Relationship Between Carbohydrate Intake (Quantity, Quality, and Time Eaten) and Mortality (Total, Cardiovascular, and Diabetes): Assessment of 2003–2014 National Health and Nutrition Examination Survey Participants

Abstract

OBJECTIVE In this study we investigated the association of the quantity, quality, and timing of carbohydrate intake with all-cause, cardiovascular disease (CVD), and diabetes mortality. RESEARCH DESIGN AND METHODS This secondary data analysis included use of National Health and Nutrition Examination Survey (2003–2014) and National Death Index data from adults (n = 27,623) for examination of the association of total daily and differences in carbohydrate intake with mortality. Participants were categorized into four carbohydrate intake patterns based on the median values of daily high- and low-quality carbohydrate intake. The differences (Δ) in carbohydrate intake between dinner and breakfast were calculated (Δ = dinner − breakfast). Cox regression models were used. RESULTS The participants who consumed more high-quality carbohydrates throughout the day had lower all-cause mortality risk (hazard ratio [HR] 0.88; 95% CI 0.79–0.99), whereas more daily intake of low-quality carbohydrates was related to greater all-cause mortality risk (HR 1.13; 95% CI: 1.01–1.26). Among participants whose daily high- and low-quality carbohydrate intake were both below the median, the participants who consumed more high-quality carbohydrates at dinner had lower CVD (HR 0.70; 95% CI 0.52–0.93) and all-cause mortality (HR 0.82; 95% CI 0.70–0.97) risk; an isocaloric substitution of 1 serving low-quality carbohydrates intake at dinner with high-quality reduced the CVD and all-cause mortality risks by 25% and 19%. There was greater diabetes mortality among the participants who consumed more low-quality carbohydrates at dinner (HR 1.78; 95% CI 1.02–3.11), although their daily high-quality carbohydrate intake was above the median. CONCLUSIONS Consuming more low-quality carbohydrates at dinner was associated with greater diabetes mortality, whereas consuming more high-quality carbohydrates at dinner was associated with lower all-cause and CVD mortality irrespective of the total daily quantity and quality of carbohydrates.

Ultra-Processed Food Intake Is Associated with Non-Alcoholic Fatty Liver Disease in Adults: A Systematic Review and Meta-Analysis

“…Bisphenol, a common ingredient in artificial UPF packaging, is associated with greater incidence and progression of NAFLD due to endocrine disruption and the pleiotropic action of the compound [ 61 ] as well as increasing the risk of other metabolic diseases such as T2D [ 62 ]. Finally, timing of eating impacts metabolic outcomes, with high consumption of low-quality carbohydrates, such as those found in UPFs, being more harmful when consumed during evening meals [ 63 ] ( Figure 8 ).…”

The association between triglyceride-glucose index and its combination with obesity indicators and cardiovascular disease: NHANES 2003–2018

“…1 . Exclusion criteria comprised the following: (1) dietary energy intake below 800 or over 4200 kcal/day for male and below 500 or more than 3500 kcal/day for female [ 29 ]; (2) participants with missing triglyceride-glucose index and its combinations with indicators of obesity; (3) participants lacking the outcome or covariates. The NCHS Research Ethics Review Board approved the NHANES study protocol, and all participants provided written informed consent.…”

Meal timing of dietary total antioxidant capacity and its association with all-cause, CVD and cancer mortality: the US national health and nutrition examination survey, 1999–2018

“…The main three meals (breakfast, lunch, dinner) or snack events were directly reported from the interviews. The average food intake from 2003 to 2018 during the 2 days was calculated [ 29 ]. Nutrient values were calculated with reference to the Food and Nutrient Database for Dietary Studies of United States Department of Agriculture.…”