Carbohydrate Intake in Relation to Cardiovascular Risk Factors in the National Health and Nutrition Examination Survey (NHANES) – A Cross-sectional Study Open Access
Chen, Aolei (Fall 2021)
Abstract
Background: Cardiovascular disease is the leading cause of mortality in many western countries. Previous studies have shown that dietary practices might impact cardiovascular health. We aimed to investigate the association between low carbohydrate diets and cardiovascular risk factors using nationally representative U.S. data.
Methods: We conducted a cross-sectional study among U.S. adults 18 years or older using data from the National Health and Nutrition Examination Survey (NHANES) cycles 2015 to 2018. Demographic data, current health status, physical activities, anthropometric measurements, dietary data (total energy, carbohydrate, fat, protein intake), cardiovascular biomarkers (systolic blood pressure, blood levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, C-reactive protein) and type-2 diabetes indicators (fasting blood glucose and insulin) were included in the study. Low-carbohydrate-diet scores were developed using deciles of percentages of energy provided by protein, carbohydrate and fat. Participants in the lowest decile of carbohydrate intake received 10 points and those in the highest decile of carbohydrate intake were given 1 point. Other deciles received the corresponding score (9,8,7,6,5,4,3 and 2, respectively). For protein and fat intakes, the scoring procedure was reversed with lowest intakes receiving the lowest scores. The overall low-carbohydrate-diet score was computed by summing all points across the three macronutrients. The lowest scores represented participants having highest carbohydrate intakes and lowest fat and protein intakes, while the highest scores indicated the lowest carbohydrate intakes and highest fat and protein intakes. Simple and multiple linear regression analyses were conducted. Age, sex, race, family poverty income ratio, physical activity, educational level, weight status, smoking status and alcohol consumption were included as confounders in multivariate models.
Results: After controlling for all potential confounders, the low-carbohydrate-diet score was inversely associate with triglyceride level (β=0.87; 95%CI, 0.75-0.99) and positively associated with high-density lipoprotein cholesterol level (β=1.08; 95%CI, 1.03-1.14). The low-carbohydrate-diet score was not associated with systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, fasting insulin and the Homeostatic Model Assessment for Insulin Resistance.
Conclusion: This study supports the premise that low carbohydrate dietary practices may be associated with selected markers of lower cardiovascular risk among U.S. adults. Long-term prospective cohort studies are needed to confirm these findings.
Table of Contents
Introduction..............................................1
Methods.....................................................1
Results.......................................................5
Discussion.................................................8
References.................................................11
About this Master's Thesis
| School | |
|---|---|
| Department | |
| Subfield / Discipline | |
| Degree | |
| Submission | |
| Language |
|
| Research Field | |
| Keyword | |
| Committee Chair / Thesis Advisor |
Primary PDF
| Thumbnail | Title | Date Uploaded | Actions |
|---|---|---|---|
|
|
Carbohydrate Intake in Relation to Cardiovascular Risk Factors in the National Health and Nutrition Examination Survey (NHANES) – A Cross-sectional Study () | 2021-12-08 09:46:26 -0500 |
|
Supplemental Files
| Thumbnail | Title | Date Uploaded | Actions |
|---|