LOW CARB AND LOW FAT DIETS AND CARDIOMETABOLIC PARAMETERS IN PARTICIPANTS OF THE LONGITUDINAL STUDY OF ADULT
HEALTH – ELSA-Brasil
Name: LETICIA BATISTA DE AZEVEDO
Publication date: 24/06/2025
Examining board:
Name |
Role |
|---|---|
| MARIA DEL CARMEN BISI MOLINA | Presidente |
| OSCAR GEOVANNY ENRIQUEZ MARTINEZ | Coorientador |
| TAÍSA SABRINA SILVA PEREIRA | Examinador Externo |
| VALDETE REGINA GUANDALINI | Examinador Interno |
Summary: Introduction: Noncommunicable chronic diseases
are responsible for approximately 74% of global deaths and are strongly
associated with less healthy dietary patterns. Dietary strategies such as
low-carbohydrate (LCD) and low-fat (LFD) diets have been studied for their
potential benefits on cardiometabolic health. Objective: To evaluate the
association between adherence to LCD and LFD and cardiometabolic parameters
among participants of the ELSA-Brasil study, through three specific aims: (1)
to identify sociodemographic, health, and lifestyle factors associated with
adherence to LCD and LFD; (2) to analyze the longitudinal association between
LCD adherence and cardiometabolic parameters in individuals with and without
diabetes; and (3) to investigate the impact of sustained adherence to LFD on
the estimated 10-year cardiovascular risk. Methods: Cross-sectional
(2008–2010) and longitudinal (2017–2019) data from the ELSA-Brasil cohort
were analyzed, involving up to 15,105 adults aged 35 to 74 years. Information
was collected through structured interviews and standardized clinical,
laboratory, and anthropometric assessments. Dietary intake was assessed using
a validated Food Frequency Questionnaire, with LCD defined as <45% of total
energy from carbohydrates and LFD as <30% of total fat and <10% saturated
fat. Logistic and quantile regression models were applied, adjusted for
sociodemographic and behavioral variables. Results: Adherence to LCD was
higher among individuals with overweight (OR = 1.35), increased waist
circumference (OR = 1.45 in men), and former smokers (OR = 1.32 in women).
Adherence to LFD was lower among non-white individuals (OR = 0.71 in women),
those aged 52 years (OR = 0.59), and men with low physical activity (OR =
0.57). LCD adherence was associated with reductions in insulin ( = –0.33
µIU/mL), HOMA-IR ( = –0.11), and HOMA-B ( = –4.95), despite a slight
increase in BMI. Among individuals with diabetes, greater reductions in
HOMA-IR ( = –1.25) and insulin levels ( = –3.61) were observed.
Finally, sustained adherence to LFD (14.4% of the sample) was significantly
associated with lower estimated 10-year cardiovascular risk, particularly in
the upper percentiles of the distribution. Conclusion: Adherence to both LCD
and LFD was associated with improvements in cardiometabolic indicators,
especially insulin sensitivity and cardiovascular risk. These effects were
observed even with moderate adherence and varied according to
sociodemographic and lifestyle characteristics.
