Associations between dietary macronutrient composition and cardiometabolic health: data from NHANES 1999-2014

Eur J Nutr. 2024 Dec 7;64(1):41. doi: 10.1007/s00394-024-03523-7.

Abstract

Purpose: Dietary macronutrients significantly impact cardiometabolic health, yet research often focuses on individual macronutrient relationships. This study aimed to explore the associations between dietary macronutrient composition and cardiometabolic health.

Methods: This study included 33,681 US adults (49.7 ± 18.3 years; 52.5% female) from the National Health and Nutrition Examination Survey during 1999-2014. Dietary data was derived from 1 to 2 separate 24-hour recalls and cardiometabolic health included lipid profile, glycemic control, blood pressure, and adiposity collected in a mobile examination center. Associations between dietary macronutrient composition and cardiometabolic health were examined using generalized additive models adjusted for age, socio-demographics, lifestyle, and diet quality.

Results: In females, triglycerides (P < 0.01) and HDL cholesterol (P < 0.01) were the least optimal in diets containing lower fat (10%) and higher carbohydrate (75%). In males, HDL cholesterol was positively associated with fat (P < 0.01) and no association with triglycerides was detected. Total-C associations were male specific (P = 0.01) and highest in diets composed of 25% protein, 30% carbohydrate, and 45% fat. In both sexes, systolic blood pressure (P ≤ 0.02) was highest in diets containing lower fat (10%) coupled with moderate protein (25%). Diastolic blood pressure associations were female specific (P < 0.01) with higher values in those consuming the upper range of fat (55%). There were no associations of macronutrient composition with glycemic control or adiposity.

Conclusion: This study revealed sex-specific relationships between macronutrient composition and cardiometabolic health. Future research is needed to explore these relationships across age groups.

Keywords: Cardiometabolic health; Cardiovascular disease; Diet; Macronutrients; NHANES.

MeSH terms

  • Adiposity
  • Adult
  • Aged
  • Blood Glucose / analysis
  • Blood Glucose / metabolism
  • Blood Pressure* / physiology
  • Cardiometabolic Risk Factors
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / prevention & control
  • Cholesterol, HDL / blood
  • Cross-Sectional Studies
  • Diet* / methods
  • Diet* / statistics & numerical data
  • Dietary Fats / administration & dosage
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nutrients* / administration & dosage
  • Nutrition Surveys* / methods
  • Nutrition Surveys* / statistics & numerical data
  • Triglycerides / blood
  • United States / epidemiology

Substances

  • Triglycerides
  • Cholesterol, HDL
  • Blood Glucose
  • Dietary Fats