title: Low-carbohydrate diets and cardiovascular and total mortality in Japanese: a 29-year follow-up of NIPPON DATA80.
abstract: 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.
authors.affiliation: Cardiovascular Epidemiology, Kyoto Women's University,35 Imakumano Kitahiyoshi-cho, Higashiyama-ku,Kyoto605-8501,Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Health and Nutrition,University of Human Arts and Sciences,Saitama,Japan.
authors.forename: Nagako
authors.initials: N
authors.lastname: Okuda
authors.affiliation: Department of Preventive Medicine and Public Health,School of Medicine, Keio University,Tokyo,Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.affiliation: Department of Health Science,Shiga University of Medical Science,Otsu,Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Kadota
authors.affiliation: Department of Health Science,Shiga University of Medical Science,Otsu,Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Miyagawa
authors.affiliation: Department of Hygiene and Preventive Medicine,Fukushima Medical University,Fukushima,Japan.
authors.forename: Takehito
authors.initials: T
authors.lastname: Hayakawa
authors.affiliation: Tsuruga City University of Nursing,Tsuruga,Japan.
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Kita
authors.affiliation: Department of Health Science,Shiga University of Medical Science,Otsu,Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Fujiyoshi
authors.affiliation: Department of Health Science,Shiga University of Medical Science,Otsu,Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Nagai
authors.affiliation: Department of Health Science,Shiga University of Medical Science,Otsu,Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Takashima
authors.affiliation: Department of Hygiene and Public Health,Teikyo University School of Medicine,Tokyo,Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.affiliation: Department of Health Science,Shiga University of Medical Science,Otsu,Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miura
authors.affiliation: Research Center for Lifestyle-Related Diseases,Tokyo,Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
authors.affiliation: Department of Health Science,Shiga University of Medical Science,Otsu,Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality / Q000517:prevention & control*; D015331:Cohort Studies; D015930:Diet Records; D050528:Diet, Carbohydrate-Restricted / Q000009:adverse effects / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000208:ethnology; D010349:Patient Compliance / Q000208:ethnology; D015995:Prevalence; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors