Epidemiology

The association between carbohydrate quality and nutrient adequacy in Australian adults

Abstract

Background/objectives

To examine the association between various carbohydrate quality indicators and nutrient adequacy in Australian adults.

Subjects/methods

Dietary data from adult participants of the 2011–2012 Australian Health Survey (weighted n = 6150) who had completed two 24 h recalls were analyzed. Glycaemic indices (GI) of foods were estimated based on a published method. Quartiles of dietary GI (dGI) and glycaemic load (dGL), and intakes of high (CHOhighGI) and low-GI carbohydrates (CHOlowGI) were derived. Estimated marginal means and standard errors of nutrient and food group intakes by quartiles were calculated using ANCOVA. Odds ratios of not meeting the nutrient reference values for Australia and New Zealand (NRVs) by quartiles of the carbohydrate quality indicators were calculated by logistic regression. Analyses were adjusted for known confounders.

Results

Participants with higher CHOhighGI had lower intakes of the majority of nutrients examined, except sodium and %energy from free sugars. They were also more than 100% more likely to not meet the NRVs of vitamin A (2.19, 95% CI 1.89, 2.84), vitamin C (3.93, 95% CI: 1.61, 9.60), vitamin E (2.63, 95% CI: 2.08, 3.31), iron (2.27, 95% CI: 1.48, 3.49), magnesium (2.50, 95% CI: 2.01, 3.12), potassium (2.25, 95% CI: 1.79, 2.83), %EFS (2.74, 95% CI: 2.22, 3.38), and LCn3PUFA (2.35, 95% CI: 1.76, 3.16). Similar results were observed for dGI and dGL, while trends for CHOlowGI were in opposite direction in general.

Conclusions

Of the carbohydrate quality indicators examined, CHOhighGI was the strongest predictor of nutrient adequacy. Improvement in nutrient adequacy likely contributed to the health protective effect of a low-GI diet.

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Fig. 1: Flow of participants.

References

  1. 1.

    Louie JCY, Flood VM, Atkinson FS, Barclay AW, Brand-Miller JC. Methodology for assigning appropriate glycaemic index values to an Australian food composition database. J Food Compos Anal. 2015;38(Suppl C):1–6. https://doi.org/10.1016/j.jfca.2014.06.002.

    Article  Google Scholar 

  2. 2.

    Foster-Powell K, Holt SH, Brand-Miller JC. International table of glycemic index and glycemic load values: 2002. Am J Clin Nutr. 2002;76:5–56. https://doi.org/10.1093/ajcn/76.1.5.

    CAS  Article  Google Scholar 

  3. 3.

    Barclay AW, Petocz P, McMillan-Price J, Flood VM, Prvan T, Mitchell P, et al. Glycemic index, glycemic load, and chronic disease risk—a meta-analysis of observational studies. Am J Clin Nutr. 2008;87:627–37. https://doi.org/10.1093/ajcn/87.3.627.

    CAS  Article  Google Scholar 

  4. 4.

    Louie JCY, Gwynn J, Turner N, Cochrane J, Wiggers J, Flood V. Dietary glycemic index and glycemic load among Indigenous and non-Indigenous children aged 10–12 years. Nutrition. 2012;28:e14–22. https://doi.org/10.1016/j.nut.2011.12.007.

    Article  Google Scholar 

  5. 5.

    Salmerón J, Manson JE, Stampfer MJ, Colditz GA, Wing AL, Willett WC. Dietary fiber, glycemic load, and risk of non—insulin-dependent diabetes mellitus in women. JAMA. 1997;277:472–7. https://doi.org/10.1001/jama.1997.03540300040031.

    Article  Google Scholar 

  6. 6.

    Louie JCY, Buyken AE, Brand-Miller JC, Flood VM. The link between dietary glycemic index and nutrient adequacy. Am J Clin Nutr. 2012. https://doi.org/10.3945/ajcn.111.015271.

  7. 7.

    Norhaizan M, Nor Faizadatul, Ain A. Determination of phytate, iron, zinc, calcium contents and their molar ratios in commonly consumed raw and prepared food in malaysia. Malays J Nutr. 2009;15:213–22.

    Google Scholar 

  8. 8.

    Louie JCY, Jones M, Barclay AW, Brand-Miller JC. Dietary glycaemic index and glycaemic load among Australian adults—results from the 2011–2012 Australian Health Survey. Sci Rep. 2017;7:43882. https://doi.org/10.1038/srep43882.

    Article  Google Scholar 

  9. 9.

    Jones M, Barclay AW, Brand-Miller JC, Louie JCY. Dietary glycaemic index and glycaemic load among Australian children and adolescents: Results from the 2011–2012 Australian Health Survey. Br J Nutr. 2016;116:178–87. https://doi.org/10.1017/S0007114516001823.

    CAS  Article  Google Scholar 

  10. 10.

    Australian Bureau of Statistics. Australian Health Survey: users’ guide, 2011–13. Canberra, ACT, Australia; 2013. https://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4363.0.55.001Main+Features12011-13?OpenDocument.

  11. 11.

    Bliss R. Researchers produce innovation in dietary recall. Agric Res. 2004;52:10–2.

    Google Scholar 

  12. 12.

    Food Standards Australia New Zealand. AUTNUT 2011–13 food composition database. Canberra, ACT, Australia; 2014. https://www.foodstandards.gov.au/science/monitoringnutrients/ausnut/ausnutdatafiles/Pages/foodnutrient.aspx.

  13. 13.

    Louie JCY, Lei L, Rangan AM. Reliability of a systematic methodology to estimate added sugars content of foods when applied to a recent Australian food composition database. J Food Compos Anal. 2016;46:36–42. https://doi.org/10.1016/j.jfca.2015.11.002.

    CAS  Article  Google Scholar 

  14. 14.

    Louie JC, Moshtaghian H, Boylan S, Flood VM, Rangan AM, Barclay AW, et al. A systematic methodology to estimate added sugar content of foods. Eur J Clin Nutr. 2015;69:154–61. https://doi.org/10.1038/ejcn.2014.256.

    CAS  Article  Google Scholar 

  15. 15.

    Harttig U, Haubrock J, Knuppel S, Boeing H. The MSM program: web-based statistics package for estimating usual dietary intake using the Multiple Source Method. Eur J Clin Nutr. 2011;65(Suppl 1):S87–91. https://doi.org/10.1038/ejcn.2011.92.

    Article  Google Scholar 

  16. 16.

    The University of Sydney. About glycemic index. Sydney, NSW, Australia; 2017. https://www.glycemicindex.com/index.php.

  17. 17.

    National Health and Medical Research Council. Nutrient Reference Values for Australia and New Zealand including recommended dietary intakes. Canberra, ACT: NHMRC; 2006.

  18. 18.

    Mok A, Ahmad R, Rangan A, Louie JCY. Intake of free sugars and micronutrient dilution in Australian adults. Am J Clin Nutr. 2018;107:94–104. https://doi.org/10.1093/ajcn/nqx008.

    Article  Google Scholar 

  19. 19.

    Australian Bureau of Statistics. Australian Health Survey: First Results, 2011–12. Canberra, ACT: ABS; 2013. https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4364.0.55.001main+features12011-12.

  20. 20.

    National Health and Medical Research Council (Australia). Australian dietary guidelines—providing the scientific evidence for healthier Australian diets. Canberra, ACT: NHMRC, DoHA; 2013.

  21. 21.

    Fisher RA. The arrangement of field experiments. In: Kotz S, Johnson N editors. Breakthroughs in Statistics. New York: Springer; 1992, p. 82–91.

  22. 22.

    Fisher RA. On the interpretation of X2 from contingency tables, and the calculation of P. J R Stat Soc. 1922;85:87–94. https://doi.org/10.2307/2340521.

    Article  Google Scholar 

  23. 23.

    Louie JCY, Buyken AE, Heyer K, Flood VM. Dietary glycaemic index and glycaemic load among Australian children and adolescents. Br J Nutr. 2011;106:1273–82. https://doi.org/10.1017/S0007114511001577.

    CAS  Article  Google Scholar 

  24. 24.

    Tornaritis MJ, Philippou E, Hadjigeorgiou C, Kourides YA, Panayi A, Savva SC. A study of the dietary intake of Cypriot children and adolescents aged 6–18 years and the association of mother’s educational status and children’s weight status on adherence to nutritional recommendations. BMC Public Health. 2014;14:13. https://doi.org/10.1186/1471-2458-14-13.

    Article  Google Scholar 

  25. 25.

    Ferrari P, Slimani N, Ciampi A, Trichopoulou A, Naska A, Lauria C, et al. Evaluation of under- and overreporting of energy intake in the 24-hour diet recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutr. 2002;5:1329–45. https://doi.org/10.1079/PHN2002409.

    CAS  Article  Google Scholar 

  26. 26.

    Brand-Miller J, Foster-Powell K. Diets with a low glycemic index: from theory to practice. Nutr Today. 1999;34:64–72.

    Article  Google Scholar 

  27. 27.

    Beebe C. Diets with a low glycemic index: not ready for practice yet! Nutr Today. 1999;34:82–6.

    Article  Google Scholar 

  28. 28.

    Sánchez-Tainta A, Zazpe I, Bes-Rastrollo M, Salas-Salvadó J, Bullo M, Sorlí JV, et al. Nutritional adequacy according to carbohydrates and fat quality. Eur J Nutr. 2016;55:93–106. https://doi.org/10.1007/s00394-014-0828-3.

    CAS  Article  Google Scholar 

  29. 29.

    Zazpe I, Sánchez-Taínta A, Santiago S, de la Fuente-Arrillaga C, Bes-Rastrollo M, Martínez JA, et al. Association between dietary carbohydrate intake quality and micronutrient intake adequacy in a Mediterranean cohort: the SUN (Seguimiento Universidad de Navarra) Project. Br J Nutr. 2014;111:2000–9. https://doi.org/10.1017/S0007114513004364.

    CAS  Article  Google Scholar 

  30. 30.

    Dwyer JT, Wiemer KL, Dary O, Keen CL, King JC, Miller KB, et al. Fortification and health: challenges and opportunities. Adv Nutr. 2015;6:124–31. https://doi.org/10.3945/an.114.007443.

    CAS  Article  Google Scholar 

  31. 31.

    Food Standards Australia New Zealand. Thiamin fortification. Canberra, ACT: FSANZ; 2016. https://www.foodstandards.gov.au/consumer/nutrition/Pages/Thiamin-fortification-.aspx.

  32. 32.

    Probst YC, Dengate A, Jacobs J, Louie JCY, Dunford EK. The major types of added sugars and non-nutritive sweeteners in a sample of Australian packaged foods. Public Health Nutr. 2017;20:3228–33. https://doi.org/10.1017/S136898001700218X.

    Article  Google Scholar 

  33. 33.

    Wong THT, Mok A, Ahmad R, Rangan A, Louie JCY. Intake of free sugar and micronutrient dilution in Australian children and adolescents. Eur J Nutr. 2019;58:2485–95. https://doi.org/10.1007/s00394-018-1801-3.

    CAS  Article  Google Scholar 

  34. 34.

    Tooze JA, Vitolins MZ, Smith SL, Arcury TA, Davis CC, Bell RA, et al. High levels of low energy reporting on 24 h recalls and three questionnaires in an elderly low-socioeconomic status population. J Nutr. 2007;137:1286–93. https://doi.org/10.1093/jn/137.5.1286.

    CAS  Article  Google Scholar 

  35. 35.

    Sun Y, Roth DL, Ritchie CS, Burgio KL, Locher JL. Reliability and predictive validity of energy intake measures from the 24 h dietary recalls of homebound older adults. J Am Diet Assoc. 2010;110:773–8. https://doi.org/10.1016/j.jada.2010.02.003.

    Article  Google Scholar 

  36. 36.

    National Institutes of Health. Dietary assessment primer—food record at a glance. 2019. https://dietassessmentprimer.cancer.gov/profiles/record/index.html.

  37. 37.

    Jenab M, Slimani N, Bictash M, Ferrari P, Bingham SA. Biomarkers in nutritional epidemiology: applications, needs and new horizons. Hum Genet. 2009;125:507–25. https://doi.org/10.1007/s00439-009-0662-5.

    Article  Google Scholar 

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Acknowledgements

The authors would like to acknowledge The Glycemic Index Foundation for providing the special edition of AUSNUT2011–2013 database for use in this study. The original data of the Australian Health Survey 2011–2012 were collected by the Australian Bureau of Statistics. The authors declare that those who carried out the original analysis and collection of the data bear no responsibility for further analysis or interpretation included in the paper.

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This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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DKYK—statistical analysis and drafting of paper. JCYL—designed and supervised the study, and subsequent editing of the final paper. Both authors read and approved the final paper. JCYL has primary responsibility of the content presented in this paper.

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Correspondence to Jimmy Chun Yu Louie.

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Kwan, D.K.Y., Louie, J.C.Y. The association between carbohydrate quality and nutrient adequacy in Australian adults. Eur J Clin Nutr 74, 1594–1602 (2020). https://doi.org/10.1038/s41430-020-0620-9

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