Adherence to Low-Carbohydrate Diet and Hemoglobin A1c Levels among Adults with Diabetes: A Population-Based Cross-sectional Study
Elta Charles and Eunkyung Lee*
Department of Health Sciences, University of Central Florida, United States of America
*Corresponding Author: Eunkyung Lee, Department of Health Sciences, University of Central Florida, United States of America.
June 30, 2021; Published: July 21, 2021
Evidence of a low-carbohydrate diet (LCD) on diabetes prognosis is not consistent. This study examined the association between adherence to LCD and hemoglobin A1c (HbA1c) levels in adults with diabetes. A total of 3,628 adults with self-reported diabetes were identified from the National Health and Nutrition Examination Survey 2005-2016. Adherence to LCD was measured using LCD scores (range 0-30) based on the proportions of energy intake from three macronutrients, with higher scores indicating lower intakes of carbohydrates. Average dietary intakes and HbA1c levels were estimated and compared across the quintiles of LCD scores. Multivariable survey logistic regression models were used to examine the associations between quintile of LCD score and elevated HbA1c levels (≥6.5%). The average diet of adults with DM consisted of 47.2% carbohydrates, 36.0% fat, and 16.8% protein, with a mean LCD score of 15.6. The mean HbA1c level was 7.15%, and 64% of participants presented with elevated HbA1c levels of ≥6.5%. There was no significant difference in odds of presenting with elevated HbA1c levels when those in the highest and lowest quintiles of LCD were compared after adjustment for potential confounders (OR=0.94; 95%CI=0.57-1.53). However, individuals in the highest quintile of LCD score showed lower intakes of total fruits, added sugars, and refined grains, but higher intakes of total energy, saturated fats, cholesterol, alcohol, and sodium compared to those in the lowest quintile. Future studies should focus more on diet quality, in addition to the composition of the diet.
Keywords:NHANES: Diabetes Mellitus; Low-carbohydrate Diet; 24-hour Recall; Prognostic Factor; Glycosylated Hemoglobin
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