Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden.
Eur J Clin Nutr. 2012 Jun;66(6):694-700. doi: 10.1038/ejcn.2012.9. Epub 2012 Feb 15.
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 Västerbotten. In 37,639 men (1460 deaths) and 39,680 women (923 deaths) from the population-based Västerbotten 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.
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 continuous = 0.721; women: HR for high vs low 1.10 (95% CI 0.91-1.32), P for continuous = 0.229). 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), P = 0.010).
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.
背景/目的：碳水化合物限制饮食的长期效果尚不清楚。我们研究了低碳水化合物、高蛋白（LCHP）评分与死亡率的关系。
研究对象/方法：这是一项基于人群的队列研究，研究对象为瑞典北部韦斯特博滕县的成年人。在基于人群的韦斯特博滕干预计划中，37639 名男性（1460 例死亡）和 39680 名女性（923 例死亡）中，添加了能量调整后的碳水化合物（递减）和蛋白质（递增）摄入量的十分位数，以创建 LCHP 评分（2-20 分）。通过 Cox 回归计算男女特定的危险比（HR）。
LCHP 评分 2-20 分的受试者的碳水化合物、蛋白质和脂肪的中位数摄入量分别为总能量摄入的 61.0%-38.6%、11.3%-19.2%和 26.6%-41.5%。在考虑饱和脂肪摄入量和已确立的风险因素后，高 LCHP 评分（14-20 分）与低 LCHP 评分（2-8 分）相比并不能预测全因死亡率（男性：高 vs 低 HR 为 1.03（95%置信区间（CI）0.88-1.20），P 连续=0.721；女性：高 vs 低 HR 为 1.10（95%CI 0.91-1.32），P 连续=0.229）。对于癌症和心血管疾病，没有发现明确的关联。碳水化合物摄入量与全因死亡率呈负相关，但仅在女性中具有统计学意义（每增加十分之一的多变量 HR 0.95（95%CI 0.91-0.99），P=0.010）。
我们的结果不支持 LCHP 评分与死亡率之间存在明确的一般关联。可能需要进行涵盖更广泛宏量营养素消耗范围的研究来检测这种关联。
