Research

Macro partitioning

Adopting a high fat-to-energy ratio (FER) and low carbohydrate-to-energy ratio (CER) diet over the course of adult life significantly increases the risk of obesity, diabetes, and all-cause mortality.

If you are changing your diet to eat more fat and fewer carbohydrates over time, be aware that this specific shift (high fat, low carb) has been linked to higher risks of obesity, diabetes, and death in long-term studies of Chinese adults. Conversely, maintaining a lower fat intake with higher carbohydrates did not show these increased risks after accounting for social factors. Focus on the overall pattern of your diet over years, not just single meals.

ModerateSupportsMEDIUM confidence
Compared to the trajectory-pattern of persistently low-FER (increased from 10 to 20%) and moderate-CER (stable and ranging from 55 to 65%) over the adult life-course, the two trajectory-patterns that showed changing to high-FER and low-CER were significantly associated with obesity [HR 1.83 [95% CI, 1.10–3.04]; HR 1.46 [95% CI, 1.02–2.17]], diabetes [HR 1.80 [95% CI, 1.03–3.16]; HR 1.49 [95% CI, 1.01–2.25]], and all-cause mortality [HR 2.29 [95% CI, 1.35–3.87]; HR 1.62 [95% CI, 1.18–2.22]].
Xiaoyu Guo et al. · Frontiers in Nutrition · 2021

Why this rating

Observational longitudinal study with large sample size but potential for residual confounding despite adjustments.

Source

Twenty-Year Trajectory-Patterns of Percentage Energy From Dietary Fat vs. Carbohydrate Throughout Adult Life and Associations With Cardio-Metabolic Disease and All-Cause Mortality

Xiaoyu Guo et al. · Frontiers in Nutrition · 2021

DOI 10.3389/fnut.2021.701188

cohort · n=10926Cited 7×
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DOI resolved against Crossref · corpus check 2026-06-10

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