Association of low-carbohydrate diet scores and type 2 diabetes in Chinese rural adults: The Henan Rural Cohort Study

Purpose To investigate the association between low-carbohydrate diet scores (LCDs) and the risk of type 2 diabetes in rural China. Methods A total of 38,100 adults were included in the Henan Rural Cohort Study. Macronutrient intake was assessed via a validated food-frequency questionnaire to create low-carbohydrate diet (LCD) scores. Multivariate logistic regression models and subgroup analysis were performed to estimate the odds ratio ( OR ) and 95% confidence interval ( 95% CI ). Results After multivariable adjustment, participants with a high total low-carbohydrate diet score have a high risk of T2D (extreme-quartile OR = 1.23, 95% CI: 1.04–1.41; P = 0.007 ), whereas plant-based LCD score is not related to T2D risk. Among individuals with a BMI < 24 (extreme-quartile OR = 1.22, 95% CI: 1.01–1.47; P < 0.001 ) or high levels of physical activity (extreme-quartile OR = 1.42, 95% CI: 1.17–1.72; P < 0.001 ), the animal-based LCD score is positively correlated with the risk of T2D. Conclusion Among Chinese rural populations, high-fat-low carbohydrate diet is associated with an increased risk of type 2 diabetes. High intake of animal protein and fat also increases T2D risk in those who are overweight or have high physical activity.