Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants

BMC Medicine

Research Article

Aurora Perez-Cornago¹  Keren Papier¹  Cody Z. Watling¹  Rebecca K. Kelly¹  Tammy Y. N. Tong¹  Timothy J. Key¹  Julie A. Schmidt²  Jennifer L. Carter³  Andrew Reynolds⁴  Carmen Piernas⁵ 

[1] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, OX3 7LF, Oxford, UK;Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, OX3 7LF, Oxford, UK;Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark;Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, OX3 7LF, Oxford, UK;Department of Medicine, University of Otago, 9016, Dunedin, New Zealand;Nuffield Department of Primary Care Health Sciences, University of Oxford, OX3 7LF, Oxford, UK;

关键词: Coronary heart disease;    Stroke;    Nutritional epidemiology;    Primary prevention;    Carbohydrates;   

DOI  :  10.1186/s12916-022-02712-7

 received in 2022-09-08, accepted in 2022-12-14,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundRecent studies have reported that the associations between dietary carbohydrates and cardiovascular disease (CVD) may depend on the quality, rather than the quantity, of carbohydrates consumed. This study aimed to assess the associations between types and sources of dietary carbohydrates and CVD incidence. A secondary aim was to examine the associations of carbohydrate intakes with triglycerides within lipoprotein subclasses.MethodsA total of 110,497 UK Biobank participants with ≥ two (maximum five) 24-h dietary assessments who were free from CVD and diabetes at baseline were included. Multivariable-adjusted Cox regressions were used to estimate risks of incident total CVD (4188 cases), ischaemic heart disease (IHD; 3138) and stroke (1124) by carbohydrate intakes over a median follow-up time of 9.4 years, and the effect of modelled dietary substitutions. The associations of carbohydrate intakes with plasma triglycerides within lipoprotein subclasses as measured by nuclear magnetic resonance (NMR) spectroscopy were examined in 26,095 participants with baseline NMR spectroscopy measurements.ResultsTotal carbohydrate intake was not associated with CVD outcomes. Free sugar intake was positively associated with total CVD (HR; 95% CI per 5% of energy, 1.07;1.03–1.10), IHD (1.06;1.02–1.10), and stroke (1.10;1.04–1.17). Fibre intake was inversely associated with total CVD (HR; 95% CI per 5 g/d, 0.96;0.93–0.99). Modelled isoenergetic substitution of 5% of energy from refined grain starch with wholegrain starch was inversely associated with total CVD (0.94;0.91–0.98) and IHD (0.94;0.90–0.98), and substitution of free sugars with non-free sugars was inversely associated with total CVD (0.95;0.92–0.98) and stroke (0.91;0.86–0.97). Free sugar intake was positively associated with triglycerides within all lipoproteins.ConclusionsHigher free sugar intake was associated with higher CVD incidence and higher triglyceride concentrations within all lipoproteins. Higher fibre intake and replacement of refined grain starch and free sugars with wholegrain starch and non-free sugars, respectively, may be protective for incident CVD.

【 授权许可】

CC BY   
© The Author(s) 2023

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