Associations between Low-Carbohydrate Diets from Animal and Plant Sources and Dyslipidemia among Korean Adults

Abstract

Background The traditional Korean diet is relatively high in carbohydrate and low in fat and protein compared with diets of non-Asian populations. In recent decades, the rapid economic growth in Korea has led to lifestyle and dietary changes, with an increase in the prevalence of dyslipidemia, a risk factor for chronic diseases. Objective To examine the association between a low carbohydrate diet (LCD) score and dyslipidemia in Korean adults. Design The Korea National Health and Nutrition Examination Survey is an ongoing nationally representative population-based cross-sectional survey that is conducted annually. Participants/setting A total of 12,199 Korea National Health and Nutrition Examination Survey participants aged >= 20 years from 2010 to 2016 were included in this study. Main outcome measures Individual components of dyslipidemia, such as hypercholesterolemia, hypertriglyceridemia, and low high-density lipoprotein cholesterol levels, were defined based on fasting blood test results. Statistical analyses Participants were classified by sex into quintiles of LCD scores calculated using 1-day 24-hour dietary recall data. A multivariable logistic regression model was used to examine the association between LCD score and each dyslipidemia component after adjusting for potential confounders. Results A higher LCD score was significantly associated with higher odds of hypercholesterolemia (odds ratio 1.36, 95% CI, 1.05 to 1.78; P for trend=0.031) and lower odds of low high-density lipoprotein cholesterol levels (odds ratio 0.72, 95% CI 0.55 to 0.94; P for trend=0.002) in women. However, in men, higher LCD scores were significantly associated with lower odds of hypertriglyceridemia (odds ratio 0.70, 95% CI 0.52 to 0.95; P for trend=0.012). More specifically, animal-based LCD scores were negatively associated with the odds of hypertriglyceridemia (odds ratio 0.65, 95% CI 0.48 to 0.87; P for trend=0.010) in men. Conclusions These results suggest that the complicated and integrated effects of macronutrient composition on individual lipid components should be considered for preventing dyslipidemia in Korean adults.