(P29-002-23) Low-Carbohydrate Dietary Patterns Are Associated With Beneficial Long-Term Changes in Systemic Markers of Inflammation in the Framingham Offspring Cohort

Objectives: To examine the long-term associations between low-carbohydrate diets (LCDs) varying in carbohydrate quality, and changes in biomarkers of inflammation and oxidative stress in a community-dwelling population.

Methods: We used data from the Framingham Offspring cohort study, exams 7 and 8 [1998- 2008; n = 2225; mean ± SD baseline age: 60.1 ± 8.9 y; 55.4% female]. Dietary intakes, health, and lifestyle data were collected at each exam over a median 6.7-y follow-up period. We assessed LCD quality using 3 LCD scores (LCDSs) reflecting higher intake of total fat and protein, and lower intake of (i) total carbohydrate (overall LCDS), (ii) low-quality carbohydrate (high-quality LCDS, HQ-LCDS) and (iii) high-quality carbohydrate (low-quality LCDS, LQ-LCDS). An overall inflammation and oxidative stress score was developed by summing the standardized values of 9 inflammatory biomarkers (C-reactive protein, interleukin 6, monocyte chemoattractant protein 1, P-selectin, tumor necrosis factor receptor II, soluble intercellular adhesion molecule-1, osteoprotegerin, lipoprotein phospholipase A2 mass and activity), along with 2 sub-scores of functionally related biomarkers. Least-square means of changes in the inflammatory scores in quintile categories of LCDSs were estimated using multivariable linear regression models adjusting for potential confounders.

Results: Overall LCDS was inversely associated with changes in the inflammation and oxidative stress score (mean ± SE in Q1: 0.17 ± 0.16, Q5: -0.35 ± 0.16; P<sub>trend= 0.01), indicating that inflammation and oxidative stress increased in those with the lowest LCDS while decreased in those with the highest LCDS. A similar but stronger inverse association was observed between HQ-LCDS and changes in the inflammation and oxidative stress score (Q1: 0.30 ± 0.16, Q5: -0.32 ± 0.16; P<sub>trend < 0.001). An inverse association was observed between overall LCDS and the cytokine sub-score (Q1: 0.09 ± 0.07, Q5: -0.16 ± 0.07; P<sub>trend = 0.04).

Conclusions: LCD patterns based on replacing either total carbohydrate or low-quality carbohydrate sources with fat and protein were associated with decreased inflammation and oxidative stress, which may result in reduced chronic disease risk associated with chronic inflammation in aging populations.

Funding Sources: IAFNS and USDA ARS