Low-Quality Carbohydrate Intake Is Associated With a Higher Prevalence of Metabolic Syndrome: The AWHS Study

• Published in: The journal of clinical endocrinology and metabolism 2024-08, Vol.109 (9), p.e1768-e1775
• Main Authors: Muñoz-Cabrejas, Ainara, Laclaustra, Martin, Guallar-Castillón, Pilar, Casasnovas, José Antonio, Marco-Benedí, Victoria, Calvo-Galiano, Naiara, Moreno-Franco, Belén
• Format: Article
• Language: English
• Subjects: Carbohydrates; Cardiovascular diseases; Cholesterol; Diet; Dietary intake; High carbohydrate diet; Hypertriglyceridemia; Low carbohydrate diet; Metabolic syndrome; Middle age
• ISSN: 0021-972X; 1945-7197; 1945-7197
• DOI: 10.1210/clinem/dgad706

Abstract Context The relationship between carbohydrate quality intake and metabolic syndrome (MetS) is of growing interest. Objective We aimed to assess the association between the adherence to a dietary carbohydrate quality index (CQI) with the occurrence of MetS in a Spanish cohort of working adults. Methods A cross-sectional study was conducted of 2316 middle-aged men, aged 50.9 (SD 3.9) years, with no previous cardiovascular disease, and pertaining to the Aragon Workers’ Health Study (AWHS) cohort. Diet was collected with a 136-item semiquantitative food-frequency questionnaire. The CQI (range 4-15) was based on: dietary fiber intake, a low glycemic index, the ratio of whole grains/total grains, and the ratio of solid carbohydrates/total carbohydrates. The higher the CQI, the healthier the diet. MetS was defined by using the harmonized National Cholesterol Education Programme–Adult Treatment Panel III (NCEP-ATP III) definition. The associations across 3-point categories of the CQI and the presence of MetS were examined using logistic regression. Results An inverse and significant association between the CQI and MetS was found. Fully adjusted odds ratios (ORs) for MetS risk among participants in the 10- to 12-point category (second highest CQI category) was 0.64 (95% CI, 0.45-0.94), and in the 13- to 15-point category (highest category) was 0.52 (95% CI, 0.30-0.88), when compared with the 4- to 6-point category (lowest category). Participants with 10 to 12 and 13 to 15 points on the CQI showed a lower risk of hypertriglyceridemia: OR 0.61 (95% CI, 0.46-0.81), and 0.48 (95% CI, 0.32-0.71) respectively. Conclusion Among middle-aged men, a higher adherence to a high-quality carbohydrate diet is associated with a lower prevalence of MetS. Triglyceridemia is the MetS component that contributed the most to this reduced risk.