Low-Carbohydrate Diet Scores and Mortality Among Adults With Incident Type 2 Diabetes
Journal article, 2023

OBJECTIVE:
The current study aims to prospectively examine the association between postdiagnosis low-carbohydrate diet (LCD) patterns and mortality among individuals with type 2 diabetes (T2D).
RESEARCH DESIGN AND METHODS:
Among participants with incident diabetes identified in the Nurses' Health Study and Health Professionals Follow-up Study, an overall total LCD score (TLCDS) was calculated based on the percentage of energy as total carbohydrates. In addition, vegetable (VLCDS), animal (ALCDS), healthy (HLCDS), and unhealthy (ULCDS) LCDS were further derived that emphasized different sources and quality of macronutrients. Multivariable-adjusted Cox models were used to assess the association between the LCDS and mortality.
RESULTS:
Among 10,101 incident T2D cases contributing 139,407 person-years during follow-up, we documented 4,595 deaths of which 1,389 cases were attributed to cardiovascular disease (CVD) and 881 to cancer. The pooled multivariable-adjusted hazard ratios (HRs, 95% CIs) of total mortality per 10-point increment of postdiagnosis LCDS were 0.87 (0.82, 0.92) for TLCDS, 0.76 (0.71, 0.82) for VLCDS, and 0.78 (0.73, 0.84) for HLCDS. Both VLCDS and HLCDS were also associated with significantly lower CVD and cancer mortality. Each 10-point increase of TLCDS, VLCDS, and HLCDS from prediagnosis to postdiagnosis period was associated with 12% (7%, 17%), 25% (19%, 30%), and 25% (19%, 30%) lower total mortality, respectively. No significant associations were observed for ALCDS and ULCDS. CONCLUSIONS:
Among people with T2D, greater adherence to LCD patterns that emphasize high-quality sources of macronutrients was significantly associated with lower total, cardiovascular, and cancer mortality.

Author

Yang Hu

Harvard School of Public Health

Gang Liu

Huazhong University of Science and Technology

Edward Yu

Harvard School of Public Health

Biqi Wang

University of Massachusetts

Clemens Wittenbecher

Chalmers, Life Sciences, Food and Nutrition Science

Jo Ann E. Manson

Harvard School of Public Health

Brigham and Women's Hospital

Eric B. Rimm

Harvard School of Public Health

Brigham and Women's Hospital

Liming Liang

Harvard School of Public Health

Kathryn Rexrode

Brigham and Women's Hospital

Walter C. Willett

Harvard School of Public Health

Brigham and Women's Hospital

Frank B. Hu

Harvard School of Public Health

Brigham and Women's Hospital

Qi Sun

Harvard School of Public Health

Brigham and Women's Hospital

Diabetes care

19355548 (eISSN)

Vol. 46 4 874-884

Subject Categories

Endocrinology and Diabetes

Cancer and Oncology

Nutrition and Dietetics

DOI

10.2337/dc22-2310

PubMed

36787923

More information

Latest update

4/23/2024