UK Dietary Policy for the Prevention of Cardiovascular Disease

Levy, Louis; Tedstone, Alison

doi:10.3390/healthcare5010009

Cited by 23 publications

(27 citation statements)

References 12 publications

(12 reference statements)

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“…The mean recorded dietary intakes for the group failed to meet current UK E% dietary recommendations for total carbohydrate (42.4 ± 1.46% vs > 50%), non-milk extrinsic sugars (18.3 ± 1.29% vs <11%), total fat (37.5 ± 1.62% vs <35%), saturated fat (13.6 ± 0.69% vs <11%), and total dietary fibre (10.4 ± 0.56g vs ≥30g) (22). The protein intake for the group was 14.8 ± 0.48 E%, although it was not possible to differentiate between animal and plant sources.…”

Section: Resultsmentioning

confidence: 83%

Elevated high density lipoprotein cholesterol and low grade systemic inflammation is associated with increased gut permeability in normoglycemic men

Robertson

Pedersen

Hinton

et al. 2018

Nutrition, Metabolism and Cardiovascular Diseases

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Section: Resultsmentioning

confidence: 83%

Elevated high density lipoprotein cholesterol and low grade systemic inflammation is associated with increased gut permeability in normoglycemic men

Robertson

Pedersen

Hinton

et al. 2018

Nutrition, Metabolism and Cardiovascular Diseases

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“…A key strength of our study is its use of the UK nationally representative data for hypothesis testing on a topic of substantial scientific and public interest. Results could, therefore, be generalizable to the UK population and possibly to other countries, as dietary recommendations (to eat more whole grain, fruits and vegetables, and lower fat, saturated fat, sodium and sugar) are rather similar across many countries [47,48]. Using prospective dietary records does not rely on memory so may provide more accurate estimates of actual intakes than food frequency questionnaires.…”

Section: Discussionmentioning

confidence: 99%

Lower carbohydrate and higher fat intakes are associated with higher hemoglobin A1c: findings from the UK National Diet and Nutrition Survey 2008–2016

2019

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Purpose Evidence of low-carbohydrate, high-fat diets (LCHF) for type 2 diabetes (T2DM) prevention is scarce. We investigated how carbohydrate intake relates to HbA1c and T2DM prevalence in a nationally representative survey dataset. Methods We analyzed dietary information (4-day food diaries) from 3234 individuals aged ≥ 16 years, in eight waves of the UK National Diet and Nutrition Survey (2008-2016). We calculated LCHF scores (0-20, higher score indicating lower %food energy from carbohydrate, with reciprocal higher contribution from fat) and UK Dietary Reference Value (DRV) scores (0-16, based on UK dietary recommendations). Associations between macronutrients and diet scores and diabetes prevalence were analyzed (in the whole sample) using multivariate logistic regression. Among those without diabetes, analyses between exposures and %HbA1c (continuous) were analyzed using multivariate linear regression. All analyses were adjusted for age, sex, body mass index, ethnicity, smoking status, total energy intake, socioeconomic status and survey years. Results In the overall study sample, 194 (6.0%) had diabetes. Mean intake was 48.0%E for carbohydrates, and 34.9%E for total fat. Every 5%E decrease in carbohydrate, and every 5%E increase in fat, was associated with 12% (95% CI 0.78-0.99; P = 0.03) and 17% (95% CI 1.02-1.33; P = 0.02) higher odds of diabetes, respectively. Each two-point increase in LCHF score is related to 8% (95% CI 1.02-1.14; P = 0.006) higher odds of diabetes, while there was no evidence for association between DRV score and diabetes. Among the participants without diagnosed diabetes (n = 3130), every 5%E decrease in carbohydrate was associated with higher %HbA1c by + 0.016% (95% CI 0.004-0.029; P = 0.012), whereas every 5%E increase in fat was associated with higher %HbA1c by + 0.029% (95% CI 0.015-0.043; P < 0.001). Each two-point increase in LCHF score is related to higher %HbA1c by + 0.010% (0.1 mmol/mol), while each two-point increase in the DRV score is related to lower %HbA1c by − 0.023% (0.23 mmol/mol). Conclusions Lower carbohydrate and higher fat intakes were associated with higher HbA1c and greater odds of having diabetes. These data do not support low(er) carbohydrate diets for diabetes prevention. Keywords Reduced carbohydrate diet • Carbohydrate-restricted diet • High-fat diet • Dietary recommendation • Glycated hemoglobin • Type 2 diabetes Abbreviations T2DM Type 2 diabetes LCHF Low-carbohydrate, high-fat diet NDNS National diet and nutrition survey DRV Dietary reference value NMES Non-milk extrinsic sugar NSP Non-starch polysaccharide BMI Body mass index NS-SEC National statistics socioeconomic classification Electronic supplementary material The online version of this article (

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“…16 From a health perspective, the EWG promotes, for example, cereals, potatoes, fruit, vegetable and fibre consumption, while recommending a limited consumption of sugar and processed meats. 17 Adhering to these individual guidelines has been associated with several health benefits including improved cardiovascular health 18 and reduced cancer risk. 19 20 From an environmental perspective, the EWG mentions the importance of a ‘balance of healthier and more sustainable food’, while providing information about protein alternatives, such as beans, peas and lentils, that typically have a lower environmental footprint than animal source food protein sources.…”

Section: Introductionmentioning

confidence: 99%

Health impacts and environmental footprints of diets that meet the Eatwell Guide recommendations: analyses of multiple UK studies

et al. 2020

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ObjectivesTo assess the health impacts and environmental consequences of adherence to national dietary recommendations (the Eatwell Guide (EWG)) in the UK.Design and settingA secondary analysis of multiple observational studies in the UK.ParticipantsAdults from the European Prospective Investigation into Cancer - Oxford(EPIC-Oxford), UK Biobank and Million Women Study, and adults and children aged 5 and over from the National Diet and Nutrition Survey (NDNS).Primary and secondary outcome measures risk of total mortality from Cox proportional hazards regression models, total greenhouse gas emissions (GHGe) and blue water footprint (WF) associated with ‘very low’ (0–2 recommendations), ‘low’ (3–4 recommendations) or ‘intermediate-to-high’ (5–9 recommendations) adherence to EWG recommendations.ResultsLess than 0.1% of the NDNS sample adhere to all nine EWG recommendations and 30.6% adhere to at least five recommendations. Compared with ‘very low’ adherence to EWG recommendations, ‘intermediate-to-high adherence’ was associated with a reduced risk of mortality (risk ratio (RR): 0.93; 99% CI: 0.90 to 0.97) and −1.6 kg CO2eq/day (95% CI: −1.5 to −1.8), or 30% lower dietary GHGe. Dietary WFs were similar across EWG adherence groups. Of the individual Eatwell guidelines, adherence to the recommendation on fruit and vegetable consumption was associated with the largest reduction in total mortality risk: an RR of 0.90 (99% CI: 0.88 to 0.93). Increased adherence to the recommendation on red and processed meat consumption was associated with the largest decrease in environmental footprints (−1.48 kg CO2eq/day, 95% CI: −1.79 to 1.18 for GHGe and −22.5 L/day, 95% CI: −22.7 to 22.3 for blue WF).ConclusionsThe health and environmental benefits of greater adherence to EWG recommendations support increased government efforts to encourage improved diets in the UK that are essential for the health of people and the planet in the Anthropocene.

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UK Dietary Policy for the Prevention of Cardiovascular Disease

Cited by 23 publications

References 12 publications

Elevated high density lipoprotein cholesterol and low grade systemic inflammation is associated with increased gut permeability in normoglycemic men

Elevated high density lipoprotein cholesterol and low grade systemic inflammation is associated with increased gut permeability in normoglycemic men

Lower carbohydrate and higher fat intakes are associated with higher hemoglobin A1c: findings from the UK National Diet and Nutrition Survey 2008–2016

Health impacts and environmental footprints of diets that meet the Eatwell Guide recommendations: analyses of multiple UK studies

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