{"doi":"10.1001/jamainternmed.2019.6980","title":"Association of Low-Carbohydrate and Low-Fat Diets With Mortality Among US Adults","abstract":"Importance: It is crucial to incorporate quality and types of carbohydrate and fat when investigating the associations of low-fat and low-carbohydrate diets with mortality. Objective: To investigate the associations of low-carbohydrate and low-fat diets with total and cause-specific mortality among US adults. Design, Setting, and Participants: This prospective cohort study used data from the US National Health and Nutrition Examination Survey from 1999 to 2014 from 37 233 adults 20 years or older with 24-hour dietary recall data. Data were analyzed from July 5 to August 27, 2019. Exposures: Overall, unhealthy, and healthy low-carbohydrate-diet and low-fat-diet scores based on the percentage of energy as total and subtypes of carbohydrate, fat, and protein. Main Outcomes and Measures: All-cause mortality from baseline until December 31, 2015, linked to National Death Index mortality data. Results: A total of 37 233 US adults (mean [SD] age, 49.7 [18.3] years; 19 598 [52.6%] female) were included in the present analysis. During 297 768 person-years of follow-up, 4866 total deaths occurred. Overall low-carbohydrate-diet and low-fat-diet scores were not associated with total mortality. The multivariable-adjusted hazard ratios for total mortality per 20-percentile increase in dietary scores were 1.07 (95% CI, 1.02-1.11; P = .01 for trend) for unhealthy low-carbohydrate-diet score, 0.91 (95% CI, 0.87-0.95; P < .001 for trend) for healthy low-carbohydrate-diet score, 1.06 (95% CI, 1.01-1.12; P = .04 for trend) for unhealthy low-fat-diet score, and 0.89 (95% CI, 0.85-0.93; P < .001 for trend) for healthy low-fat-diet score. The associations remained similar in the stratification and sensitivity analyses. Conclusions and Relevance: In this study, overall low-carbohydrate-diet and low-fat-diet scores were not associated with total mortality. Unhealthy low-carbohydrate-diet and low-fat-diet scores were associated with higher total mortality, whereas healthy low-carbohydrate-diet and low-fat-diet scores were associated with lower total mortality. These findings suggest that the associations of low-carbohydrate and low-fat diets with mortality may depend on the quality and food sources of macronutrients.","journal":"JAMA Internal Medicine","year":2020,"id":50605,"datarank":0.7846662925281881,"base_score":5.231108616854587,"endowment":5.231108616854587,"self_citation_contribution":0.7846662925281881,"citation_network_contribution":0.0,"self_endowment_contribution":0.7846662925281881,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":186,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6665,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":249684,"name":"Yanjun Guo","orcid":"0000-0002-5927-778X","position":1,"is_corresponding":false},{"id":55333,"name":"Frank B. Hu","orcid":"0000-0002-8233-6274","position":2,"is_corresponding":false},{"id":249685,"name":"Liegang Liu","orcid":"0000-0002-7029-1224","position":3,"is_corresponding":false},{"id":90132,"name":"Qibin Qi","orcid":"0000-0002-2687-1758","position":4,"is_corresponding":false},{"id":249683,"name":"Zhilei Shan","orcid":"0000-0002-6723-3381","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T20:39:29.006085Z","pmid":"31961383","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}