A Cross-sectional Study Of Low-carbohydrate Diets And Fasting Glucose Abnormalities,Diabetes

Objective The prevalence of diabetes and abnormal fasting blood glucose was high in China,and a healthy diet can effectively control blood glucose and reduce the risk of diabetes.Low-carbohydrate diet（LCD）are clinically used for short-term glycemic control in diabetes patients.However,studies on LCD and the risk of abnormal fasting blood glucose,diabetes have been inconsistent in general population.In addition,the impact of LCDs from different food sources on health may not be same.Compared with Europe and The United States,China has a higher carbohydrate intake level.Therefore,it may be of great significance to investigate low-carbohydrate diet in the context of high carbohydrate intake levels.We used a population-based cross-sectional study in Lu’an to construct total LCD score,plant-based LCD score,animal-based LCD score,and assessed the association between LCDs and fasting glucose abnormality,diabetes.Methods A complex sampling method was used to select subjects aged 18 and above in Lu’an.Investigators conduct questionnaires face-to-face with the participants.The questionnaire included demographic characteristics,disease and medication history,personal habits,and food frequency questionnaire（FFQ）.According to the average consumption and frequency of each food of participants,the energy percentage of carbohydrate,protein,fat,plant protein,plant fat,animal protein and animal fat were calculated,and then total LCD,plant-based LCD,animal-based LCD were calculated.Abnormal fasting blood glucose was defined as fasting blood glucose≥6.1mmol/L,and diabetes was defined as fasting blood glucose≥7.0mmol/L.Adjustment covariates include age,sex,total energy,region,marital status,family annual per capita income,education level,smoking,drinking,physical activity,family history of diabetes,hypertension and body mass index（BMI）.The association between LCDs and abnormal fasting blood glucose,diabetes was analyzed by using unconditional logistic regression model,and odds ratio（OR）and 95%confidence interval（CI）were calculated.Linear regression was further used to explore the relationship between LCDs and insulin resistance.Results A total of 2,243 subjects in this study,including 202 subjects with abnormal fasting blood glucose and 88 subjects with diabetes.After adjusting for BMI and other covariates,the multivariable ORs for participants the highest tertile were 0.65(95%CI:0.45-0.95,P_trend=0.02)for fasting glucose abnormalities comparing to lowest total LCD,and no association was found between total LCD and diabetes(OR=1.03,95%CI:0.59-1.80,P_trend=0.91).Similarly,higher plant-based LCD score was associated with a lower risk of abnormal fasting glucose(OR=0.61,95%CI:0.42-0.89,P_trend=0.01),and no association was found between plant-based LCD and diabetes(OR=1.06,95%CI:0.61-1.84,P_trend=0.89).After adjusting for BMI and other covariables,animal-based LCD reduced the risk of abnormal fasting glucose(OR=0.60,95%CI:0.40-0.89,P_trend=0.01),while no association was found between animal-based LCD and diabetes(OR=0.63,95%CI:0.35-1.13,P_trend=0.12).Compared with the lowest tertile of plant-based LCD,the highest tertile of plant-based LCD decreased triglyceride to high-density lipoprotein levels(OR=0.90,95%CI:0.84-0.96,P_trend=0.01).Conclusion Higher total LCD score,plant-based LCD score,and animal-based LCD score were inversely associated with the risk of fasting glucose abnormalities.Therefore,the recommendation to follow a low-carbohydrate diet may be beneficial for the prevention of abnormal fasting glucose and help prevent diabetes.