Table 4. Multivariable-Adjusted ORs and 95% CIs for Metabolic Diseases according to Dietary Carbohydrate Intake by Sex.
| Dietary carbohydrate intake (% of energy) | ||||||||
|---|---|---|---|---|---|---|---|---|
| <55% | 55–60% | 60–65% | 65–70% | 70–75% | 75–80% | >80% | p for trend | |
| Men (n=5966) | n=961 | n=671 | n=879 | n=991 | n=1038 | n=773 | n=653 | |
| Obesity* | 1.00 | 0.92 (0.72–1.17) | 0.89 (0.71–1.13) | 1.01 (0.82–1.26) | 0.89 (0.70–1.12) | 0.73 (0.56–0.96) | 0.84 (0.62–1.12) | 0.1013 |
| Metabolic syndrome† | 1.00 | 1.24 (0.91–1.70) | 1.44 (1.06–1.97) | 1.26 (0.94–1.69) | 1.44 (1.08–1.93) | 1.35 (0.99–1.84) | 1.35 (0.91–1.99) | 0.0465 |
| Increased waist circumference | 1.00 | 0.77 (0.60–0.99) | 0.84 (0.65–1.09) | 0.85 (0.67–1.07) | 0.78 (0.60–1.00) | 0.74 (0.55–1.00) | 0.80 (0.59–1.09) | 0.0686 |
| Elevated TG | 1.00 | 1.25 (0.98–1.58) | 1.27 (1.00–1.61)** | 1.30 (1.03–1.65) | 1.30 (1.01–1.68) | 1.28 (0.98–1.69) | 1.41 (1.03–1.92) | 0.0281 |
| Reduced HDL cholesterol | 1.00 | 0.95 (0.71–1.25) | 1.18 (0.91–1.52) | 1.16 (0.91–1.49) | 1.25 (0.97–1.61) | 1.27 (0.96–1.69) | 1.32 (0.99–1.76) | 0.0112 |
| Elevated blood pressure | 1.00 | 1.16 (0.89–1.50) | 1.03 (0.80–1.34) | 1.17 (0.92–1.50) | 1.14 (0.89–1.46) | 1.04 (0.79–1.35) | 1.27 (0.94–1.74) | 0.2414 |
| Elevated fasting glucose | 1.00 | 1.13 (0.87–1.47) | 1.30 (1.00–1.70)†† | 1.25 (0.98–1.59) | 1.27 (1.00–1.60)‡‡ | 1.26 (0.96–1.66) | 1.13 (0.80–1.59) | 0.1422 |
| Type 2 diabetes‡ | 1.00 | 0.87 (0.55–1.37) | 1.12 (0.75–1.67) | 1.00 (0.69–1.46) | 1.22 (0.85–1.77) | 1.08 (0.72–1.62) | 1.03 (0.67–1.60) | 0.4812 |
| Hypercholesterolemia§ | 1.00 | 1.20 (0.85–1.69) | 1.16 (0.83–1.64) | 1.13 (0.81–1.59) | 1.38 (1.01–1.88) | 1.10 (0.74–1.64) | 1.25 (0.81–1.92) | 0.2449 |
| Hypertriglyceridemia∥ | 1.00 | 1.25 (0.94–1.65) | 1.12 (0.84–1.50) | 1.17 (0.89–1.55) | 1.12 (0.84–1.49) | 1.08 (0.78–1.50) | 1.12 (0.76–1.63) | 0.6391 |
| Atherogenic dyslipidemia¶ | 1.00 | 1.17 (0.83–1.65) | 1.39 (1.01–1.92) | 1.20 (0.89–1.62) | 1.32 (0.96–1.80) | 1.37 (0.97–1.94) | 1.33 (0.96–1.94) | 0.0569 |
| Women (n=7140) | n=1057 | n=748 | n=1048 | n=1158 | n=1173 | n=933 | n=1023 | |
| Obesity* | 1.00 | 1.15 (0.88–1.49) | 1.07 (0.83–1.38) | 0.92 (0.72–1.17) | 1.11 (0.88–1.41) | 1.01 (0.78–1.32) | 0.94 (0.72–1.25) | 0.6412 |
| Metabolic syndrome† | 1.00 | 1.24 (0.86–1.80) | 1.24 (0.87–1.77) | 0.85 (0.61–1.18) | 1.18 (0.85–1.65) | 1.16 (0.82–1.64) | 1.17 (0.82–1.66) | 0.5713 |
| Increased waist circumference | 1.00 | 1.08 (0.79–1.47) | 1.09 (0.80–1.46) | 0.86 (0.65–1.13) | 1.02 (0.79–1.32) | 1.03 (0.76–1.40) | 0.97 (0.72–1.31) | 0.7233 |
| Elevated TG | 1.00 | 1.23 (0.92–1.64) | 1.20 (0.89–1.61) | 0.98 (0.75–1.28) | 1.12 (0.86–1.47) | 1.13 (0.85–1.51) | 1.12 (0.83–1.52) | 0.7096 |
| Reduced HDL cholesterol | 1.00 | 1.17 (0.92–1.48) | 1.08 (0.87–1.35) | 1.04 (0.84–1.30) | 1.15 (0.90–1.45) | 1.27 (1.00–1.61)§§ | 1.38 (1.06–1.80) | 0.0301 |
| Elevated blood pressure | 1.00 | 1.10 (0.77–1.56) | 1.05 (0.78–1.41) | 1.12 (0.86–1.45) | 1.16 (0.88–1.53) | 1.19 (0.89–1.60) | 1.30 (0.96–1.75) | 0.0714 |
| Elevated fasting glucose | 1.00 | 1.11 (0.81–1.50) | 0.94 (0.72–1.24) | 0.78 (0.59–1.01) | 1.08 (0.83–1.41) | 0.99 (0.74–1.31) | 0.91 (0.67–1.24) | 0.6229 |
| Type 2 diabetes‡ | 1.00 | 0.83 (0.48–1.43) | 0.85 (0.53–1.35) | 0.52 (0.32–0.82) | 0.85 (0.55–1.31) | 0.90 (0.56–1.46) | 0.92 (0.60–1.41) | 0.9517 |
| Hypercholesterolemia§ | 1.00 | 1.39 (0.94–2.07) | 1.19 (0.83–1.71) | 1.09 (0.77–1.56) | 1.41 (0.99–2.03) | 1.44 (0.97–2.13) | 1.41 (0.97–2.07) | 0.0636 |
| Hypertriglyceridemia∥ | 1.00 | 0.90 (0.58–1.38) | 1.09 (0.73–1.63) | 0.69 (0.45–1.05) | 1.03 (0.70–1.52) | 0.98 (0.64–1.50) | 0.94 (0.60–1.46) | 0.8516 |
| Atherogenic dyslipidemia¶ | 1.00 | 1.31 (0.91–1.90) | 1.15 (0.81–1.64) | 0.85 (0.61–1.19) | 1.15 (0.85–1.64) | 1.18 (0.85–1.64) | 1.26 (0.89–1.77) | 0.3807 |
OR, odds ratio; CI, confidence interval; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; HDL, high-density lipoprotein; TG, triglyceride.
All analyses accounted for the complex sampling design effect and appropriate sampling weights of the national survey using PROC SURVEY in SAS. Multivariate adjusted logistic regression was used to estimate ORs (95% CIs) and p values for trends after adjustment for age, education, household income, residence, current smoking, current alcohol drinking, physical activity, BMI (except for the model with obesity and increased waist circumference), and energy intake.
*Obesity (BMI ≥25 kg/m2), †Definition of metabolic syndrome (three or more abnormalities): increased waist circumference (≥90 cm for men and ≥85 cm for women), elevated triglycerides (≥150 mg/dL), reduced HDL cholesterol (<40 mg/dL for men and <50 mg/dL for women), elevated blood pressure (SBP ≥130 mm Hg or DBP ≥85 mm Hg), or elevated fasting glucose (≥100 mg/dL), ‡Type 2 diabetes (fasting glucose ≥126 mg/dL or medication use), §Hypercholesterolemia (≥240 mg/dL or medication use), ∥Hypertriglyceridemia (≥200 mg/dL), ¶Atherogenic dyslipidemia (HDL<40 mg/dL for men, <50 mg/dL for women, and TG ≥150 mg/dL), **p=0.0551, ††p=0.0472, ‡‡p=0.0479, §§p=0.0520.