Dietary carbohydrate quality index and cardio-metabolic risk factors

Arman Maghoul; Nami Mohammadian Khonsari; Sasan Asadi; Zahra Esmaeili Abdar; Hanieh-Sadat Ejtahed; Mostafa Qorbani

doi:10.1024/0300-9831/a000794

Dietary carbohydrate quality index and cardio-metabolic risk factors

Int J Vitam Nutr Res. 2023 Nov 27. doi: 10.1024/0300-9831/a000794. Online ahead of print.

Authors

Arman Maghoul¹, Nami Mohammadian Khonsari², Sasan Asadi³, Zahra Esmaeili Abdar¹, Hanieh-Sadat Ejtahed^{4

5}, Mostafa Qorbani^{1

6}

Affiliations

¹ Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
² Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran.
³ Department of Community Medicine, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Kurdistan Province, Iran.
⁴ Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁵ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁶ Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

PMID: 38009678
DOI: 10.1024/0300-9831/a000794

Abstract

Introduction: Improving the quality of diet is known as one of the practical ways to reduce cardio-metabolic risk factors (CMRFs). The carbohydrate quality index (CQI) is a relatively new index to evaluate diet quality. It is calculated based on the ratio of solid carbohydrates to total carbohydrates, dietary fibre intake, glycemic index and the ratio of whole grains to total grains. This systematic review and meta-analysis was designed to investigate the association between dietary CQI and CMRFs. Methods: In this systematic review, some international databases, including Scopus, PubMed, EMBASE, Web of Science, and Google Scholar up to July 2022, were searched according to appropriate keywords. All observational studies with an English full text assessing the association between the dietary CQI and CMRFs were included. Two researchers independently extracted the data and assessed the quality of the articles with the Newcastle-Ottawa Scale. Random/fixed-effect meta-analysis was used to pool standardized mean difference (SMD) as an effect size. Results: 11 studies with a total of 63962 subjects were found to be eligible and included in the qualitative synthesis; only BMI, WC and metabolic syndrome reached the threshold of 3 reports with the same effect size and thus only 5 were included in the meta-analysis. The main finding of the included studies was that there were inverse associations between CQI and CMRFs, mainly obesity, glucose metabolism indices, and blood pressure. In the five studies included in the random effect meta-analysis, the association between CQI and body mass index (SMD: 0.45, 95%CI: -0.12, 1.01), waist circumference (SMD: -0.09, 95%CI: -0.34, 0.15) and metabolic syndrome (SMD: 0.63, 95%CI: -0.01, 1.28) was not statistically significant. Conclusion: Although the qualitative findings support the positive association of CQI with CMRFs, the evidence is insufficient to conclude robust findings. Further observational and interventional studies are needed to clearly elucidate this association.

Keywords: carbohydrate quality index; cardio-metabolic risk factors; obesity.

Publication types

Review