Abstract P407: Low-Carbohydrate Dietary Pattern and Mortality in US Adults: The Third National Health and Nutritional Examination Survey (NHANES III)
Few studies have examined the relationship between low-carbohydrate diets and mortality. We examined the association between three low-carbohydrate dietary patterns and all-cause and cardiovascular disease (CVD) mortality in a nationally representative sample of U.S. adults. Participants in the NHANES III who were 20 years and older who attended baseline examinations (1988- 1994) and provided a 24-hour dietary recall were included and followed until their death or Dec 31, 2006. A total of 16,521 men and women were included in the study. Dietary intake of carbohydrate, fat (total, saturated, monounsaturated+ polyunsaturated) and protein (total, animal, vegetable) as a percent of energy were divided into 10 strata based on the distribution and summed to create three different low-carbohydrate-diet (LCD) scores: an overall LCD score was calculated based on total carbohydrate, fat, and protein; an animal-based LCD was calculated using saturated fat and animal protein intake; and a prudent LCD score was calculated using unsaturated fat and vegetable protein intake. Cox proportional hazard models adjusted for age, gender, race, body mass index (kg/m2), physical activity (metabolic equivalent/ min), total energy intake (kcal), alcohol intake (g), smoking status, and history of hypertension, CVD, and type-2 diabetes were used to identify associations between LCD scores and mortality endpoints. During the 13 years of follow-up, 3805 deaths (including 1655 due to cardiovascular diseases) were documented. A higher overall LCD score was significantly associated with higher all-cause and CVD mortality (P for trend=0.03 for all-cause mortality and P for trend=0.002 for CVD mortality). Likewise, the animal-based LCD score was positively associated with all-cause and cardiovascular mortality (P for trend=0.03 for all-cause mortality and P for trend=0.001 for CVD mortality). In contrast, the prudent LCD score was not associated with either mortality endpoint. A low-carbohydrate dietary pattern which incorporated higher intakes of saturated fat and animal protein was associated with higher all-cause and cardiovascular disease mortality; while the pattern incorporated higher intakes of unsaturated fat and vegetable protein was not associated with either all-cause or CVD mortality.
- © 2013 by American Heart Association, Inc.