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European Journal of Nutrition

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Open Access 01-09-2020 | Nutrition | Original Contribution

Lower carbohydrate and higher fat intakes are associated with higher hemoglobin A1c: findings from the UK National Diet and Nutrition Survey 2008–2016

Authors: Chaitong Churuangsuk, Michael E.J. Lean, Emilie Combet

Published in: European Journal of Nutrition | Issue 6/2020

Abstract

Purpose

Evidence of low-carbohydrate, high-fat diets (LCHF) for type 2 diabetes (T2DM) prevention is scarce. We investigated how carbohydrate intake relates to HbA1c and T2DM prevalence in a nationally representative survey dataset.

Methods

We analyzed dietary information (4-day food diaries) from 3234 individuals aged ≥ 16 years, in eight waves of the UK National Diet and Nutrition Survey (2008–2016). We calculated LCHF scores (0–20, higher score indicating lower %food energy from carbohydrate, with reciprocal higher contribution from fat) and UK Dietary Reference Value (DRV) scores (0–16, based on UK dietary recommendations). Associations between macronutrients and diet scores and diabetes prevalence were analyzed (in the whole sample) using multivariate logistic regression. Among those without diabetes, analyses between exposures and %HbA1c (continuous) were analyzed using multivariate linear regression. All analyses were adjusted for age, sex, body mass index, ethnicity, smoking status, total energy intake, socioeconomic status and survey years.

Results

In the overall study sample, 194 (6.0%) had diabetes. Mean intake was 48.0%E for carbohydrates, and 34.9%E for total fat. Every 5%E decrease in carbohydrate, and every 5%E increase in fat, was associated with 12% (95% CI 0.78–0.99; P = 0.03) and 17% (95% CI 1.02–1.33; P = 0.02) higher odds of diabetes, respectively. Each two-point increase in LCHF score is related to 8% (95% CI 1.02–1.14; P = 0.006) higher odds of diabetes, while there was no evidence for association between DRV score and diabetes. Among the participants without diagnosed diabetes (n = 3130), every 5%E decrease in carbohydrate was associated with higher %HbA1c by + 0.016% (95% CI 0.004–0.029; P = 0.012), whereas every 5%E increase in fat was associated with higher %HbA1c by + 0.029% (95% CI 0.015–0.043; P < 0.001). Each two-point increase in LCHF score is related to higher %HbA1c by + 0.010% (0.1 mmol/mol), while each two-point increase in the DRV score is related to lower %HbA1c by − 0.023% (0.23 mmol/mol).

Conclusions

Lower carbohydrate and higher fat intakes were associated with higher HbA1c and greater odds of having diabetes. These data do not support low(er) carbohydrate diets for diabetes prevention.

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Title: Lower carbohydrate and higher fat intakes are associated with higher hemoglobin A1c: findings from the UK National Diet and Nutrition Survey 2008–2016
Authors: Chaitong Churuangsuk
Michael E.J. Lean
Emilie Combet
Publication date: 01-09-2020
Publisher: Springer Berlin Heidelberg
Keywords: Nutrition
Type 2 Diabetes
Published in: European Journal of Nutrition / Issue 6/2020
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI: https://doi.org/10.1007/s00394-019-02122-1

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Lower carbohydrate and higher fat intakes are associated with higher hemoglobin A1c: findings from the UK National Diet and Nutrition Survey 2008–2016

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Purpose

Methods

Results

Conclusions

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