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Carbohydrates and Type 2 Diabetes Risk

Do high-carb diets heighten T2D risk in women?

Publish date:: November 24, 2015

Women who consume a diet with high starch, low fiber, and a high starch-to-cereal fiber ratio had a greater risk for developing type 2 diabetes, according to a study of >70,000 women who were free of cardiovascular disease, cancer, and diabetes at baseline. During nearly 1.5 million person-years follow-up, nearly 7,000 incident type 2 diabetes cases were ascertained. Researchers also discovered:

• Higher carbohydrate intake was not associated with type 2 diabetes (RR=0.98).

• Starch was associated with a higher type 2 diabetes risk (RR=1.23).

• Total fiber (RR=0.80), cereal fiber (RR=0.71), and fruit fiber (RR=0.79) were associated with a lower type 2 diabetes risk.

• Positive associations were observed between the ratios of carbohydrates to cereal fiber (RR=1.28), starch to total fiber (RR=1.12), and starch to cereal fiber (RR=1.39).

Citation: Alessa HB, Bhupathiraju SN, Malik VS, et al. Carbohydrate quality and quantity and risk of type 2 diabetes in US women. [Published online ahead of print November 4, 2015]. Am J Clin Nutr doi: 10.3945/ajcn.115.116558.

Commentary: Increasingly it appears that it is not just carbohydrates, but the type of carbohydrate that matters. The results of this study support the current recommendations from the American Diabetes Association which do not recommend a diet low in carbohydrates to prevent diabetes, but do recommend a diet high in fiber, fruits, and vegetables. Consistent with the findings in the present study the ADA recommends, “carbohydrate intake from vegetables, fruits, whole grains, legumes, and dairy products should be advised over intake from other carbohydrate sources, especially those that contain added fats, sugars, or sodium.”¹ —Neil Skolnik, MD

1. American Diabetes Association Standards of Medical Care in Diabetes—2015. Diabetes Care 2015;38(Suppl. 1):S1–S90. doi: 10.2337/dc15-S001.

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