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Healthy and unhealthy low-carbohydrate diets and plasma markers of cardiometabolic risk

Published online by Cambridge University Press:  30 September 2022

Yong Huang ,
Xiude Li ,
Tengfei Zhang ,
Xueke Zeng ,
Meiling Li ,
Haowei Li ,
Hu Yang ,
Chenghao Zhang ,
Yu Zhu  and
Zhuang Zhang
...Show all authors
Yong Huang
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, Hefei, Anhui, People’s Republic of China NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, People’s Republic of China Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Xiude Li
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, Anhui, People’s Republic of China Anhui Provincial Institute of Translational Medicine, Hefei, Anhui, People’s Republic of China
Tengfei Zhang
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Xueke Zeng
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Meiling Li
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Haowei Li
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Hu Yang
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Chenghao Zhang
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Yu Zhu
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Zhuang Zhang
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
Min Tang
Affiliation:
Department of Gastroenterology and Hepatology and Clinical Nutrition, The Fourth Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui, People’s Republic of China
Wanshui Yang*
Affiliation:
Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, Hefei, Anhui, People’s Republic of China NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, People’s Republic of China Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, Anhui, People’s Republic of China
*
* Corresponding author: Wanshui Yang, email wanshuiyang@gmail.com
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Abstract

Previous studies have reported inconsistent associations between low-carbohydrate diets (LCD) and plasma lipid profile. Also, there is little evidence on the role of the quality and food sources of macronutrients in LCD in cardiometabolic health. We investigated the cross-sectional associations between LCD and plasma cardiometabolic risk markers in a nationwide representative sample of the US population. Diet was measured through two 24-h recalls. Overall, healthy (emphasising unsaturated fat, plant protein and less low-quality carbohydrates) and unhealthy (emphasising saturated fat, animal protein and less high-quality carbohydrate) LCD scores were developed according to the percentage of energy as total and subtypes of carbohydrate, protein and fat. Linear regression was used to estimate the percentage difference of plasma marker concentrations by LCD scores. A total of 34 785 participants aged 18–85 years were included. After adjusting for covariates including BMI, healthy LCD was associated with lower levels of insulin, homoeostatic model assessment for insulin resistance (HOMA-IR), C-reactive protein (CRP) and TAG, and higher levels of HDL-cholesterol, with the percentage differences (comparing extreme quartile of LCD score) of −5·91, −6·16, −9·13, −9·71 and 7·60 (all P trend < 0·001), respectively. Conversely, unhealthy LCD was associated with higher levels of insulin, HOMA-IR, CRP and LDL-cholesterol (all P trend < 0·001). Our results suggest that healthy LCD may have positive, whereas unhealthy LCD may have negative impacts on CRP and metabolic and lipid profiles. These findings underscore the need to carefully consider the quality and subtypes of macronutrients in future LCD studies.

Keywords

Low-carbohydrate dietInsulin responseInflammatory biomarkerCardiometabolic biomarkerDietary patterns
Type
Research Article
Information
British Journal of Nutrition , Volume 130 , Issue 1 , 14 July 2023 , pp. 137 - 146
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Nutrition Society

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Footnotes

†

These authors contributed equally as co-first authors for this article.

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