Low carbohydrate diet and all cause and cause-specific mortality

Area of Science:

• Nutritional Epidemiology
• Dietary Patterns and Health Outcomes
• Public Health Nutrition

Background:

• Limited evidence exists on low-carbohydrate diet (LCD) scores and mortality risk in Asian populations, who typically consume high amounts of carbohydrates.
• Understanding these associations is crucial for public health recommendations in diverse ethnic groups.

Purpose of the Study:

• To investigate the association between various low-carbohydrate diet (LCD) scores and the risk of total and cause-specific mortality among Asian adults.
• To differentiate the impact of animal- vs. plant-based sources within LCDs on mortality.

Main Methods:

• A prospective cohort study in Japan involving 43,008 men and 50,646 women aged 45-75 years, with a median follow-up of 16.9 years.
• Low-carbohydrate diet (LCD) scores were calculated based on the percentage of energy from carbohydrate, fat, and protein, including variations for animal and plant sources.
• Cox proportional hazards models were used to assess the association between LCD scores and mortality risk.

Main Results:

• A U-shaped association was observed between the overall LCD score and total mortality, as well as cardiovascular disease (CVD) and heart disease mortality.
• LCD scores emphasizing animal protein and fat also showed a U-shaped association with total mortality.
• Conversely, an LCD score high in plant-based protein and fat was linearly associated with a lower risk of total mortality, CVD, heart disease, and cerebrovascular disease.

Conclusions:

• Diets low in carbohydrates but high in animal-derived protein and fat, or high-carbohydrate diets low in animal protein and fat, are associated with increased mortality risk.
• Low-carbohydrate diets rich in plant-based protein and fat demonstrate a protective association, reducing the risk of total and CVD mortality.