Nakamura Yasuyuki, Okuda Nagako, Okamura Tomonori, Kadota Aya, Miyagawa Naoko, Hayakawa Takehito, Kita Yoshikuni, Fujiyoshi Akira, Nagai Masato, Takashima Naoyuki, Ohkubo Takayoshi, Miura Katsuyuki, Okayama Akira, Ueshima Hirotsugu
Cardiovascular Epidemiology, Kyoto Women's University,35 Imakumano Kitahiyoshi-cho, Higashiyama-ku,Kyoto605-8501,Japan.
Department of Health and Nutrition,University of Human Arts and Sciences,Saitama,Japan.
Br J Nutr. 2014 Sep 28;112(6):916-24. doi: 10.1017/S0007114514001627.
Long-term safety of consuming low-carbohydrate diets (LCD) in Asian populations, whose carbohydrate intake is relatively high, is not known. In the present study, the association of LCD with CVD and total mortality was assessed using data obtained in the NIPPON DATA80 (National Integrated Project for Prospective Observation of Non-communicable Disease and Its Trends in the Aged 1980) during 29 years of follow-up. At baseline in 1980, data were collected from study participants aged ≥ 30 years from randomly selected areas in Japan. LCD scores were calculated based on the percentage of energy as carbohydrate, fat and protein, estimated by 3 d weighed food records. A total of 9200 participants (56% women, mean age 51 years) were followed up. During the follow-up, 1171 CVD deaths (52% in women) and 3443 total deaths (48% in women) occurred. The multivariable-adjusted hazard ratio (HR) for CVD mortality using the Cox model comparing the highest v. lowest deciles of LCD score was 0·60 (95% CI 0·38, 0·94; P(trend) = 0·021) for women and 0·78 (95% CI 0·58, 1·05; P(trend) = 0·079) for women and men combined; the HR for total mortality was 0·74 (95% CI 0·57, 0·95; P(trend) = 0·029) for women and 0·87 (95% CI 0·74, 1·02; P(trend) = 0·090) for women and men combined. None of the associations was statistically significant in men. No differential effects of animal-based and plant-fish-based LCD were observed. In conclusions, moderate diets lower in carbohydrate and higher in protein and fat are significantly inversely associated with CVD and total mortality in women.
在碳水化合物摄入量相对较高的亚洲人群中，食用低碳水化合物饮食（LCD）的长期安全性尚不清楚。在本研究中，利用日本全国非传染性疾病前瞻性观察综合项目（NIPPON DATA80，1980年老年人非传染性疾病及其趋势）29年随访期间获得的数据，评估了LCD与心血管疾病（CVD）及全因死亡率之间的关联。1980年基线时，从日本随机选取地区年龄≥30岁的研究参与者中收集数据。LCD得分根据3天称重食物记录估算的碳水化合物、脂肪和蛋白质能量百分比计算得出。共对9200名参与者（56%为女性，平均年龄51岁）进行了随访。随访期间，发生了1171例CVD死亡（女性占52%）和3443例全因死亡（女性占48%）。使用Cox模型比较LCD得分最高与最低十分位数时，女性CVD死亡率的多变量调整风险比（HR）为0.60（95%CI 0.38, 0.94；P趋势 = 0.021），女性和男性合并后的HR为0.78（95%CI 0.58, 1.05；P趋势 = 0.079）；女性全因死亡率的HR为0.74（95%CI 0.57, 0.95；P趋势 = 0.029），女性和男性合并后的HR为0.87（95%CI 0.74, 1.02；P趋势 = 0.090）。在男性中，这些关联均无统计学意义。未观察到基于动物的LCD和基于植物-鱼类的LCD有差异效应。总之，碳水化合物含量较低、蛋白质和脂肪含量较高的适度饮食与女性的CVD和全因死亡率显著负相关。
