(01-03-11) Low-carbohydrate diet scores and risk of type 2 diabetes in men.

de Koning L, Fung TT, Liao X, Chiuve S, Rimm EB, Willett WC, Spiegelman D, Hu FB.

Departments of Nutrition, Harvard School of Public Health, Boston, MA;
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and
Harvard, Boston, MA.
Abstract
BACKGROUND: Fat and protein sources may influence whether low-carbohydrate
diets are associated with type 2 diabetes (T2D).

OBJECTIVE: The objective was to compare the associations of 3 low-carbohydrate
diet scores with incident T2D.

DESIGN: A prospective cohort study was conducted in participants from the
Health Professionals Follow-Up Study who were free of T2D, cardiovascular
disease, or cancer at baseline (n = 40,475) for up to 20 y. Cumulative averages
of 3 low-carbohydrate diet scores (high total protein and fat, high animal
protein and fat, and high vegetable protein and fat) were calculated every 4 y
from food-frequency questionnaires and were associated with incident T2D by
using Cox models.

RESULTS: We documented 2689 cases of T2D during follow-up. After adjustments
for age, smoking, physical activity, coffee intake, alcohol intake, family
history of T2D, total energy intake, and body mass index, the score for high
animal protein and fat was associated with an increased risk of T2D [top
compared with bottom quintile: hazard ratio (HR): 1.37; 95% CI: 1.20, 1.58; P
for trend < 0.01]. Adjustment for red and processed meat attenuated this
association (HR: 1.11; 95% CI: 0.95, 1.30; P for trend = 0.20). A high score
for vegetable protein and fat was not significantly associated with the risk of
T2D overall but was inversely associated with T2D in men aged <65 y (HR: 0.78;
95% CI: 0.66, 0.92; P for trend = 0.01, P for interaction = 0.01).

CONCLUSIONS: A score representing a low-carbohydrate diet high in animal
protein and fat was positively associated with the risk of T2D in men. Low-
carbohydrate diets should obtain protein and fat from foods other than red and
processed meat.

Source: Am J Clin Nutr. 2011 Feb 10. [Epub ahead of print]

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