Low-carbohydrate-diet score and risk of type 2 diabetes in women.
BACKGROUND
Low-carbohydrate weight-loss diets remain popular; however, the long-term effects of these diets are not known.


OBJECTIVE
The objective was to examine the association between low-carbohydrate-diet score and risk of type 2 diabetes


METHODS
We prospectively examined the association between low-carbohydrate-diet score (based on percentage of energy as carbohydrate, fat, and protein) and risk of diabetes among 85 059 women in the Nurses' Health Study.


RESULTS
During 20 y of follow-up, we documented 4670 cases of type 2 diabetes. The multivariate relative risk (RR) of diabetes, after adjustment for body mass index and other covariates, in a comparison of the highest decile of low-carbohydrate-diet score with the lowest was 0.90 (95% CI: 0.78, 1.04; P for trend = 0.26). The multivariate RR for the comparison of extreme deciles of low-carbohydrate-diet score based on total carbohydrate, animal protein, and animal fat was 0.99 (95% CI: 0.85, 1.16; P for trend = 1.0), whereas the RR for a low-carbohydrate-diet score based on total carbohydrate, vegetable protein, and vegetable fat was 0.82 (95% CI: 0.71, 0.94; P for trend = 0.001). A higher dietary glycemic load was strongly associated with an increased risk of diabetes in a comparison of extreme deciles (RR: 2.47; 95% CI: 1.75, 3.47; P for trend < 0.0001)). A higher carbohydrate consumption was also associated with an increased risk of diabetes in a comparison of extreme deciles (RR: 1.26; 95% CI: 1.07, 1.49; P for trend = 0.003).


CONCLUSIONS
These data suggest that diets lower in carbohydrate and higher in fat and protein do not increase the risk of type 2 diabetes in women. In fact, diets rich in vegetable sources of fat and protein may modestly reduce the risk of diabetes.
Halton
Thomas L
TL
Department of Nutrition, Harvard School of Public Health, Boston, MA 02215, USA.
Liu
Simin
S
Manson
Joann E
JE
Hu
Frank B
FB
D000328:Adult; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D004034:Diet Surveys; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D038321:Glycemic Index; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009726:Nurses / Q000706:statistics & numerical data; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins