ 44 , 45 ]. In contrast, one of these meta-analyses analysed the source of protein of the diet and it was observed that LCD high in plant-based sources of protein and fat was associated with a lower risk of total (HR 0.89; 95% CI: 0.83–0.94 for highest versus lowest quintile), and CVD mortality (HR 0.82; 95% CI 0.73–0.92 for highest versus lowest quintile) [ 45 ].…”

The adverse metabolic effects of branched-chain amino acids are mediated by isoleucine and valine

“…Recently, a growing body of literature has demonstrated that ''a calorie is not just a calorie.'' Prospective and retrospective cohort analyses suggest that consumption of dietary protein, particularly from animal sources, increases the risk of diabetes, insulin resistance, and cancer and is associated with a higher overall risk of mortality (Akter et al, 2020;Huang et al, 2020;Lagiou et al, 2007;Levine et al, 2014;Sluijs et al, 2010). A short-term randomized control trial found that individuals consuming a low-protein (LP) diet lost weight without calorie restriction; an LP diet also reduced adiposity and lowered fasting blood glucose (FBG) (Fontana et al, 2016).…”