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Low‐carbohydrate diets (LCDs) are popular among people attempting weight loss and recommended for pregnant women with gestational diabetes (GDM), but they may increase health risks if nutritionally inadequate. We aimed to describe the dietary intake of post‐partum women according to their relative carbohydrate intake, overall, and among women attempting weight loss or diagnosed with GDM in their recent pregnancy. This cross‐sectional population‐based cohort study included 2093 post‐partum women aged 25–36 years who participated in the Australian Longitudinal Study on Women's Health. Dietary intake was assessed using a validated food frequency questionnaire. Relative carbohydrate intake was determined using a previously developed LCD score. Data were weighted to account for oversampling of women from rural/remote areas. More than half of women (n[weighted] = 1362, 66.3%) were trying to lose weight, and 4.6% (n[weighted]=88) had GDM in their recent pregnancy. Women with the lowest relative carbohydrate intake (LCD score quartile 4) consumed 36.8% of total energy intake from carbohydrates, and had a lower intake of refined grains, whole grains, fruit and fruit juice, and a higher intake of red and processed meat, compared with women with the highest relative carbohydrate intake (quartile 1). Different food groups, both healthy and unhealthy, were restricted depending on whether women were attempting weight loss and had recent GDM. These findings may reflect a lack of knowledge among post‐partum women on carbohydrates and dietary guidelines. Health professionals may have an important role in providing advice and support for post‐partum women who wish to restrict their carbohydrate intake, to ensure optimal diet quality. Key messages: Low‐carbohydrate diets have become increasingly popular, but they may increase health risks if nutritionally inadequate.In a national population‐based study of Australian post‐partum women, relatively low carbohydrate intake was associated with healthy and unhealthy food choices, including consumption of less refined grains and fruit juice, but also less whole grains and fruit and more red meat and processed meat.Given the critical role of carbohydrate quantity and quality in disease prevention, health professionals should inform and support women who wish to restrict their carbohydrate intake to consume a balanced diet in line with dietary guidelines. [ABSTRACT FROM AUTHOR]

Grains are important sources of carbohydrates in global dietary patterns. The majority of these carbohydrates, especially in refined‐grain products, are digestible. Most carbohydrate digestion takes place in the small intestine where monosaccharides (predominantly glucose) are absorbed, delivering energy to the body. However, a considerable part of the carbohydrates, especially in whole grains, is indigestible dietary fibers. These impact gut motility and transit and are useful substrates for the gut microbiota affecting its composition and quality. For the most part, the profile of digestible and indigestible carbohydrates and their complexity determine the nutritional quality of carbohydrates. Whole grains are more complex than refined grains and are promoted as part of a healthy and sustainable diet mainly because the contribution of indigestible carbohydrates, and their co‐passenger nutrients, is significantly higher. Higher consumption of whole grain is recommended because it is associated with lower incidence of, and mortality from, CVD, type 2 diabetes, and some cancers. This may be due in part to effects on the gut microbiota. Although processing of cereals during milling and food manufacturing is necessary to make them edible, it also offers the opportunity to still further improve the nutritional quality of whole‐grain flours and foods made from them. Changing the composition and availability of grain carbohydrates and phytochemicals during processing may positively affect the gut microbiota and improve health. [ABSTRACT FROM AUTHOR]

In pregnant women with type 1 diabetes, a low but sufficient, intake of carbohydrates is important to aim for near normal glycemic control. However, knowledge about the carbohydrate intake in this group is limited. To assess the average quantity and quality of carbohydrate intake in pregnant women with type 1diabetes compared to healthy pregnant women and current dietary reference intakes. A narrative literature search was performed in PubMed, Embase, and Cochrane Library and by using a snow‐ball search technique to identify papers published on studies conducted in industrialized countries within the last 20 years. Intakes of carbohydrate were assessed qualitatively in relation to the Dietary Reference Intakes recommended by the American Diabetes Association and quantitatively as mean intake of dietary fiber. Five observational studies including 810 pregnant women with type 1 diabetes and 15 observational studies with a total of 118,246 healthy pregnant women were identified. The mean total carbohydrate intake was within the Acceptable Macronutrient Distribution Range (45%–64% of energy intake) in both groups. In pregnant women with type 1 diabetes, the average total intake was 218 ± 19 g/day, which was 20% (53 g/day) lower than in healthy pregnant women. Mean intake of dietary fiber in women with diabetes was lower than the recommended adequate intake for healthy women. With the limitations of pronounced heterogeneity across the included studies, pregnant women with type 1 diabetes reported a mean total carbohydrate intake, which was lower than in healthy pregnant women but still within the recommended range. [ABSTRACT FROM AUTHOR]

Abstract: Background: Dietary carbohydrate quality may play an important role in disease development. We evaluated the association between carbohydrate quality index (CQI) and the prevalence of obesity and metabolic disorders among adults in South Korea. Methods: We analysed 12 027 adults aged 19–64 years from the fifth Korea National Health and Nutrition Examination Survey (KNHANES). CQI was based on four criteria: crude fibre intake, dietary glycaemic index (DGI), whole grains/total grains ratio and solid carbohydrates/total carbohydrates ratio. Results: Participants with a lower CQI were younger, had a lower income and were more likely to be smokers and to drink alcohol. The highest quintile CQI group showed the lowest DGI and the lowest consumption of liquid carbohydrates and refined grains, as well as the highest consumption of solid carbohydrates, crude fibre and whole grains (P < 0.05). A higher CQI was negatively associated with the prevalence of obesity (odds ratio = 0.83; 95% confidence interval = 0.69–0.99) and hypertension (odds ratio = 0.78; 95% confidence interval = 0.61–0.99) but was not associated with other metabolic disorders. Conclusions: These results suggest that the quality of carbohydrates consumed is associated with the risk of obesity and hypertension. However, the cross‐sectional design does not preclude reverse causality. [ABSTRACT FROM AUTHOR]

Some studies focused on the effect of the dietary glycemic index on lipoproteins and apolipoproteins in adults; however, little evidence exists among adolescents regarding the effect of a low glycemic index (LGI) diet on apolipoproteins and lipoprotein (a) (Lpa). This study was conducted to evaluate the effect of an LGI diet on the lipid profile, apolipoproteins and Lpa among overweight and obese adolescent girls. For this parallel designed randomized clinical trial, 50 healthy overweight/obese girls at pubertal ages were randomly allocated to an LGI or a healthy nutritional recommendations (HNR) based diet. Equal macronutrient distributed diets were prescribed to both groups. Biochemical measurements included lipid profile, apolipoprotein A, apolipoprotein B and Lpa were conducted before and after 10 weeks of intervention. Forty one adolescent girls completed the study. The dietary glycemic index in the LGI group was 42.67 ± 0.067. There were no differences in the mean of blood lipid indices baseline and after intervention between two groups. There were no significant differences between the two groups regarding lipid profiles, apolipoproteins and Lpa. There were no significant differences in lipid profiles, apolipoproteins and Lpa between the LGI diet and the HNR-based diet and the impact of these two diets on lipid profile was equal in this trial. Trial registry code: IRCT201109272839N4. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore the relationships between dietary carbohydrate, other macronutrients, carbohydrate quality and nutritional adequacy in the diets of free-living Australian teenagers, and to consider the implications for total carbohydrate recommendations. Methods: Using the Children's Nutrition and Physical Activity Survey (2007) database, the nutrient intakes of boys and girls aged 14-16 years were assessed by quintile of carbohydrate intake. Results: Carbohydrate intake was inversely associated with intakes of saturated fat, polyunsaturated fat, long-chain omega 3, monounsaturated fat and protein (for each association, P for trend <0.001). Carbohydrate intake was associated with increased intake of fibre in boys ( P for trend <0.05) but not girls, the association being nonlinear. As carbohydrate intake increased, the densities of fibre, vitamin C, folate, thiamin and β-carotene declined and the density of sugar increased, implying a decline in carbohydrate quality. Nutritional adequacy was generally compatible with a wide range of carbohydrate intakes. Conclusions: In combination, the exchanges of carbohydrate for polyunsaturated fat, long-chain omega 3, monounsaturated fat and protein would be expected to increase coronary disease risk via several mechanisms. This implies that there may be a progressive increase in coronary risk as carbohydrate intakes increase across the Acceptable Macronutrient Distribution Range (AMDR), as the exchange of carbohydrate for saturated fat is now considered to be neutral for coronary risk. There is a case for lowering the upper and lower boundaries of the AMDR for carbohydrate intake as a strategy for chronic disease prevention. Lower boundaries would be unlikely to increase the risk for obesity or nutrient inadequacy. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to develop a model for conceptualising the nutritional quality of carbohydrate-rich foods, using nutrient density and glycaemic index. Methods: A nutrient density score based on six distinguishing nutrients was developed. Nutrient density scores and glycaemic indices for 95 carbohydrate-rich foods were plotted on two dimensional axes, arranged into four carbohydrate quality quadrants. The classifications of foods and groups of foods were then assessed against Australian and American dietary guidelines' recommendations. Results: The model showed considerable capacity to discriminate between the nutritional qualities of carbohydrate-rich foods. In general, the ranking of foods was consistent with dietary guidelines' recommendations with most core foods including dairy products, legumes, starchy vegetables, breads and breakfast cereals falling into the two highest quality categories. Non-core foods such as biscuits, donuts, pastries, sweets and soft drinks fell into the lowest quality category. There were two points of inconsistency between the model and the dietary guidelines, in relation to some fruits and cereals. Nutrient density scores for fruits varied widely. Many cereal foods, including rice and pasta, fell in the lower quality categories and were ranked similarly to biscuits and pastries. Total sugar content was a minor discriminator of nutritional quality using this model. Conclusions: Ranking the nutritional quality of carbohydrate-rich foods using this model suggests that dietary recommendations for cereal foods in dietary guidelines and food guides may need to be reconsidered. More emphasis may need to be placed on nutrient density and less on sugar content. [ABSTRACT FROM AUTHOR]