title: Dietary carbohydrate quantity and quality in relation to obesity: A pooled analysis of three Finnish population-based studies.
abstract: BACKGROUND
  The relationship between carbohydrate intake, dietary glycaemic index (GI) and load (GL), and obesity remains unsolved. Sugar intake and obesity represent a timely topic, but studies on sugar subcategories are scarce. We aimed to study whether total carbohydrate, sucrose, lactose, fibre, dietary GI, and GL are associated with obesity in 25-79-year-old Finns.
  
  
  METHODS
  Our pooled analysis included three cross-sectional population-based studies: the DILGOM Study (n = 4842), the Helsinki Birth Cohort Study (n =1979), and the Health 2000 Survey (n = 5521). Diet was assessed by a validated food-frequency questionnaire, and anthropometric measurements were collected by standardised protocols. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression analysis.
  
  
  RESULTS
  In the model, which included sex, age, education, smoking, physical activity, and energy intake, the likelihood of being obese (body mass index ⩾ 30 kg/m(2)) appeared lower in the highest quartiles of total carbohydrate (OR 0.65; 95% CI 0.57-0.74; P for trend < 0.0001), sucrose (OR 0.53; 95% CI 0.47-0.61; P < 0.0001), and dietary GL (OR 0.64; 95% CI 0.56-0.73; P < 0.0001) compared to the lowest quartiles. In contrast, dietary GI did not associate with obesity. Fibre intake associated inversely with abdominal obesity (OR 0.80; 95% CI 0.71-0.90; P < 0.001). The inverse sucrose-obesity relationship appeared stronger in high fruit consumers compared to low fruit consumers (P for interaction 0.02). CONCLUSIONS ALTHOUGH MOST OF THE STUDIED CARBOHYDRATE EXPOSURES WERE ASSOCIATED WITH A DIMINISHED LIKELIHOOD OF BEING OBESE, PROSPECTIVE STUDIES ARE NEEDED TO ASSESS TEMPORAL RELATIONS TO SUPPORT CAUSAL INFERENCE.
authors.affiliation: Department of Health, National Institute for Health and Welfare, Helsinki, Finland niina.kaartinen@thl.fi.
authors.forename: Niina E
authors.initials: NE
authors.lastname: Kaartinen
authors.affiliation: Department of Health, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Paul
authors.initials: P
authors.lastname: Knekt
authors.affiliation: Department of Health, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Noora
authors.initials: N
authors.lastname: Kanerva
authors.affiliation: Department of Health, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Liisa M
authors.initials: LM
authors.lastname: Valsta
authors.affiliation: Department of Health, National Institute for Health and Welfare, Helsinki, Finland Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland Department of Clinical Practice and Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland Folkhälsan Research Centre, Helsinki, Finland.
authors.forename: Johan G
authors.initials: JG
authors.lastname: Eriksson
authors.affiliation: Department of Health, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Harri
authors.initials: H
authors.lastname: Rissanen
authors.affiliation: Department of Health, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Tuija
authors.initials: T
authors.lastname: Jääskeläinen
authors.affiliation: Department of Health, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Satu
authors.initials: S
authors.lastname: Männistö
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004034:Diet Surveys; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000009:adverse effects* / Q000592:standards; D005260:Female; D005387:Finland / Q000453:epidemiology; D038321:Glycemic Index; D000067940:Glycemic Load; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*
chemical_list: D004040:Dietary Carbohydrates
keywords: Dietary carbohydrate; body mass index; fibre; glycaemic index; glycaemic load; meta-analysis; obesity; pooled analysis; sucrose; waist circumference