Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis.

Bowl of Vegetable Salad and FruitsDietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis was published in Lancet Public Health this past summer (August 2018), reported that both a low-carb diet (less than 40 percent of calories from carbs)  and high-carb consumption (more than 70 percent of calories from carbs), was associated with a higher rate of death from all causes.  The article was a surprise to many and was one of the most widely talked-about articles on the internet in 2018.  Marc Bellemare submitted a response to the Lancet, arguing that the presence of unobserved confounders weakens the study's conclusion.

What do you think? Is dietary research missing the bigger picture or jumping to conclusions?

Read the full study here (open access), and share your thoughts below.

11 Comments
Order by: Votes | Oldest | Newest
Dr.Ing Nditange Shigwedha
Dr.Ing Nditange Shigwedha
BSc, MSc, PhD, Post-PhD
Harbin Institute of Technology (HIT)
Harbin, China
3weeks ago

Actually, it does not matter - whether a
dietary carb is categorized as a low-carb diet (< 40 % of calories from
carbs) or a high-carb diet (> 70 % of calories from carbs) because dietary
carbs consist of carbohydrates with a degree of polymerization of 3 or more
that commonly occur in foods of plant origin and are not digested and absorbed
by the small intestine. In my evaluation, more dietary research is lacked to
determine the reasons for a higher rate of mortality. In particular, that kind
of research may concentrate on discovering alternative digestive processes
because humans do not have the intestinal enzymes required to digest dietary
carbs in the belly and small intestine. What is known so far is that the
salivary and pancreatic
??amylases are the only
enzymes envied for starch digestion. Indisputably, the current dietary research
appeared to have dropped the bigger picture. I would advise these researchers
to see my chapter on the very topic at 
http://dx.doi.org/10.5772/64091 for additional details.

Recommended 1 time
3weeks ago

Regarding this study, I could not locate the specificities of the types of carbohydrates consumed, or the glycemic indexes of the carbohydrates. With that said, I find it quite interesting the possible correlation between restricting carbohydrates and increased mortality, something that definitely requires more research,

Thank you.

Recommended 1 time
Dr Iqbal Master
Dr Iqbal Master
MBChB
King Dinuzulu Hospital ( King George V )
Durban, KwaZulu-Natal, South Africa
3weeks ago

I think more work needs to be done. Not all circumstances have been taken into consideration. Factors like patients weigh / BMI , economic status , access to food , co-morbid conditions, degree of access to health care and the actual types of foods eaten need to be considered. Whether the food eaten was highly processed or GMO would also be factors. What the actual cause of death (like a traumatic death) and comparison with the death rate in country specific cohorts. I think the study is important especially in light of the conflict in the world of nutrition and the divergent views but much more research is needed.

Recommended 1 time
Arghya Ray
Arghya Ray
Livingston Research
"Not all circumstances have been taken into consideration" ... This is my point too. Thanks for your input.
1week ago
Dr Monica BUTNARIU
Dr Monica BUTNARIU
chemist
Banat's University Timisoara
doctor habilitate, professor
Timisoara, Romania
3weeks ago

Is dietary research missing the bigger picture and jumping to conclusions.

But I think the presented results are generalized

Dr. Sriram Seshadri
Dr. Sriram Seshadri
PhD
Institute of Science, Nirma University
Academic Coordinator
Ahmedabad, Gujarat, India
3weeks ago

The said article is definitely one the most shocking paper. Dietary intake has been looked from the perspective of onset of disease and which has been a widely accepted fact. But correlating the same with mortality doesnot make sense. 

Dr Alfredo I Servín-Caamaño
Dr Alfredo I Servín-Caamaño
Md
Hospital general de mexico
Dr
Mexico city, Mexico, Mexico
3weeks ago

I think this is agree with the fact that hi protein and fat diets arw better in cv mortality.

Mr. Daniel Fotio
Mr. Daniel Fotio
MD
Inter-States Pesticides' Committee of Central Africa (CPAC)
Research Officer
Yaoundé, Centre, Cameroon
3weeks ago

Congratulation to the authors.

They wanted to find out the link between the rate of carbohydrate consumption and mortality. I would have suggested to also find out the link between carbohydrate consumption and fat including the type of fats consumption because there is a clear link in the body both of them in the body. 


Dr. Robert John Zagar
Dr. Robert John Zagar
PhD MPH
Juvenile Division Circuit Court of Cook County, ART LLC, Chicago School of Professional Psychology
Psychologist, General Manager, Professor
Chiago, Illinois, United States
1week ago

I wonder if your patients might benefit from Professor Tombak's Can We Live 150 Years or Cure the Incurable.

Arghya Ray
Arghya Ray
Livingston Research
A Level Writer
India
1week ago

Personally, I feel that mortality analysis is not only strange but whimsical in relation with carbohydrate intake. I am fully afraid that I might be wrong, but long-term data on death rates and causatives may be plagued with several factors that can affect the quality of the study by Seidelmann et al (2018) in a lateral way. Bellemare (2018) has informatively pointed out this issue. According to him, in the context of unobserved cofounders that might have affected the study, an example can be described as the following:

"One example could be whether individuals tended to have highly variable bodyweight due to extreme diets (ie, diets that are too low or too high in carbohydrate intake), which was not observed in this study."

Another example of cofounder can be cited as the possibility of having some genetic condition of the study subject concerned. Suppose, somebody's death was caused by the effects of a hidden genetic condition, which might been affecting carbohydrate metabolism ... potentially leading to a condition like, say, false diabetes ! According to Pacurar (2017), "Genetic disorder in carbohydrates metabolism" may lead to considerable health issues that might cause general degeneration in the patients, especially when the said condition persists without timely diagnosis.

Statistical correlation thus appears to be potentially flawed, although Seidelmann et al (2018) have done sufficient literature review, data collection and analysis, plus futuristic implications.

Frankline Sevidzem Wirsiy
Frankline Sevidzem Wirsiy
BSc, MSc, PhDc
University of Buea
Ph.D.c
Douala, Littoral, Cameroon
2 days ago

The epidemic of overweight and obesity presents a major challenge to
chronic disease prevention and health across the life course around the
world. With this in mind, we cannot say that dietary research is missing the bigger picture or better still jumping to conclusions.

Clinical nutrition research has played a pivotal role in establishing
causality between diet or nutrient intake and health outcome measures
and in the determination of dietary requirements and levels of
supplementation to achieve specific outcomes. Because the studies are
performed with humans, clinical nutrition research can be readily
translated into public health messages.


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