Macro partitioning
High intake of starch (primarily from rice) is inversely associated with total, cardiovascular, and non-cancer/non-cardiovascular mortality in Japanese men, whereas high intake of total sugars (including glucose, fructose, and sucrose) is positively associated with these mortality risks.
For Japanese men, prioritizing starch (like rice) over sugars (including glucose, fructose, and sucrose) is associated with lower mortality risk. High sugar intake, regardless of source (free or natural), is linked to higher mortality. Women showed no significant association for starch, but free sugar intake was positively associated with mortality. Focus on reducing total sugar intake rather than just free sugars, and maintain starch intake as a primary energy source.
In men, intake of starch was inversely associated with total mortality after controlling for covariates (hazard ratio (HR) for the highest quartile v. lowest quartile: 0·71; 95 % CI 0·60, 0·84; Ptrend < 0·001). Intakes of total sugars, glucose, fructose, sucrose, maltose and free and naturally occurring sugars were significantly positively associated with total mortality in men (HR for the highest v. lowest quartile of total sugar: 1.27; 95 % CI 1.12, 1.45; Ptrend < 0.0001).
Why this rating
Large prospective cohort (n=29,079), long follow-up (16 years), validated FFQ, and adjustment for extensive covariates; however, observational design limits causal inference.
Source
Intake of starch and sugars and total and cause-specific mortality in a Japanese community: the Takayama Study
Chisato Nagata et al. · British Journal Of Nutrition · 2019
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