Low-carbohydrate, high-protein score and mortality in a northern Swedish population-based cohort
Abstract
Background/objective Long-term effects of carbohydrate-restricted diets are unclear. We examined a low-carbohydrate, high-protein (LCHP) score in relation to mortality.Subjects/methods This is a population-based cohort study on adults in the northern Swedish county of Västerbotten. In 37,639 men (1460 deaths) and 39,680 women (923 deaths) from the population-based Västerbotten Intervention Program, deciles of energy-adjusted carbohydrate (descending) and protein (ascending) intake were added to create an LCHP score (2-20 points). Sex-specific hazard ratios (HR) were calculated by Cox regression.Results Median intakes of carbohydrates, protein and fat in subjects with LCHP scores 2-20 ranged from 61.0% to 38.6%, 11.3% to 19.2% and 26.6% to 41.5% of total energy intake, respectively. High LCHP score (14-20 points) did not predict all-cause mortality compared with low LCHP score (2-8 points), after accounting for saturated fat intake and established risk factors (men: HR for high vs low 1.03 (95% confidence interval (CI) 0.88-1.20), P for continuous = 0.721; women: HR for high vs low 1.10 (95% CI 0.91-1.32), P for continuous = 0.229). For cancer and cardiovascular disease, no clear associations were found. Carbohydrate intake was inversely associated with all-cause mortality, though only statistically significant in women (multivariate HR per decile increase 0.95 (95% CI 0.91-0.99), P = 0.010).Conclusion Our results do not support a clear, general association between LCHP score and mortality. Studies encompassing a wider range of macronutrient consumption may be necessary to detect such an association.
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Few longitudinal studies have reported on total protein intake and CHD events, with generally null results.
“Few longitudinal studies have reported on total protein intake and CHD events, with generally null results.189, 386”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [386]
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Garden, L., & Paterson, K. (2014) · Diapedia.org eBooks · doi:10.14496/dia.8105345813.6
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- Authors
- Nilsson, L. M., Winkvist, A., Eliasson, M., Jansson, J.-H., Hallmans, G., Johansson, I., Lindahl, B., Lenner, P., & Van Guelpen, B.
- Affiliations
- Umeå University (SE)
- University of Gothenburg (SE)
- Sunderby sjukhus (SE)
- Skellefteå Hospital (SE)
- Corresponding author
- Nilsson, L M
- Venue
- European Journal of Clinical Nutrition
- Published
- 2012-02-15
- Volume
- 66
- Issue
- 6
- Pages
- 694-700
- ISSN
- 0954-3007 (ISSN-L)
- 1476-5640
- OpenAlex
- W1996049554
- Cited by
- 69
- References
- 31
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 4 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 5 · 2019: 8 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 5 · 2014: 5 · 2013: 5 · 2012: 1
- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- high-protein low-carbohydrate diet, carbohydrate intake, protein intake, macronutrient composition, all-cause mortality, cancer mortality, cardiovascular mortality, saturated fat intake, sex differences
- MeSH terms
- Adult, Energy Intake, Cardiovascular Diseases, Cause of Death, Dietary Carbohydrates, Dietary Fats, Dietary Proteins, Female, Humans, Male, Middle Aged, Neoplasms, Risk Factors, Sweden, Cohort Studies, Proportional Hazards Models, Diet, Carbohydrate-Restricted
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