Abstract P329: Low-carbohydrate Diets and Incidence, Prevalence, and Progression of Coronary Artery Calcium in the Multi-ethnic Study of Atherosclerosis (mesa)

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Tian Hu ◽  
David Jacobs ◽  
Jennifer Nettleton ◽  
Lyn Steffen ◽  
Alain Bertoni ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Relative Risk ◽  
Coronary Artery Calcium ◽  
Robust Regression ◽  
Total Carbohydrate ◽  
Carbohydrate Diet ◽  
Low Carbohydrate Diet ◽  
Low Carbohydrate ◽  
The Mean

Background: The coronary artery calcium (CAC) score is associated with the risk of coronary heart disease. We aimed to assess the relationship between low-carbohydrate dietary patterns and CAC scores in the MESA cohort. Methods: Our sample included 5,702 men and women who were free of clinical cardiovascular disease and had food frequency questionnaires at baseline (2000-2002), and at least one measure of CAC during follow-up. We excluded those with implausible energy intake (<600 kcal/day or >6000 kcal/day) or daily physical activity (>24 hours). Two low-carbohydrate-diet (LCD) scores were generated: an overall LCD score was calculated based on total carbohydrate, fat, and protein, and a plant-based LCD score was calculated using intakes of unsaturated fat (excluding trans fat) and vegetable protein. CAC scores at exam 1 and at 2 and 3 (18 and 36 months later) were used in multivariable relative risk regression models to examine the association between LCD scores and CAC prevalence and incidence (binary), while robust regression was used to examine CAC progression (continuous). Analyses were adjusted for demographic, socioeconomic, lifestyle, and cardiovascular risk factors. Results: The mean age was 62 years, 48% of participants were male, and 40.8% were White. The mean (SD) levels of carbohydrate intake as a percentage of energy were 64.2 (5.2), 56.1 (4.9), 51.5 (3.7), 47.5 (4.0), and 42.1 (5.6) from the lowest to the highest quintiles of the overall LCD score. There were 2,652 (46.5%) participants who had positive CAC scores at baseline and 252 participants who had newly positive scores for CAC during follow-up. Among those with prevalent CAC at baseline, the median (IQR) of increases in CAC was 47 (132) over follow-ups. For incident CAC, relative risk estimates (95% CI) from Quintile 1 to 5 were 1, 0.73 (0.52, 1.02), 0.65 (0.45, 0.95), 0.90 (0.63, 1.28), 1.05 (0.77, 1.42) for overall LCD scores, and were 1, 1.14 (0.81, 1.61), 0.98 (0.71, 1.37), 1.08 (0.78, 1.49), 1.15 (0.82, 1.62) for plant-based LCD scores, respectively. No significant trend was observed for associations with incident CAC. There was no significant association between any LCD score and CAC prevalence or progression among those with positive CAC scores at baseline. Conclusions: A low-carbohydrate diet, including a plant-based low-carbohydrate diet, was not associated with prevalence, incidence, or progression of CAC among those with prevalent CAC at baseline.

scholarly journals Low-carbohydrate diets and prevalence, incidence and progression of coronary artery calcium in the Multi-Ethnic Study of Atherosclerosis (MESA)

2019 ◽  
Vol 121 (4) ◽  
pp. 461-468 ◽  
Author(s):  
Tian Hu ◽  
David R. Jacobs ◽  
Lydia A. Bazzano ◽  
Alain G. Bertoni ◽  
Lyn M. Steffen
Keyword(s):  
Coronary Artery ◽  
Robust Regression ◽  
Epidemiological Studies ◽  
Total Carbohydrate ◽  
Baseline Measure ◽  
Cross Sectional ◽  
Ethnic Study ◽  
Low Carbohydrate ◽  
The Relationship

AbstractThe evidence linking low-carbohydrate diets (LCD) to CVD is controversial, and results from epidemiological studies are inconsistent. We aimed to assess the relationship between LCD patterns and coronary artery Ca (CAC) scores from computed tomography in the Multi-Ethnic Study of Atherosclerosis cohort. Our sample included 5614 men and women free of clinical CVD at baseline (2000–2002), who had a FFQ, a baseline measure and ≥1 measure of CAC during follow-up. We excluded those with implausible energy intake or daily physical activity. The overall, animal-based and plant-based LCD scores were calculated based on intakes of macronutrients. Relative risk regression and robust regression models were used to examine the cross-sectional and longitudinal relationship between LCD score quintile and CAC outcomes, after adjustment for multiple cardiovascular risk factors. The mean age of participants was 63 years. The median intakes of total carbohydrate, fat and protein were 53·7, 30·5 and 15·6 % energy/d, respectively. Among 2892 participants with zero CAC scores at baseline, 264 developed positive scores during 2·4-year follow-up (11–59 months). Among those with positive scores at baseline, the median increase in CAC was 47 units over the course of follow-up. The overall, the animal-based and the plant-based LCD scores were not associated with CAC prevalence, incidence and progression. In conclusion, diets low in carbohydrate and high in fat and/or protein, regardless of the sources of protein and fat, were not associated with higher levels of CAC, a validated predictor of cardiovascular events, in this large multi-ethnic cohort.

scholarly journals Low-Carbohydrate Diet Score and Coronary Artery Calcium Progression

2020 ◽  
Author(s):  
Jing-Wei Gao ◽  
Qing-Yun Hao ◽  
Hai-Feng Zhang ◽  
Xiong-Zhi Li ◽  
Zhi-Min Yuan ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Total Energy ◽  
Coronary Artery Calcium ◽  
Hazard Ratio ◽  
Dietary Factors ◽  
Carbohydrate Intake ◽  
Low Carbohydrate Diet ◽  
Increased Risk ◽  
Low Carbohydrate

Objective: To investigate whether low-carbohydrate diets (LCDs) were associated with coronary artery calcium (CAC) progression. Approach and Results: We included the participants who completed computed tomography assessment of baseline CAC in 2000 to 2001 (year 15) and follow-up (year 20 or 25) and food frequency questionnaire (years 0, 7, and 20) in the CARDIA study (Coronary Artery Risk Development in Young Adults). CAC progression was defined as CAC >0 at follow-up among participants with baseline CAC of 0 and an annualized change of 10 or percent change of ≥10% for those with 0<baseline CAC<100 or baseline CAC≥100, respectively. Among 2226 included participants (age, 40.4±3.5 years; 45.4% men), the carbohydrate intake accounted for 47.8±6.5% of total energy, and 204 (9.2%) had CAC at baseline (year 15). Over a mean follow-up of 8.3 years, 591 (26.5%) participants had CAC progression. After adjustment for traditional cardiovascular risk factors and other dietary factors, carbohydrate intake as a percentage of total energy was inversely associated with the risk of CAC progression (hazard ratio, 0.731 [95% CI, 0.552–0.968]; P =0.029). Furthermore, the animal-based but not plant-based LCD score was significantly associated with a higher risk of CAC progression (animal-based LCD score: hazard ratio, 1.456 [95% CI, 1.015–2.089]; P =0.041; plant-based LCD score: hazard ratio, 1.016 [95% CI, 0.821–1.257]; P =0.884; both comparing extreme groups). Conclusions: LCDs starting at a young age are associated with an increased risk of subsequent CAC progression, particularly when animal protein or fat are chosen to replace carbohydrates. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00005130.

Abstract P072: Low-Carbohydrate-Diets and Cardiovascular and Total Mortality in Japanese. A 29-year Follow-up of NIPPON DATA80

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Yasuyuki Nakamura ◽  
Nagako Okuda ◽  
Tomonori Okamura ◽  
Aya Kadota ◽  
Naoko Miyagawa ◽  
...  
Keyword(s):  
Cox Model ◽  
Total Mortality ◽  
Noncommunicable Disease ◽  
Carbohydrate Diet ◽  
Low Carbohydrate Diet ◽  
Asian Populations ◽  
Low Carbohydrate ◽  
Study Participants

Background: Long-term safety of low-carbohydrate-diets in Asian populations, whose carbohydrate intake is relatively high, is not known. Methods: We examined the association of low-carbohydrate-diets with CVD and total mortality using the National Integrated Project for Prospective Observation of Noncommunicable Disease and Its Trends in the Aged, (NIPPON DATA80) database with a 29-year follow-up. At the baseline in 1980, data were collected on study participants ages≥30 years from randomly selected areas in Japan. We calculated low-carbohydrate-diet scores based on the percentage of energy as carbohydrate, fat, and protein, estimated by 3-day weighed food records. We followed 9,200 participants (56% women, mean age 51 y). Results: During the follow-up, there were 1,171 CVD deaths (52% in women), and 3,443 total deaths (48% in women). The multivariate-adjusted hazard ratio (HR) for CVD mortality using the Cox model comparing highest versus lowest deciles for a low-carbohydrate-diet score was 0.59 (95% confidence interval [CI], 0.38-0.92, trend P=0.019) for women; 0.74 (95% CI: 0.55-0.99, trend P=0.033) for women and men combined; HR for total mortality was 0.73 (95% CI: 0.57-0.93, trend P=0.020) for women; 0.84 (95% CI: 0.72-0.99, trend P=0.030) for women and men combined. None of the associations in men alone were statistically significant. We did not note any differential effects between animal and plant based low-carbohydrate-diets. Conclusions: Moderate diets lower in carbohydrate and higher in protein and fat were significantly inversely associated with CVD and total mortality in women, and women and men combined.

Abstract P070: A Low Carbohydrate Diet from Plant or Animal Sources and Mortality Among Myocardial Infarction Survivors

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Shanshan Li ◽  
Alan Flint ◽  
Jennifer Pai ◽  
John P Forman ◽  
Frank B Hu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Mortality ◽  
Health Benefit ◽  
Health Study ◽  
Carbohydrate Diet ◽  
Low Carbohydrate Diet ◽  
Low Carbohydrate ◽  
All Cause Mortality ◽  
Total Plant

Background: The healthiest dietary pattern for myocardial infarction (MI) survivors is not known. Specific long-term benefits of a low carbohydrate diet (LCD) is unknown, whether it mainly be from animal or vegetable sources. Objective: To examine the associations between post-MI adherence to a low carbohydrate diet (LCD), measured by a total, plant- and animal-based low carbohydrate diet score (LCDS), in relation to all-cause and cardiovascular mortality. Design: We included 2,258 women from the Nurses’ Health Study and 1,840 men from the Health Professional Follow-Up Study, who had survived a first MI during follow-up, provided pre-MI and at least one post-MI food frequency questionnaire (FFQ). Results: Adherence to a LCD high in animal sources of protein and fat was associated with higher all-cause and cardiovascular mortality (HR=1.31, 95% CI: 1.05-1.63 for all-cause mortality; HR= 1.49, 95% CI: 1.08-2.06 for cardiovascular mortality comparing extreme quintiles). An increase in adherence to an animal-based LCD prospectively assessed from the pre- to post-MI period was associated with higher all-cause mortality and cardiovascular mortality (HR=1.29, 95% CI: 1.03-1.63 for all-cause mortality; HR=1.53, 95% CI: 1.10-2.12 for cardiovascular mortality comparing extreme quintiles). An increase in adherence to a plant-based LCD was not associated with lower all-cause or cardiovascular mortality. Conclusions: Greater adherence to a LCD high in animal sources of fat and protein was associated with higher all-cause and cardiovascular mortality post-MI. We did not find a health benefit from greater adherence to an overall LCD post MI.

Abstract 18434: Coronary Artery Calcium Progression and Atrial Fibrillation: The Multi-ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Wesley T O'Neal ◽  
Jimmy T Efird ◽  
Waqas T Qureshi ◽  
Joseph Yeboah ◽  
Alvaro Alonso ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cox Regression ◽  
Chinese Americans ◽  
Ethnic Study ◽  
Increased Risk ◽  
The Mean ◽  
Study Participants

Introduction: Coronary artery calcium (CAC) measured at a single time point has been associated with an increased risk for atrial fibrillation (AF). It is currently unknown whether CAC progression over time carries a similar risk. Methods: A total of 5,612 study participants (mean age 62 ± 10; 52% women; 39% whites; 27% blacks; 20% Hispanics; 12% Chinese-Americans) from the Multi-Ethnic Study of Atherosclerosis (MESA) were included in this analysis. Phantom-adjusted Agatston scores for baseline and follow-up measurements were used to compute the change in CAC per year (1 to 100, 101 to 300, and >300 units/year) compared with participants with ≤0 change. The mean time between CT scan for study participants was 2.4 ± 0.84 years. AF was ascertained by review of hospital discharge records and from Medicare claims data through December 31, 2010. Cox regression was used to compute hazard ratios (HR) and 95% confidence intervals (95%CI) for the association between CAC progression and AF and models were adjusted for socio-demographics, cardiovascular risk factors, and baseline CAC. Results: At baseline, 2,904 (52%) participants had no evidence of CAC and 2,708 (48%) had CAC values >0. The mean CAC progression for those with baseline CAC was 46.1 ± 85.2 units per year and for those without baseline CAC was 0.84 ± 4.8 units per year. Over a median follow-up of 5.6 years, a total of 203 (3.6%) incident AF cases occurred. Any CAC progression (>0/year) was associated with an increased risk for AF (HR=1.55, 95%CI=1.10, 2.19) and the risk increased with higher levels of CAC progression per year (≤0/year: HR=1.0 [reference]; 1 to 100/year: HR=1.47, 95%CI=1.03, 2.09; 101 to 300/year: HR=1.92, 95%CI=1.15, 3.20; >300/year: HR=3.23, 95%CI=1.48, 7.05). An interaction was observed by age with the association of CAC progression with AF being stronger for younger (<61 years: HR=3.53, 95%CI=1.29, 9.69) compared with older (≥61 years: HR=1.42, 95%CI=0.99, 2.04) participants (p-interaction=0.037). Conclusion: CAC progression during an average of 5-6 years of follow-up is associated with an increased risk for AF. The associated risk is greater in individuals with faster CAC progression.

scholarly journals Continuous Glucose Monitoring With Low-Carbohydrate Diet Coaching in Adults With Prediabetes: Mixed Methods Pilot Study

JMIR Diabetes ◽  
10.2196/21551 ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. e21551
Author(s):  
Olivia Yost ◽  
Melissa DeJonckheere ◽  
Spring Stonebraker ◽  
Grace Ling ◽  
Lorraine Buis ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Food Intake ◽  
The Body ◽  
Total Carbohydrate ◽  
Carbohydrate Diet ◽  
Dietary Changes ◽  
Low Carbohydrate Diet ◽  
Low Carbohydrate ◽  
The Impact ◽  
Hba1c Levels

Background Type 2 diabetes mellitus (T2DM) is preventable; however, few patients with prediabetes participate in prevention programs. The use of user-friendly continuous glucose monitors (CGMs) with low-carbohydrate diet coaching is a novel strategy to prevent T2DM. Objective This study aims to determine the patient satisfaction and feasibility of an intervention combining CGM use and low-carbohydrate diet coaching in patients with prediabetes to drive dietary behavior change. Methods We conducted a mixed methods, single-arm pilot and feasibility study at a suburban family medicine clinic. A total of 15 adults with prediabetes with hemoglobin A1c (HbA1c) levels between 5.7% and 6.4% and a BMI >30 kg/m2 were recruited to participate. The intervention and assessments took place during 3 in-person study visits and 2 qualitative phone interviews (3 weeks and 6 months after the intervention). During visit 1, participants were asked to wear a CGM and complete a food intake and craving log for 10 days. During visit 2, the food intake and craving log along with the CGM results of the participants were reviewed and the participants received low-carbohydrate diet coaching, including learning about carbohydrates and personalized feedback. A second CGM sensor, with the ability to scan and record glucose trends, was placed, and the participants logged their food intake and cravings as they attempted to reduce their total carbohydrate intake (<100 g/day). During visit 3, the participants reviewed their CGM and log data. The primary outcome was satisfaction with the use of CGM and low-carbohydrate diet. The secondary outcomes included feasibility, weight, and HbA1c change, and percentage of time spent in hyperglycemia. Changes in attitudes and risk perception of developing diabetes were also assessed. Results The overall satisfaction rate of our intervention was 93%. The intervention induced a weight reduction of 1.4 lb (P=.02) and a reduction of HbA1c levels by 0.71% (P<.001) since enrollment. Although not significantly, the percentage of time above glucose goal and average daily glucose levels decreased slightly during the study period. Qualitative interview themes indicated no major barriers to CGM use; the acceptance of a low-carbohydrate diet; and that CGMs helped to visualize the impact of carbohydrates on the body, driving dietary changes. Conclusions The use of CGMs and low-carbohydrate diet coaching to drive dietary changes in patients with prediabetes is feasible and acceptable to patients. This novel method merits further exploration, as the preliminary data indicate that combining CGM use with low-carbohydrate diet coaching drives dietary changes, which may ultimately prevent T2DM.

Low-Carbohydrate-Diet Score and its Association with the Risk of Diabetes: A Systematic Review and Meta-Analysis of Cohort Studies

2017 ◽  
Vol 49 (08) ◽  
pp. 565-571 ◽  
Author(s):  
Nazli Namazi ◽  
Bagher Larijani ◽  
Leila Azadbakht
Keyword(s):  
Cohort Studies ◽  
Web Of Science ◽  
Meta Analysis ◽  
Systemic Review ◽  
Carbohydrate Diet ◽  
Low Carbohydrate Diet ◽  
Relative Risks ◽  
Low Carbohydrate ◽  
Diet Score

AbstractThe association between a low-carbohydrate diet (LCD) score and the risk of diabetes mellitus (DM) is contradictory. This study is a systemic review of cohort studies that have focused on the association between the LCD score and DM. We searched PubMed/Medline, Scopus, Embase, ISI Web of Science, and Google Scholar for papers published through January 2017 with no language restrictions. Cohort studies that reported relative risks (RRs) with 95% confidence intervals (CI) for DM were included. Finally, 4 studies were considered for our meta-analysis. The total number of participants ranged from 479 to 85 059. Among 4 cohort studies, 8 081 cases with DM were observed over follow-up durations ranging from 3.6 to 20 years. A marginal significant association was observed between the highest LCD score and the risk of DM (RR=1.17; 95% CI: 0.9, 1.51). Moreover, the RRs for studies with energy adjustments showed a significant association (RR: 1.32; 95% CI: 1.17, 1.49; I2: 0%). Based on our findings, study qualities score of less or equal to 7 had a significant influence on the pooled effect size (RR=1.31, 95%CI: 1.15, 1.49; I2: 0%), whereas the overall RR in the studies with quality score more than 7 was 1.09 (95% CI: 0.73, 1.63). In conclusion, we have found that the highest LCD score was marginally associated with the risk of DM. However, more prospective cohort studies are needed to clarify the effects of the LCD score on the risk of DM.

Sign in / Sign up

Export Citation Format

Share Document