About The Buzz: High Carbohydrate Intake Connected to Higher Risk of Mortality?

TheBUZZ High Carbohydrate Intake Connected to Higher Risk of Mortality?


New research observing 135,000 people from five (5) continents indicates that moderate fat intake and lower carbohydrate intake may reduce risk of death.


The Prospective Urban Rural Epidemiology (PURE) study is a large cohort study (cohort studies follow participants for years to collect valuable research information, instead of days, weeks or months) spanning 18 countries with an average follow-up of 7.5 years. The study assessed the relationship between macronutrients – carbohydrates, fat and protein – and risk of mortality and cardiovascular disease.

Participants were between ages 35-70 years and from the following countries: Canada, Sweden, United Arab Emirates (high-income), Argentina, Brazil, Chile, China, Columbia, Iran, Malaysia, occupied Palestinian territory, Poland, South Africa, Turkey (middle-income), Bangladesh, India, Pakistan and Zimbabwe (low-income). Information on socioeconomic status (education, income, employment), lifestyle (smoking, physical activity and alcohol intake), health history, medication use and a physical assessment that included height, weight, hip circumference, and blood pressure were collected. To assess habitual food intake, participants completed country-specific food frequency questionnaires at the beginning of the study and were contacted annually to reassess health status and dietary intake.

In all regions except Africa, the most common cause of mortality was cancer, followed by respiratory disease. In Africa, infectious disease was the leading cause of death, followed by respiratory diseases. Carbohydrate intake was highest in China, south Asia and Africa, with 65% of south Asian participants consuming at least 60% of energy from carbohydrates and 33% consuming more than 70% from carbohydrates. Individuals from low- and middle-income countries consumed a very high carbohydrate diet, especially from highly refined sources, such as white bread and white rice.


Study results indicated that, in all countries, higher carbohydrate intake (more than 60% of total daily energy) was associated with higher risk of death overall, but not with cardiovascular disease, heart attack, stroke and cardiovascular disease death. Higher fat intake was associated with a lower risk of death, non-cardiovascular disease mortality and stroke. In fact, by replacing carbohydrates with saturated fatty acids, participants reduced their risk of stroke by 20%.


Every day in the United States 2,200 Americans die from cardiovascular disease, an average of one (1) death every 40 seconds.2 Those numbers translate to 800,000 deaths per year – more than the total deaths from all forms of cancer combined.2 Diet plays a major role in the development of cardiovascular diseases. The daily food choices we make have a huge impact on our current and long-term health. The good news is that improving diet and lifestyle may have a positive effect on your health. For example, by quitting smoking, a person can lower their blood pressure and heart rate and reduce their risk of heart attack within 24 hours.3

For decades, fat consumption has been frowned upon “based on the presumption that that replacing saturated fatty acids with carbohydrates and unsaturated fats would lower LDL (bad) cholesterol and therefore should reduce cardiovascular disease events.”1 In this study, researchers concluded that increasing total fat intake to about 35% of energy while also lowering carbohydrate intake might lower risk of death.


Since fruit, vegetables and legumes contain some carbohydrates, it can be easy to misunderstand how to decrease carbohydrates with dietary guidance. Consider swapping highly refined carbohydrates, such as white rice and white bread, for whole grain alternatives whenever possible.


1 Dehghan, Mahshid et al. “Associations of Fats and Carbohydrate Intake with Cardiovascular Disease and Mortality in 18 Countries from Five Continents (PURE): a Prospective Cohort Study.” The Lancet, Elsevier, 29 Aug. 2017. View
2 Benjamin, Emelia J et al. “Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association.” Circulation, American Heart Association, Inc., 1 Jan. 2017. View
3 “Benefits of Quitting.” Smokefree.gov, U.S. Department of Health and Human Services. View

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