ArticleDiabetes care2025
Low-Carbohydrate Diets of Varying Macronutrient Quality and Risk of Type 2 Diabetes in Three U.S. Prospective Cohort Studies.
Article in Diabetes care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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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.
The trial behind it
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Who cites it
5 citing papers in PubMed.
- Association of breakfast skipping with diet-quality-based low-carbohydrate and low-fat diet scores and metabolic syndrome components among Korean young adults: Korea National Health and Nutrition Examination Survey 2021-2023.Nutrition research and practice · 2026Article
- Plant-Based Nutrition and Type 2 Diabetes Mellitus: Prevention, Risk, Metabolic Health and the Role of Legumes, Dietary Fiber, and Red Meat.Nutrients · 2026Review
- Planetary health diet index and risk of irritable bowel syndrome: a prospective cohort study.European journal of nutrition · 2026Article
- Comment on Liu et al. Low-Carbohydrate Diets of Varying Macronutrient Quality and Risk of Type 2 Diabetes in Three U.S. Prospective Cohort Studies. Diabetes Care 2025;48:2095-2102.Diabetes care · 2026Article
- Four night eating behavior subtypes in young and middle-aged adults with type 2 diabetes: insights for targeted public health interventions.Frontiers in public health · 2026Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveTo prospectively examine associations between five low-carbohydrate diets (LCDs), differentiated by macronutrient quality, and type 2 diabetes (T2D) risk. RESEARCH DESIGN AND
methodsThis cohort study included 199,006 U.S. adults from the Nurses' Health Study (NHS) (1984-2018), NHSII (1991-2019), and Health Professionals Follow-up Study (1986-2018); free of T2D, cardiovascular disease, and cancer at baseline; and followed over 30 years. Diet was assessed every 2-4 years using validated food frequency questionnaires since baseline. Five LCD scores were derived based on intakes of protein, fat, and carbohydrates from contrasting food sources. The primary outcome was incident T2D.
resultsDuring 4,987,761 person-years of follow-up, 20,452 T2D cases were documented. After adjustments for baseline BMI and other covariates, higher overall LCD score was associated with higher T2D risk (hazard ratio comparing highest vs. lowest quintile 1.31 [95% CI 1.25-1.37]; P-trend < 0.001). An animal-based LCD emphasizing animal protein and fat and an unhealthy LCD score further deemphasizing whole grains and other high-quality carbohydrates were associated with higher T2D risk (1.39 [1.32-1.45] and 1.44 [1.37-1.51]; both P-trend < 0.001). In contrast, a vegetable-based LCD emphasizing plant protein and fat was associated with a 6% lower T2D risk (0.94 [0.90-0.98]; P-trend = 0.004), and a healthy LCD further deemphasizing refined carbohydrates was associated with a 16% lower T2D risk (0.84 [0.81-0.88]; P-trend < 0.001]). Associations for overall, animal-based, and unhealthy LCDs were stronger among participants with lower baseline BMI and were partially mediated by weight change.
conclusionsLCDs may not be beneficial for primary prevention of T2D unless they prioritize plant-based protein, healthy fats, and high-quality carbohydrates.
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