Data
regarding the dietary habits of tens of thousands of adults in the United
States suggest that those who follow healthful low fat and low carb diets have
a lower overall death risk.
“Diet plays an important role in […] public
health, and suboptimal diet is estimated as the first leading cause of death
and the third leading cause of disability-adjusted life-years lost in the
[U.S.],” write Dr. Zhilei Shan — from the Harvard T. H. Chan School of Public
Health in Boston, MA — and colleagues in their new study paper.
Their findings now appear
in the journal JAMA Internal
Medicine.
In their research, Dr. Shan
and team analyzed the data of more than 37,000 people to determine whether or
not there were any associations between different diet types and mortality.
More specifically, the
investigators wanted to find out if different types of low fat and low carb
diet are associated with total mortality.
Although there have been
several studies into the links between diet and death risk, the researchers
note that — to their knowledge — none have looked specifically at how low carb
and low fat diets of different qualities may fit into the equation.
“Consumption of
carbohydrates from refined grains and added sugars has been adversely
associated with health outcomes, whereas consumption of carbohydrates from
whole grains, nonstarchy vegetables, and whole fruits appears to be
beneficial,” explain the study authors.
“Likewise,” they say,
“replacing saturated fat with unsaturated fat was associated with lower risk of
heart disease and mortality.”
For these reasons, the
investigators thought it was important to identify and emphasize any
associations between different diet types, different quality diets, and
mortality risk.
Low fat, low carb, and
mortality
For their study, the
researchers analyzed the data of 37,233 U.S. adults with a mean age of 49.7
years. The data came from eight cycles of the National Health and Nutrition
Examination Survey (NHANES), from 1999 to 2014.
In total, the follow-up
period accounted for 297,768 person years. This refers to the amount of
follow-up time for all the participants included in the NHANES surveys.
During this time, the
researchers recorded a total of 4,866 deaths, of which 849 were related to
heart disease and 1,068 were related to cancer.
Using the NHANES reports
regarding people’s macronutrient consumption, the researchers were able to
infer different diet quality types.
The team found no
association between overall low carb and low fat diet scores and total
mortality risk.
However,
they did find an association between unhealthful low carb and low fat diet
scores — indicating adherence to poor quality low fat and low carb diets — and
a higher total mortality risk.
On the other hand, better
quality low fat and low carb diets were associated with a lower total mortality
risk.
The researchers also report
that “participants with a higher overall [low carb dirt score] score” —
indicative of a poorer quality diet — “were more likely to be older and
non-Hispanic white, to have higher [body mass index], educational level, income
level, and cholesterol intake, and to have lower total energy intake.”
As for those with higher
low fat diet scores, the investigators point out that they tended to be part of
an ethnic minority group, to not smoke, to have lower weights, and to have
lower cholesterol levels.
When trying to find an
explanation for the association between different diet quality types and
mortality risk, Dr. Shan and colleagues point out that many biological
mechanisms could play a role.
They write, “Fat provides
more than twice as much energy as carbohydrates and protein by weight. A high
saturated fat diet is highly palatable and may […] [lead] to overconsumption
and obesity.”
“Low
quality carbohydrates, such as refined grains and added sugars, provide limited
nutritional value, and their high glycemic load could be associated with high
postprandial glucose and insulin, inflammation, insulin resistance, and
dyslipidemia.”
Although the researchers
emphasize that the main strength of their study was the sheer size of the
population sample — as well as the lengthy follow-up time for data collection —
they also caution that the research had a number of limitations.
These include the fact that
they could not identify which specific versions of the various low carb and low
fat diets each participant had followed.
This means, in the study
authors’ words, that “the results could not be directly translated to the
assessment of health benefit or risk associated with the popular versions of
the diets.”
They also note that the
participants self-reported the data regarding their diets, which means that
they may not be entirely accurate. The team was also unable to verify whether
or not the relationship between diet quality and mortality risk was of a causal
nature.
The funding for this study
came from the Young Scientists Fund of the National Natural Science Foundation
of China, the Major International (Regional) Joint Research Project of the
National Natural Science Foundation of China, and the National Institutes of
Health (NIH).
It is also worth noting
that some of the researchers disclosed possible conflicts of interests, as some
received personal fees and grants — for separate work — from private sponsors
including the California Walnut Commission and the Standard Process,
Metagenics, and Diet Quality Photo Navigation program.
Source: Medical News Today