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Difference in association of carbohydrate intake with all-cause mortality between middle-aged and older Korean adults with and without diabetes mellitus: A prospective study

Authors
 Young-Hwan Park  ;  Hye Sun Lee  ;  Juyeon Yang  ;  Li Rang Lim  ;  Yu-Jin Kwon  ;  Ji-Won Lee 
Citation
 CLINICAL NUTRITION, Vol.43(5) : 1117-1124, 2024-05 
Journal Title
CLINICAL NUTRITION
ISSN
 0261-5614 
Issue Date
2024-05
MeSH
Aged ; Cause of Death ; Diabetes Mellitus* / epidemiology ; Diabetes Mellitus* / mortality ; Diet / statistics & numerical data ; Dietary Carbohydrates* / administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Prospective Studies ; Republic of Korea / epidemiology ; Risk Factors
Keywords
Added sugar ; Carbohydrate ; Diabetes mellitus ; Mortality
Abstract
Background & aims
The relationship between diet and health, particularly the role of carbohydrates, has been extensively studied. However, carbohydrate intake based on individual health conditions remains unclear. Here, we aimed to investigate whether the association between carbohydrate intake and all-cause mortality varied between individuals with and without diabetes mellitus (DM).

Methods
This prospective cohort study used data from the Korean Genome and Epidemiology Study (KoGES). Overall, 143,050 participants were included, with 10.1% having DM. Dietary intake was assessed using a semiquantitative food frequency questionnaire. Cox proportional hazards regression models were used to assess the association between carbohydrate intake and mortality after adjusting for confounders.

Results
The study showed that 5436 deaths occurred during the median follow-up period of 10.1 years. A significant interaction between carbohydrate intake and DM was observed in the study population (interaction p = 0.061). Higher carbohydrate intake proportion was associated with an increased risk of all-cause mortality among individuals with DM (adjusted hazard ratio [HR], p-value = 1.10 [1.01–1.20], p = 0.032). Conversely, no association was observed between the proportion of carbohydrate intake and all-cause mortality in participants without DM. Additionally, both total sugar and added sugar intakes were associated with an increased risk of all-cause mortality in participants with DM (adjusted HR, p-value = 1.02 [1.01–1.04], p < 0.001 and 1.18 [1.13–1.24], p < 0.001).

Conclusions
High carbohydrate (%) and added sugar intake were associated with an increased mortality risk in individuals with DM. Reducing carbohydrate intake and opting for healthy carbohydrates to mitigate mortality risk may be beneficial for individuals with DM, particularly when compared with the general population.
Full Text
https://www.sciencedirect.com/science/article/pii/S0261561424000980
DOI
10.1016/j.clnu.2024.03.024
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Family Medicine (가정의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kwon, Yu-Jin(권유진) ORCID logo https://orcid.org/0000-0002-9021-3856
Lee, Ji Won(이지원) ORCID logo https://orcid.org/0000-0002-2666-4249
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/199143
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