Dietary carbohydrate and the risk of type 2 diabetes: an updated systematic review and dose–response meta-analysis of prospective cohort studies

Abstract We did this study to clarify the association between carbohydrate intake and the risk of type 2 diabetes (T2D) and potential effect modification by geographical location. PubMed, Scopus and Web of Science were searched to find prospective cohort studies of dietary carbohydrate intake and T2...

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Main Authors: Fatemeh Hosseini, Ahmad Jayedi, Tauseef Ahmad Khan, Sakineh Shab-Bidar
Format: Article
Language:English
Published: Nature Portfolio 2022-02-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-022-06212-9
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author Fatemeh Hosseini
Ahmad Jayedi
Tauseef Ahmad Khan
Sakineh Shab-Bidar
author_facet Fatemeh Hosseini
Ahmad Jayedi
Tauseef Ahmad Khan
Sakineh Shab-Bidar
author_sort Fatemeh Hosseini
collection DOAJ
description Abstract We did this study to clarify the association between carbohydrate intake and the risk of type 2 diabetes (T2D) and potential effect modification by geographical location. PubMed, Scopus and Web of Science were searched to find prospective cohort studies of dietary carbohydrate intake and T2D risk. A random-effects dose–response meta-analysis was performed to calculate the summary hazard ratios (HRs) and 95%CIs. The quality of cohort studies and the certainty of evidence was rated using the Newcastle–Ottawa Scale and GRADE tool, respectively. Eighteen prospective cohort studies with 29,229 cases among 607,882 participants were included. Thirteen studies were rated to have high quality, and five as moderate quality. The HR for the highest compared with the lowest category of carbohydrate intake was 1.02 (95%CI: 0.91, 1.15; I2 = 67%, GRADE = low certainty). The HRs were 0.93 (95%CI: 0.82, 1.05; I2 = 58%, n = 7) and 1.26 (95%CI: 1.11, 1.44; I2 = 6%, n = 6) in Western and Asian countries, respectively. Dose–response analysis indicated a J shaped association, with the lowest risk at 50% carbohydrate intake (HR50%: 0.95, 95%CI: 0.90, 0.99) and with risk increasing significantly at 70% carbohydrate intake (HR70%: 1.18, 95%CI: 1.03, 1.35). There was no association between low carbohydrate diet score and the risk of T2D (HR: 1.14, 95%CI: 0.89, 1.47; I2 = 90%, n = 5). Carbohydrate intake within the recommended 45–65% of calorie intake was not associated with an increased risk of T2D. Carbohydrate intake more than 70% calorie intake might be associated with a higher risk.
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spelling doaj.art-17ddd15e691c41e9867066dd59494fe62022-12-21T23:59:32ZengNature PortfolioScientific Reports2045-23222022-02-011211910.1038/s41598-022-06212-9Dietary carbohydrate and the risk of type 2 diabetes: an updated systematic review and dose–response meta-analysis of prospective cohort studiesFatemeh Hosseini0Ahmad Jayedi1Tauseef Ahmad Khan2Sakineh Shab-Bidar3Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS)Social Determinant of Health Research Center, Semnan University of Medical SciencesDepartment of Nutritional Sciences, Faculty of Medicine, University of TorontoDepartment of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS)Abstract We did this study to clarify the association between carbohydrate intake and the risk of type 2 diabetes (T2D) and potential effect modification by geographical location. PubMed, Scopus and Web of Science were searched to find prospective cohort studies of dietary carbohydrate intake and T2D risk. A random-effects dose–response meta-analysis was performed to calculate the summary hazard ratios (HRs) and 95%CIs. The quality of cohort studies and the certainty of evidence was rated using the Newcastle–Ottawa Scale and GRADE tool, respectively. Eighteen prospective cohort studies with 29,229 cases among 607,882 participants were included. Thirteen studies were rated to have high quality, and five as moderate quality. The HR for the highest compared with the lowest category of carbohydrate intake was 1.02 (95%CI: 0.91, 1.15; I2 = 67%, GRADE = low certainty). The HRs were 0.93 (95%CI: 0.82, 1.05; I2 = 58%, n = 7) and 1.26 (95%CI: 1.11, 1.44; I2 = 6%, n = 6) in Western and Asian countries, respectively. Dose–response analysis indicated a J shaped association, with the lowest risk at 50% carbohydrate intake (HR50%: 0.95, 95%CI: 0.90, 0.99) and with risk increasing significantly at 70% carbohydrate intake (HR70%: 1.18, 95%CI: 1.03, 1.35). There was no association between low carbohydrate diet score and the risk of T2D (HR: 1.14, 95%CI: 0.89, 1.47; I2 = 90%, n = 5). Carbohydrate intake within the recommended 45–65% of calorie intake was not associated with an increased risk of T2D. Carbohydrate intake more than 70% calorie intake might be associated with a higher risk.https://doi.org/10.1038/s41598-022-06212-9
spellingShingle Fatemeh Hosseini
Ahmad Jayedi
Tauseef Ahmad Khan
Sakineh Shab-Bidar
Dietary carbohydrate and the risk of type 2 diabetes: an updated systematic review and dose–response meta-analysis of prospective cohort studies
Scientific Reports
title Dietary carbohydrate and the risk of type 2 diabetes: an updated systematic review and dose–response meta-analysis of prospective cohort studies
title_full Dietary carbohydrate and the risk of type 2 diabetes: an updated systematic review and dose–response meta-analysis of prospective cohort studies
title_fullStr Dietary carbohydrate and the risk of type 2 diabetes: an updated systematic review and dose–response meta-analysis of prospective cohort studies
title_full_unstemmed Dietary carbohydrate and the risk of type 2 diabetes: an updated systematic review and dose–response meta-analysis of prospective cohort studies
title_short Dietary carbohydrate and the risk of type 2 diabetes: an updated systematic review and dose–response meta-analysis of prospective cohort studies
title_sort dietary carbohydrate and the risk of type 2 diabetes an updated systematic review and dose response meta analysis of prospective cohort studies
url https://doi.org/10.1038/s41598-022-06212-9
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