Highlights
- •There was a U-shape association of total carbohydrate intake with new-onset diabetes.
- •49–56% of energy from carbohydrate intake showed lowest risk of new-onset diabetes.
- •There was an L-shaped association of high-quality carbohydrate with new-onset diabetes.
- •There was a J-shaped association of low-quality carbohydrate with new-onset diabetes.
- •Plant LCD scores for low-quality carbohydrate were inversely associated with new-onset diabetes.
Abstract
Aim
The association of carbohydrate intake with diabetes risk remains uncertain. We aimed
to evaluate the prospective associations of the amount and types of carbohydrate intake
with new-onset diabetes.
Methods
A total of 16,260 non-diabetic participants from the China Health and Nutrition Survey
(CHNS) were included. Dietary intake was collected by three consecutive 24-h dietary
recalls combined with a household food inventory. Participants with self-reported
physician diagnosed diabetes, or fasting plasma glucose ≥7.0 mmol/L or glycated hemoglobin
≥6.5% during the follow-up were defined having new-onset diabetes.
Results
During a median follow-up of 9 years (158,930 person-years), 1100 participants developed
diabetes. Overall, there was a U-shaped association between percent of energy from
carbohydrate intake and new-onset diabetes, with minimal risk at 49–56% of energy
from total carbohydrate intake (quartile 2) (P for nonlinearity <0.001). Moreover, there was an L-shaped association between high-quality
carbohydrate intake and new-onset diabetes (P for nonlinearity <0.001), and a J-shaped association of low-quality carbohydrate
intake with new-onset diabetes (P for nonlinearity <0.001). Furthermore, there was an inverse association between the
plant-based low-carbohydrate diet scores for low-quality carbohydrate and new-onset
diabetes. However, a reversed J-shaped association was found between the animal-based
low-carbohydrate diet scores for low-quality carbohydrate and new-onset diabetes (P for nonlinearity <0.001).
Conclusions
There was a U-shape association between percent of total carbohydrate intake and new-onset
diabetes, with the lowest risk at 49–56% carbohydrate intake. Our findings provide
some evidence for the intake of high-quality carbohydrate, and the substitution of
plant-based products for low-quality carbohydrate for primary prevention of diabetes.
Abbreviations:
CHNS (China Health and Nutrition Survey), IDF (International Diabetes Federation), FCT (food composition table), LCD (low-carbohydrate diet), SBP (systolic blood pressure), DBP (diastolic blood pressure), BMI (body mass index), HbA1c (glycated hemoglobin), SD (standard deviation), CI (confidence interval), IQR (inter-quartile range)Keywords
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Article info
Publication history
Published online: August 12, 2021
Accepted:
August 10,
2021
Received:
June 4,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
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- Corrigendum to ‘Dietary carbohydrate intake and new-onset diabetes: A Nationwide Cohort Study in China’ [Metab Clin Exp 123 (2021) 154865]Metabolism - Clinical and ExperimentalVol. 127
