Carbohydrate intake and biomarkers of glycemic control among US adults: the third National Health and Nutrition Examination Survey (NHANES III)

• Published in: The American journal of clinical nutrition 2003-06, Vol.77 (6), p.1426-1433
• Main Authors: Yang, Eun Ju, Kerver, Jean M, Park, Yi Kyung, Kayitsinga, Jean, Allison, David B, Song, Won O
• Format: Article
• Language: English
• Subjects: Adult; adults; Biological and medical sciences; biomarkers; Biomarkers - analysis; blood glucose; Blood Glucose - metabolism; c-peptide; C-Peptide - blood; carbohydrate intake; Carbohydrates; cross-sectional studies; Dietary Carbohydrates - administration & dosage; energy; Female; Fundamental and applied biological sciences. Psychology; Glycated Hemoglobin A - analysis; glycemic control; glycohemoglobin; Humans; Insulin - blood; low fat milk; Male; men; Middle Aged; National Health and Nutrition Examination Survey; noninsulin-dependent diabetes mellitus; Nutrition; Nutrition Surveys; Osmolar Concentration; regression analysis; risk; sugars; United States; vegetables; whole grain foods; women
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/77.6.1426

Background: Recommendations for preventing and treating type 2 diabetes include consuming carbohydrates, predominantly from whole grains, fruit, vegetables, and low-fat milk. However, the quantity and type of carbohydrates consumed may contribute to disorders of glycemic control. Objective: We evaluated the association between carbohydrate intakes and biomarkers of glycemic control in a nationally representative sample of healthy US adults who participated in a cross-sectional study, the third National Health and Nutrition Examination Survey. Design: The sample (5730 men and 6125 women aged ≥ 20 y) was divided into quintiles of carbohydrate intake (as a percentage of energy). Carbohydrate intakes were examined in relation to glycated hemoglobin (Hb A1c), plasma glucose, serum C-peptide, and serum insulin concentrations by using logistic regression. Results: Carbohydrate intakes were not associated with Hb A1c, plasma glucose, or serum insulin concentrations in men or women after adjustment for confounding variables. Carbohydrate intakes were inversely associated with serum C-peptide concentrations in men and women. Odds ratios for elevated serum C-peptide concentrations for increasing quintiles of carbohydrate intake were 1.00, 0.88, 0.57, 0.39, and 0.75 (P for trend = 0.016) in men, and 1.00, 0.69, 0.57, 0.36, and 0.41 (P for trend = 0.007) in women. When carbohydrate intakes were further adjusted for intakes of total and added sugar, the association of serum C-peptide with carbohydrate intakes was strengthened in men. Conclusions: Carbohydrate intakes were not associated with Hb A1c, plasma glucose, or serum insulin concentrations but were inversely associated with the risk of elevated serum C-peptide; this supports current recommendations regarding carbohydrate intake in healthy adults.