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Low-carbohydrate, high-protein score and mortality in a northern Swedish population-based cohort.

Journal article
Authors LM Nilsson
Anna Winkvist
Mats Eliasson
Jan-Håkan Jansson
Göran Hallmans
Ingegerd Johansson
Bernt Lindahl
Per Lenner
Bethany Van Guelpen
Published in European Journal of Clinical Nutrition
Volume 66
Issue 6
Pages 694-700
ISSN 0954-3007
Publication year 2012
Published at Institute of Medicine, Department of Clinical Nutrition
Pages 694-700
Language en
Keywords Nutrition, diet , mortality, carbohydrates, Adult, Cardiovascular Diseases, mortality, Cause of Death, Cohort Studies, Diet, Carbohydrate-Restricted, Dietary Carbohydrates, pharmacology, Dietary Fats, administration & dosage, Dietary Proteins, pharmacology, Energy Intake, Female, Humans, Male, Middle Aged, Neoplasms, mortality, Proportional Hazards Models, Risk Factors, Sweden, epidemiology
Subject categories Public health medicine research areas


BACKGROUND/OBJECTIVE: Long-term effects of carbohydrate-restricted diets are unclear. We examined a low-carbohydrate, high-protein (LCHP) score in relation to mortality. SUBJECTS/METHODS: This is a population-based cohort study on adults in the northern Swedish county of Va¨sterbotten. In 37 639 men (1460 deaths) and 39 680 women (923 deaths) from the population-based Va¨sterbotten Intervention Program, deciles of energy-adjusted carbohydrate (descending) and protein (ascending) intake were added to create an LCHP score (2 --20 points). Sex-specific hazard ratios (HR) were calculated by Cox regression. RESULTS: Median intakes of carbohydrates, protein and fat in subjects with LCHP scores 2--20 ranged from 61.0% to 38.6%, 11.3% to 19.2% and 26.6% to 41.5% of total energy intake, respectively. High LCHP score (14 --20 points) did not predict all-cause mortality compared with low LCHP score (2 --8 points), after accounting for saturated fat intake and established risk factors (men: HR for high vs low 1.03 (95% confidence interval (CI) 0.88 -- 1.20), P for continuous¼0.721; women: HR for high vs low 1.10 (95% CI 0.91 -- 1.32), P for continuous¼0.229). For cancer and cardiovascular disease, no clear associations were found. Carbohydrate intake was inversely associated with all-cause mortality, though only statistically significant in women (multivariate HR per decile increase 0.95 (95% CI 0.91 -- 0.99), P¼0.010). CONCLUSION: Our results do not support a clear, general association between LCHP score and mortality. Studies encompassing a wider range of macronutrient consumption may be necessary to detect such an association.

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