Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants
Abstract Background Recent 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 carbo...
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-022-02712-7 |
| _version_ | 1797864492060639232 |
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| author | Rebecca K. Kelly Tammy Y. N. Tong Cody Z. Watling Andrew Reynolds Carmen Piernas Julie A. Schmidt Keren Papier Jennifer L. Carter Timothy J. Key Aurora Perez-Cornago |
| author_facet | Rebecca K. Kelly Tammy Y. N. Tong Cody Z. Watling Andrew Reynolds Carmen Piernas Julie A. Schmidt Keren Papier Jennifer L. Carter Timothy J. Key Aurora Perez-Cornago |
| author_sort | Rebecca K. Kelly |
| collection | DOAJ |
| description | Abstract Background Recent 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. Methods A 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. Results Total 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. Conclusions Higher 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. |
| first_indexed | 2024-04-09T22:52:47Z |
| format | Article |
| id | doaj.art-556e7622dbf242b8b48fa130da98dcca |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-04-09T22:52:47Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-556e7622dbf242b8b48fa130da98dcca2023-03-22T11:32:32ZengBMCBMC Medicine1741-70152023-02-0121111610.1186/s12916-022-02712-7Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participantsRebecca K. Kelly0Tammy Y. N. Tong1Cody Z. Watling2Andrew Reynolds3Carmen Piernas4Julie A. Schmidt5Keren Papier6Jennifer L. Carter7Timothy J. Key8Aurora Perez-Cornago9Cancer Epidemiology Unit, Nuffield Department of Population Health, University of OxfordCancer Epidemiology Unit, Nuffield Department of Population Health, University of OxfordCancer Epidemiology Unit, Nuffield Department of Population Health, University of OxfordDepartment of Medicine, University of OtagoNuffield Department of Primary Care Health Sciences, University of OxfordCancer Epidemiology Unit, Nuffield Department of Population Health, University of OxfordCancer Epidemiology Unit, Nuffield Department of Population Health, University of OxfordClinical Trial Service Unit and Epidemiological Studies Unit, University of OxfordCancer Epidemiology Unit, Nuffield Department of Population Health, University of OxfordCancer Epidemiology Unit, Nuffield Department of Population Health, University of OxfordAbstract Background Recent 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. Methods A 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. Results Total 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. Conclusions Higher 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.https://doi.org/10.1186/s12916-022-02712-7Coronary heart diseaseStrokeNutritional epidemiologyPrimary preventionCarbohydrates |
| spellingShingle | Rebecca K. Kelly Tammy Y. N. Tong Cody Z. Watling Andrew Reynolds Carmen Piernas Julie A. Schmidt Keren Papier Jennifer L. Carter Timothy J. Key Aurora Perez-Cornago Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants BMC Medicine Coronary heart disease Stroke Nutritional epidemiology Primary prevention Carbohydrates |
| title | Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants |
| title_full | Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants |
| title_fullStr | Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants |
| title_full_unstemmed | Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants |
| title_short | Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants |
| title_sort | associations between types and sources of dietary carbohydrates and cardiovascular disease risk a prospective cohort study of uk biobank participants |
| topic | Coronary heart disease Stroke Nutritional epidemiology Primary prevention Carbohydrates |
| url | https://doi.org/10.1186/s12916-022-02712-7 |
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