Low-Carbohydrate Diet Macronutrient Quality and Weight Change

作者：Binkai Liu, Yang Hu, Sharan K. Rai, Molin Wang, Frank B. Hu, Qi Sun · 发表于：JAMA Network Open · 年份：2023 · DOI：10.1001/jamanetworkopen.2023.49552 · 被引用次数：24 · 研究领域：Diet and metabolism studies、Nutritional Studies and Diet、Agriculture Sustainability and Environmental Impact

Importance: The associations of low-carbohydrate diets (LCDs) with long-term weight management remains unclear, and the source and quality of macronutrients within LCDs are less explored. Objectives: To prospectively examine associations between changes in LCD indices and weight change among US adults. Design, Setting, and Participants: This prospective cohort study included initially healthy participants at baseline from the Nurses' Health Study (NHS; 1986-2010), Nurses' Health Study II (NHSII; 1991-2015), and Health Professionals Follow-up Study (HPFS; 1986-2018). Data analysis was performed between November 2022 and April 2023. Exposures: Five LCD indices were examined: (1) a total LCD (TLCD) emphasizing overall lower carbohydrate intake; (2) an animal-based LCD (ALCD) that emphasized animal-sourced protein and fat; (3) a vegetable-based LCD (VLCD) that emphasized plant-sourced protein and fat; (4) a healthy LCD (HLCD) emphasizing less refined carbohydrates, more plant protein, and healthy fat; and (5) an unhealthy LCD (ULCD) emphasizing less healthful carbohydrates, more animal protein, and unhealthy fat. Main Outcomes and Measures: The outcome of interest was 4-year changes in self-reported body weight. Results: A total of 123 332 participants (mean [SD] age, 45.0 [9.7] years; 103 320 [83.8%] female) were included in this study. The median carbohydrate intake (as a percentage of energy) of the highest quintiles of TLCD score at baseline ranged from 38.3% in HPFS to 40.9%...