Dietas low carb e low fat e parâmetros cardiometabólicos em participantes do estudo longitudinal de saúde do adulto – ELSA-Brasil
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2025-06-24
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Azevedo, Leticia Batista de
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Universidade Federal do Espírito Santo
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Introduction: Chronic noncommunicable diseases are responsible for approximately 74% of global deaths and are strongly associated with unhealthy dietary patterns. Dietary strategies such as low-carb (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 diets and cardiometabolic outcomes in participants of the Longitudinal Study of Adult Health (ELSA-Brasil), with three specific objectives: (1) to identify sociodemographic, health, and lifestyle factors associated with adherence to LCD and LFD; (2) to analyze the longitudinal association between LCD and cardiometabolic parameters in individuals with and without diabetes; and (3) to investigate the association between adherence to a LFD and variations in waist circumference (WC) in participants of the ELSA-Brasil cohort. Methods: Cross sectional (2008–2010) and longitudinal (2008–2010 and 2017–2019) analyses, whose baseline comprised 15,105 adults aged 35 to 74 years. Information was obtained through interviews, clinical, laboratory, and standardized anthropometric examinations. Dietary intake was assessed by the Food Frequency Questionnaire, with classification of DLC (<45% carbohydrates) and DLF (<30% total fat and <10% salty foods). Logistic and quantile regression models were used, adjusted for sociodemographic and behavioral variations, extensions in the SATA Software version 16.0, statistical significance at p<0.05. Results: Adherence to DLC was higher among individuals with overweight (OR = 1.35), larger waist circumference (OR = 1.45 in men), and former smokers (OR = 1.32 in women). Adherence to DLF was lower among non white individuals (OR = 0.71 in women), ≥52 years (OR = 0.59), and with low physical activity (OR = 0.57 in men). Adherence to DLC over a mean of 9 years among individuals without diabetes was associated with reduced insulin (β = –0.33 µIU/mL), HOMA-IR (β = –0.11), and HOMA-B (β = –4.95), despite the level of increase in BMI. Among individuals with diabetes, greater reductions in HOMA-IR (β = –1.25) and insulin (β = –3.61) were observed. Finally, sustained adherence to DLF (14.4% of the sample) was associated with protection against WC gain, particularly in individuals with a greater tendency to accumulate abdominal adiposity. Conclusion: Adherence to DLC and DLF was associated with improved cardiometabolic indicators, especially insulin sensitivity and cardiovascular risk. The effects were observed even with moderate adherence and varied according to sociodemographic and lifestyle characteristics.
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