Association between Carbohydrate Intake and Serum Lipids

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http://www.jacn.org/current.shtml

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http://www.jacn.org/cgi/content/abstract/25/2/155

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Journal of the American College of Nutrition, Vol. 25, No. 2, 155-163
(2006)
Published by the American College of Nutrition
Association between Carbohydrate Intake and Serum Lipids
Yunsheng Ma, MD, PhD, Youfu Li, MD, MPH, David E. Chiriboga, MD, MPH,
Barbara C. Olendzki, RD, MPH, James R. Hebert, MSPH, ScD, Wenjun Li,
PhD, Katherine Leung, MPH, Andrea R. Hafner, BS and Ira S. Ockene, MD
Division of Preventive and Behavioral Medicine (Y.M., D.E.C., B.C.O.,
W.L., K.G., A.R.H.)
Division of Cardiovascular Medicine (Y.L., I.S.O.)
University of Massachusetts Medical School, Worcester, Massachusetts,
Department of Biostatistics and Epidemiology, University of South
Carolina, Columbia, South Carolina (J.R.H.)
Address correspondence to: Yunsheng Ma, MD, Ph.D., Division of
Preventive and Behavioral Medicine, Department of Medicine, University
of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA
01655. E-mail: Yunsheng.Ma@umassmed.edu

Background: The effect of dietary carbohydrate on blood lipids has
received considerable attention in light of the current trend in
lowering carbohydrate intake for weight loss.
Objectives: To evaluate the association between carbohydrate intake and
serum lipids.
Methods: Blood samples and 24-hour dietary and physical activity recall
interviews were obtained from each subject at quarterly intervals for
five consecutive quarters between 1994 and 1998 from 574 healthy adults
in Central Massachusetts. Relationships between serum lipids and dietary
carbohydrate factors were assessed using linear mixed models and
adjusting for other risk factors known to be related to blood lipids.
Both cross-sectional and longitudinal results were reported.
Results: Cross-sectional analysis results from this study suggest that
higher total carbohydrate intake, percentage of calories from
carbohydrate, glycemic index (GI) and/or glycemic load (GL) are related
to lower high-density lipoprotein cholesterol (HDL-C) and higher serum
triacylglycerol levels, while higher total carbohydrate intake and/or GL
are related to lower total and low-density lipoprotein cholesterol
(LDL-C) levels. In a one-year longitudinal analysis, GL was positively
associated with total and LDL-C levels, and there was an inverse
association between percentage of calories from carbohydrate and HDL-C
levels.
Conclusions: Results suggest that there is a complex and predominantly
unfavorable effect of increased intake of highly processed carbohydrate
on lipid profile, which may have implications for metabolic syndrome,
diabetes, and coronary heart disease. Further studies in the form of
randomized controlled trials are required to investigate these
associations and determine the implications for lipid management.

Key words: dietary carbohydrates, LDL cholesterol, glycemic index,
longitudinal studies

Copyright 2006 by the American College of Nutrition.

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