Dietary carbohydrate quality and risk of breast cancer among women

Background A few studies have examined the relationship between carbohydrate quality index (CQI) and risk of breast cancer (BC) among women in Middle Eastern countries. We studied the associations between carbohydrate quality index and the risk of BC in overall and by menopausal status. Methods In this case-control study, dietary intake of 461 women with pathologically confirmed BC within the past year were examined. The same information were collected for 495 apparently healthy controls using a 168-item validated FFQ. Carbohydrate quality was determined by considering four criteria including: ratio of solid carbohydrates to total carbohydrates, dietary fiber intake, GI and the ratio of whole grains to total grains. Results Mean GI and GL of participants were totally 57.5 ± 7.2 and 245.7 ± 64.7, respectively. A trend toward significant association was seen between GI and odds of BC in the whole population; such that after stratifying analysis by menopausal status, premenopausal women in the highest quartile of GI were 1.85 times higher likely to have BC than those in the lowest quartile (95% CI: 1.12, 3.07, P = 0.01). We found that women with the greatest CQI had lower odds for BC, compared with those with the lowest CQI (0.63; 95% CI: 0.43–0.94, P = 0.03). This association was remained after stratifying analysis by menopausal status in premenopausal (0.55; 95% CI: 0.34–0.90, P = 0.04). Conclusion We found that GI was directly and CQI inversely associated with odds of BC. In order to determine the effects of dietary carbohydrate quality prospective cohort studies are needed.

Association between carbohydrate quality index and general and central obesity in adults: a population-based study in Iran

Introduction: To determine whether dietary carbohydrates quality index (CQI), glycemic index, and glycemic load is associated with general and abdominal obesity. Methods: 850 participants, 20 to 59 years old, were enrolled in a cross-sectional study from five Tehran districts through health houses. The 168 items in the semi--quantitative food frequency questionnaire were used to assess dietary intake. The CQI was calculated by using the following four components: glycemic index, total fiber, solid carbohydrate to total carbohydrate ratio, and whole grains: total grains ratio. Results: After adjusting for confounding factors, the chance of obesity in men (OR=0.38, 95% CI 0.15to 0.95; P=0.04) measured by waist circumference (WC) was significantly lower in the fourth quintile of CQI in comparison with the first quintile. In addition, OR for obesity in men (OR=2.53, 95% CI0.52 to 1.37; P=0.04) was significantly 2.5 times higher among those in the fourth quintile of glycemic index compared with those in the lowest quintile. There was no significant association between dietary carbohydrates with general obesity in men and women. Conclusion: In summary, dietary CQI is significantly inversely related to central obesity in men,according to this study. Additionally, adherence to a diet with a higher glycemic index in men is positively associated with central obesity.

Toward an Evidence-Based Definition and Classification of Carbohydrate Food Quality: An Expert Panel Report

Carbohydrate-containing crops provide the bulk of dietary energy worldwide. In addition to their various carbohydrate forms (sugars, starches, fibers) and ratios, these foods may also contain varying amounts and combinations of proteins, fats, vitamins, minerals, phytochemicals, prebiotics, and anti-nutritional factors that may impact diet quality and health. Currently, there is no standardized or unified way to assess the quality of carbohydrate foods for the overall purpose of improving diet quality and health outcomes, creating an urgent need for the development of metrics and tools to better define and classify high-quality carbohydrate foods. The present report is based on a series of expert panel meetings and a scoping review of the literature focused on carbohydrate quality indicators and metrics produced over the last 10 years. The report outlines various approaches to assessing food quality, and proposes next steps and principles for developing improved metrics for assessing carbohydrate food quality. The expert panel concluded that a composite metric based on nutrient profiling methods featuring inputs such as carbohydrate–fiber–sugar ratios, micronutrients, and/or food group classification could provide useful and informative measures for guiding researchers, policymakers, industry, and consumers towards a better understanding of carbohydrate food quality and overall healthier diets. The identification of higher quality carbohydrate foods could improve evidence-based public health policies and programming—such as the 2025–2030 Dietary Guidelines for Americans.

Carbohydrate and Lipid Dietary Quality Indexes: Trends in the Brazilian Population

Objectives Our aim was to evaluate the qualitative profile of carbohydrate (CHO) and fat intake and the modification in 10-year period according to demographic and socioeconomic variables. Methods Data from two Brazilian National Dietary Survey with nationally representative sample of individuals ≥10 years old. The dietary Carbohydrate Quality Index (CQI) is a score ranging from 4 to 20 calculated from dietary fiber intake, global glycemic index, solid CHO to total CHO ratio and CHO from wholegrains to CHO from total grains ratio. Lipid Quality Index (LQI) was estimated by dividing the sum of the dietary content of monounsaturated and polyunsaturated fatty acids by the sum of saturated with trans fatty acids. Both indexes were categorized in quintiles in ascending order for best quality. Information about sex, age (categorized in adolescents, adults and elderly), income (quartiles), urban and rural area and lastly body mass index (categorized in obesity, overweight and normal/underweight) was collected. The estimates were generated separately for each survey and their 95% confidence intervals were compared to identify changes in time. Results CQI reduced in the Brazilian population, but was not significant. There was a significant reduction in the quintile of greater CHO quality over time for adolescentes (2,8%), first quartile of income (3,3%) and people living in rural área (5,3%). Otherwise the frequency of people that have better dietary quality for CHO increased for the last quartile of income (3,2%) over time. It was observed an increase for the population and for several categories at the second quintile for CQI, including men, adolescents, people in lowest quartile for income and people living in rural area. >The LQI raised 1,6% across 10 years in Brazilian population. It also increased between women (3,2%), adults (2,1%), last quartile of income (4,2%), urban area (2,2%) and obese (4,1%). Additionally, the frequency of people in the lowest quartile for income that presented the best quality in their diet for fats decreased 3,7% in 10 years. Conclusions Strategies to improve the dietary carbohydrate quality should be taken into consideration; particular attention should be given to dietary quality of carbohydrates and lipids of people with lowest income values in the Brazilian population. Funding Sources Not applicable.

Carbohydrate Quality of a Middle-aged and Older Population in Singapore and Its Association with Cardiometabolic Health

Objectives Carbohydrate quality plays a key role in cardiometabolic health, though this has not been well investigated in Asian populations. This study aimed to assess the carbohydrate quality of middle-aged and older adults in Singapore, and its association with various cardiometabolic health-related markers. Methods A secondary data analysis of a cross-sectional study consisting of 104 adults (59 ± 6 years, mean ± SD) was conducted. Carbohydrate quality was evaluated by their adherence to: (i) Singapore recommended daily allowance (RDA) for dietary fiber intake, (ii) Singapore recommended daily whole grain intake, (iii) World Health Organization free sugars limit and (iv) the balanced carbohydrate metrics (BCM). The BCM was reflected by a ratio of at least 1g of fiber per 10g of carbohydrates (10:1, simple ratio), or variations including free sugars criteria. Food intake was collected using 3-day food record. Measurements of cardiometabolic health-related markers were body mass index, waist circumference, blood pressure, blood lipid-lipoprotein markers (total, low-density lipoprotein and high-density lipoprotein cholesterol and triglycerides) and glucose and 10-year risk to coronary heart disease. The association between dietary carbohydrate quality and cardiometabolic health-related markers, as well as associations amongst the 4 measures of carbohydrate quality were evaluated using Fisher's exact test. Results 36%, 20%, 87% and 34% of the population met the fiber RDA, whole grain recommendation, free sugars limit and BCM respectively. A significant association in adherence to each measure of carbohydrate quality was found across all 4 measures (P < 0.05), except for between the whole grain recommendation and free sugars limit. The simple ratio was associated with a lower systolic blood pressure (P = 0.04) while no association was observed with other cardiometabolic health-related markers. Conclusions Consuming a diet adhering to the simple ratio of at least 1g of fiber for every 10g of carbohydrates may improve blood pressure and subsequently lower cardiometabolic disease risk. Funding Sources National University of Singapore, Singapore Economic Development Board and Société des Produits Nestlé SA

The association between carbohydrate quality index and nutrient adequacy in Iranian adults

Purpose This paper aims to evaluate the association between carbohydrate quality index (CQI) and nutrient adequacy in Iranian adults. Design/methodology/approach A total of 268 men and women with ages ranged from 18 to 70 years were evaluated in a cross-sectional study. The CQI was calculated by adding together the three components, namely, the ratio of solid to total carbohydrate, dietary fiber and glycemic index. The scores of three components were summed to calculate the CQI, with a higher score indicating a higher dietary carbohydrate quality. The odds ratios (ORs) of nutrient adequacy ratio (NAR), defined as the ratio of intake of a nutrient to the age- and gender-specific recommended dietary allowance, for the intake of energy and 10 nutrients across quartiles of the CQI were calculated by logistic regression analysis and expressed with 95% confidence intervals (CIs). Findings CQI ranged between 3 to 15 (mean ± SD: 9 ± 1.9). Being in top versus bottom quartile of the CQI was associated with a higher NAR of folic acid (OR: 3.20, 95% CI: 1.06–9.62; P-trend: <0.001), vitamin A (OR: 3.66; 95% CI: 1.46–9.17; P-trend: <0.001), magnesium (OR: 5.94; 95% CI; 1.71–20.53; P-trend: <0.001), vitamin C (OR: 7.85; 95% CI; 2.99–20.59; P-trend: <0.001). Originality/value A higher CQI was associated with greater micronutrient consumption adequacy in Iranian adults. The results suggest that increasing the consumption of total fiber and solid carbohydrates and decreasing the glycemic index of the diet and liquid carbohydrates can improve micronutrient intake adequacy.