Studies on the intake of different types of carbohydrates and long-term mortality are sparse.
We examined the association of starch, total and each type of sugar, and free sugars with the risk of total and cause-specific mortality in a cohort of the general population in Japan. Study subjects were 29,079 residents from the Takayama Study, Japan, who responded to a self-administered questionnaire in 1992. Diet was assessed by a validated food-frequency questionnaire at the baseline. Mortality was ascertained during 16 years of follow-up. We noted 2,901 deaths (974 cancer-related and 775 cardiovascular-related) in men and 2,438 death (646 cancer-related and 903 cardiovascular-related) in women. In men, intake of starch was inversely associated with total mortality after controlling for covariates (the hazard ratio (HR) and 95% CI for the highest quartile versus lowest quartile: 0.71; 0.60-0.84; P-trend < 0.001). Intakes of total sugars, glucose, fructose, sucrose, maltose, and added and naturally occurring sugars were significantly positively associated with total mortality in men (HR and 95% CI for the highest versus lowest quartile of total sugar: 1.27; 1.12-1.45; P-trend < 0.0001). Similar relations were observed for cardiovascular mortality and non-cancer, non-cardiovascular mortality in men. In women, there was no significant association between any type of carbohydrates and mortality except that free sugars was significantly positively associated with the risk of total and non-cancer, non-cardiovascular mortality. Data suggest that the high intake of starch reduces mortality, whereas the high intake of sugars, including glucose, fructose, and sucrose, increase mortality in Japanese men.