Evidence map›Paper›PMID 36678215›Full record

ArticleNutrients2023

Multi-Nutrient Analysis of Dietary Macronutrients with All-Cause, Cardiovascular, and Cancer Mortality: Data from NHANES 1999-2014.

Nicholas A Koemel, Alistair M Senior, David S Celermajer, Amanda Grech, Tim P Gill, Stephen J Simpson, David Raubenheimer, Michael R Skilton

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nutrients, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
3.5field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Nicholas A KoemelCharles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
Alistair M SeniorCharles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
David S CelermajerSydney Medical School, The University of Sydney, Sydney 2006, Australia.ORCID 0000-0001-7640-0439
Amanda GrechCharles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
Tim P GillCharles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
Stephen J SimpsonCharles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
David RaubenheimerCharles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
Michael R SkiltonCharles Perkins Centre, The University of Sydney, Sydney 2006, Australia.ORCID 0000-0003-2793-2388
The University of Sydney · AU

Funding

National Health and Medical Research Council GNT1149976University of Sydney Faculty of Medicine and Health Executive Dean Stipend Scholarship
6 · The paper itself

Abstract

Macronutrients are a major component of the human diet. However, few studies have assessed their collective association with mortality. We sought to evaluate the associations of macronutrient intake with all-cause, cardiovascular, and cancer mortality in US adults using a multi-nutrient approach. This prospective cohort analysis used data from the National Health and Nutrition Examination Survey from the years 1999 to 2014. The participants included 33,681 US adults aged 20−85 years (52.5% female). The maximum follow-up time was 16.8 years, with a total of 4398 total deaths, including 772 cardiovascular deaths and 952 cancer deaths. The associations between mortality and dietary macronutrients were explored using three-dimensional generalized additive models, allowing for visual and statistical inference of complex nonlinear associations. Absolute macronutrient intake demonstrated a three-way interactive association with all-cause mortality (p < 0.001), cardiovascular mortality (p = 0.02), and cancer mortality (p = 0.05), adjusted for age, sex, ethnicity, socioeconomic status, dietary quality, and lifestyle. Compositionally, a high caloric diet composed of moderately high protein (20%), moderate fat (30%), and moderate carbohydrate (50%) levels was associated with the highest mortality risk. Across the total energy intake levels, lower mortality risk was observed in two separate regions consisting of higher protein (30%), higher carbohydrate (60%), and lower fat levels (10%) or lower protein (10%), moderate carbohydrate (45%), and higher fat levels (45%). These findings highlight a complex nonlinear and interactive association between macronutrients and all-cause mortality such that several distinct dietary compositions are associated with similarly high or low risk. Future research is needed to explore the drivers of these associations and whether they differ across varying dietary patterns and populations.

Indexed as

Dietary CarbohydratesNeoplasmsAdultDietDiet, Fat-RestrictedEnergy IntakeFemaleHumansMaleNutrientsNutrition SurveysProspective StudiesDietary CarbohydratesNutrientscancercardiovascular diseasedietmacronutrientsmortalityNHANES

Identifiers

PMID36678215
PMCPMC9865351
OpenAlexW4315648623

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.