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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

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posted on 2022-09-29, 19:52 authored by Wanying Hou, Tianshu Han, Xinyi Sun, Yunyan Chen, Jiaxu Xu, YU WANGYU WANG, Xue Yang, Wenbo Jiang, Changhao Sun

  

Objective

This study 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 used National Health and Nutrition Examination Survey(2003-2014) and National Death Index data from adults(n = 27,623) to examine 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(△) in carbohydrate intake between dinner and breakfast were calculated(△=dinner-breakfast). Cox regression models were employed.

Results

The participants who consumed more high-quality carbohydrates throughout the day had a lower all-cause mortality risk(hazard ratio(HR)=0.88; 95%confidence interval(CI):0.79-0.99), whereas more daily intake of low-quality carbohydrates was related to a 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 a lower CVD(HR=0.70; 95%CI:0.52-0.93) and all-cause mortality risk(HR=0.82; 95%CI:0.70-0.97); an isocaloric substitution of 1 serving of low-quality carbohydrates intake at dinner with high-quality reduced the CVD and all-cause mortality risks by 25% and 19%. The participants who consumed more low-quality carbohydrates at dinner had greater diabetes mortality(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. 

Funding

HMU Marshal Initiative Funding x HMUMIF-21010

National Natural Science Foundation of China x 82073534

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