Nutritional determinants of the increase in energy intake associated with a high-fat diet

Two studies were performed to evaluate the short-term effect of a high-fat diet on spontaneous energy intake and the respective contribution of diet composition and energy density of food. Ingestion of high-fat foods was associated with a significant increase in energy intake in the two studies (P less than 0.05). In study 1 this increase was accompanied by a reduction in total weight of food consumed when compared with values obtained under low-fat-diet conditions. Moreover, the occurrence of satiety coincided with a level of carbohydrate intake corresponding to the expected daily carbohydrate oxidation when high-fat foods contained a moderate amount of carbohydrates. In study 2, where the carbohydrate content of high-fat foods was unusually low (less than or equal to 25% of their energy content), carbohydrate intake was lower than usual carbohydrate oxidation. Under the conditions of this study, energy density of foods seemed to play a significant role on the occurrence of satiety.     

Carbohydrates, appetite and feeding behavior in humans

The view of carbohydrates in relation to obesity has changed over the past few decades from being conducive to overconsumption and weight gain to being protective. This article reviews the mechanisms by which carbohydrate is purported to protect against weight gain. Although carbohydrate is metabolized and stored in the body less efficiently than fat, when de novo lipogenesis is invoked on very high carbohydrate diets, the beneficial effect on energy balance is likely to be minimal when typical high fat Western diets are consumed. However, it has been suggested that high carbohydrate foods may influence energy balance by reducing food intake through greater satiety effects, reducing energy density and displacing fat from the diet-the fat-sugar seesaw effect. To date, there seem to be few differences between sugars and starches on satiety and energy intake, but few studies have examined this. Some reduced-fat, and, therefore, higher carbohydrate, foods are highly energy dense. High carbohydrate foods do not necessarily have a low energy density. Evidence from recent studies suggests that adding carbohydrate, and especially sugar, to the diet neither displaces fat from the diet nor protects against elevated energy intake. Although it is easier to overeat on high fat than low fat foods, simply replacing fat with carbohydrate in the diet may not be as protective against overconsumption as the energy density or fat-sugar seesaw arguments suggest.     

The effect of food intake on mood

Literature consistently demonstrates that individuals experiencing emotional distress, especially depression, report a craving and preference for sweet carbohydrate/fat rich foods. This relationship exists in individuals experiencing fall/winter seasonal affective disorder, premenstrual syndrome, and some obse individuals. The cravings and preference for these foods occur only during the fall and winter in indivuduals with seasonal affective disorder and in the luteal phase of the menstrual cycle in individuals with premenstrual disorder which is the time when symptoms of depression are experienced. Additionally, unipolar depressed individuals increase their preference for sweet carbohydrate/fat rich foods as they become depressed. They also increase their consumption of carbohydrates from sucrose. Several studies indicate that sweet carbohydrate/fat rich foods are consumed because of the resulting mood enhancement. However, other studies have revealed that elimination of intake of added sucrose and/or caffeine from the diet of unipolar depressed individuals results in an amelioration of depression that is maintained as long as the substance they are sensitive to, added sucrose or caffeine, is not consumed. The cravings and preference which some depressed individuals have for sweet carbohydrate/fat rich foods seems to result from the enhancement in mood following consumption. Paradoxically, however, a better long-term strategy for mood enhancement may be to totally eliminate added sucrose and caffeine from the diet of depressed individuals.     

Craving for sweet carbohydrate and fat-rich foods – possible triggers and impact on nutritional intake

Summary  This paper presents a review of the literature pertaining to the measurement and prevalence of, and triggers for, cravings for sweet carbohydrate and fat-rich foods, and considers the impact of such cravings on nutrient intake. Difficulties in defining the construct and measurement of food cravings are discussed, and recent progress highlighted in the measurement arena by the development of two psychometric instruments that appear to have good validity and reliability. With regards to triggers for cravings for sweet carbohydrate and fat-rich foods, most studies have focused on negative mood state. While it is likely that a variety of food-related cues may influence cravings ( e.g. the smell, sight, taste, and mouth-feel or texture of food, as well as thoughts of and images of food), this is an area that has received relatively little attention in the scientific literature. Similarly, there is a lack of information about the impact of cravings on nutrient intake. Preliminary data indicate that, at least for older people, cravers' nutrient intake meets or exceeds the recommended daily amounts for most nutrients. However, energy intake is higher among cravers compared with non-cravers, and a greater proportion of their energy comes from carbohydrates, especially sugars. This may have an adverse effect on subsequent weight gain. Indeed, these preliminary data found cravers to have a higher body mass index than non-cravers.     

Fenfluramine suppresses snack intake among carbohydrate cravers but not among noncarbohydrate cravers

Two groups of obese individuals who consume excessive calories primarily as snack foods have been distinguished: carbohydrate cravers and noncarbohydrate cravers. Both groups consume about 800 calories from snacks (860 kcal vs 879 kcal) and about 2000 calories from meals (1906 kcal vs 2080 kcal) daily. The carbohydrate-cravers consume almost all of their snacks as carbohydrate-rich foods (7 ± 0.4 CHO snacks/day vs 0.9 ± 0.12 protein snacks/day) whereas the noncarbohydrate cravers consume approximately equal numbers of protein and carbohydrate snacks (4.5 ± 0.6 carbohydrate snacks/day vs 3.5 ± 0.5 protein snacks/day). D-fenfluramine significantly reduced the intakes of calories (range 24–44%) and carbohydrates (range 28–41%) from snacks among the carbohydrate cravers over a three month treatment period. The drug did not affect snack intake by the noncarbohydrate cravers until the third month of treatment when the consumption of both types of snacks decreased significantly. D-fenfluramine decreased mealtime carbohydrate intake among the carbohydrate cravers throughout the treatment period (range 16–23%); mealtime protein intake declined comparably (range 14–18%) during the first and third treatment months. The drug had no effect on mealtime carbohydrate nor protein intake by noncarbohydrate cravers.     

Carbohydrate bioavailability

There is consensus that carbohydrate foods, in the form of fruit, vegetables and whole-grain products, are beneficial to health. However, there are strong indications that highly processed, fibre-depleted, and consequently rapidly digestible, energy-dense carbohydrate food products can lead to over-consumption and obesity-related diseases. Greater attention needs to be given to carbohydrate bioavailability, which is determined by the chemical identity and physical form of food. The objective of the present concept article is to provide a rational basis for the nutritional characterisation of dietary carbohydrates. Based on the properties of carbohydrate foods identified to be of specific relevance to health, we propose a classification and measurement scheme that divides dietary carbohydrates into glycaemic carbohydrates (digested and absorbed in the small intestine) and non-glycaemic carbohydrates (enter the large intestine). The glycaemic carbohydrates are characterised by sugar type, and by the likely rate of digestion described by in vitro measurements for rapidly available glucose and slowly available glucose. The main type of non-glycaemic carbohydrates is the plant cell-wall NSP, which is a marker of the natural fibre-rich diet recognised as beneficial to health. Other non-glycaemic carbohydrates include resistant starch and the resistant short-chain carbohydrates (non-digestible oligosaccharides), which should be measured and researched in their own right. The proposed classification and measurement scheme is complementary to the dietary fibre and glycaemic index concepts in the promotion of healthy diets with low energy density required for combating obesity-related diseases.     

Nutritional/physiologic assessment of carbohydrates

Out of the energy-rich nutrients the reduction in the dietary intake of fats entails an increase in carbohydrate intake. The various carbohydrates owing to differences in their chemical and physical properties influence differentially satiety, and plasma levels of glucose and lipids. The present survey gives a short account on the carbohydrates occurring in the nutrients, deals with their effects on metabolism, and discusses the relationship between carbohydrate intake and obesity on the basis of recent research findings. At present, it appears that there is no convincing evidence available, which would suggest that the action by simple sugars and by complex carbohydrates is different on glucose tolerance, plasma lipid profile, and on the development of obesity.     

中国成人膳食生糖负荷现状调查

目的了解目前中国居民碳水化合物的消费情况与成人膳食生糖负荷的现状。方法使用2002年中国居民营养与健康状况调查数据,根据食物血糖生成指数(glycemic index,GI)和碳水化合物摄入量计算膳食生糖负荷(glycemic load,GL)。分析中国成人膳食GL的性别、年龄和城乡分布,分析不同膳食GL/4184kJ水平居民的膳食结构,探索中国成人膳食GL/4184kJ的合理范围。结果我国成人膳食GL92%来源于粮谷类。每人每日膳食GL平均为269.5,农村287.3,城市233.0,农村高于城市。青年平均为279.0,中年272.2,老年238.8,青年最高,其次是中年,最低是老年。男性平均为292.8,女性249.0,男性高于女性。低膳食GL/44184kJ的人群膳食碳水化合物供能比低,脂肪供能比高,粮谷类消费低,脂肪消费高,超重和肥胖发生率高。结论粮谷类是我国成人膳食GL的最主要来源。我国居民低膳食GL/4184kJ的人群粮谷类消费过低,脂肪消费过高,膳食结构不合理。城市居民较农村居民更为严重。以人群粮谷类食物摄入量、碳水化合物供能比、脂肪供能比在推荐的合理范围为依据,初步认为中国成人的膳食GL/4184kJ适宜范围为80~120。     

Carbohydrate and the Regulation of Blood Glucose and Metabolism

Classifying the glycemic responses of carbohydrate foods using the glycemic index (GI) requires standardized methodology for valid results. Dietary carbohydrates influence metabolism by at least four mechanisms: nature of the monosaccharides absorbed, amount of carbohydrate consumed, rate of absorption, and colonic fermentation. Reducing glycemic responses by reducing carbohydrate intake increases postprandial serum free-fatty acids (FFA) and does not improve overall glycemic control in diabetic subjects. By contrast, low-GI diets reduce serum FFA and improve glycemic control. Thus, current evidence supports FAO/WHO recommendations to maintain a high-carbohydrate diet and choose low-GI starchy foods.     

Cholecystokinin-A receptors are involved in food intake suppression in rats after intake of all fats and carbohydrates tested

The hypothesis of these studies was that all fats and carbohydrates suppress food intake, at least in part, via cholecystokinin-A receptors (CCKAR). Fat (coconut oil, beef tallow, olive and safflower oil) and carbohydrate (cornstarch, sucrose, glucose and fructose) preloads were given intragastrically (1 g/4 mL) 30 min before feeding. Devazepide (0.25 mg/kg), a CCKAR antagonist, was given intraperitoneally at 60 or 30 min before or with each of the macronutrient preloads. Devazepide reversed food intake suppression caused by all fat and carbohydrate sources, but the effect was not consistently related to the time of devazepide administration or to any specific feeding interval. Among the fats, coconut and olive oil were most responsive to devazepide. The effect of all carbohydrates on food intake was decreased by devazepide. We conclude that CCKAR play a role in food intake suppression caused by all fats and carbohydrates, but their role is dependent upon the composition of the fat or carbohydrate.     

Low carbohydrate diets, pro: time to rethink our current strategies.

Obesity-attributable medical expenditures in the United States are estimated at 75 billion dollars annually, half of which are financed by Medicare and Medicaid. In 2002, the estimated 80,000 bariatric surgical procedures cost between 15,000 to 30,000 dollars per patient. It is now believed that poor diet and physical inactivity may soon overtake tobacco as the leading cause of death. These findings, along with escalating health care costs and an aging population, are compelling reasons for US health care and public health systems to create more effective preventive approaches than have been used to date to reverse this epidemic. According to current trends, obesity will become the #1 cause of death by 2005, with the toll surpassing 500,000 deaths a year, rivaling the annual deaths from cancer. Conditions of overweight and obesity are associated with diabetes, hypertension, hypercholesterolemia, asthma, arthritis, and poor health status. The successful experiences by many individuals who have limited their carbohydrate intake and mounting scientific studies supporting low- or controlled-carbohydrate diets' physiologic and metabolic action warrant a closer look at this dietary regimen as a potentially viable option to current conventional approaches. For individuals with high serum triglyceride and low high-density lipoprotein (HDL) levels, truncal obesity, or insulin resistance (metabolic syndrome or hyperinsulinemia), reducing carbohydrate intake has been shown to improve these parameters without adverse clinical effects. Studies are beginning to validate the benefit of controlling carbohydrate intake for individuals with type 2 diabetes. The controlled-carbohydrate regimen could be a viable alternative dietary approach for weight management used by clinicians managing patients who are failing with conventional approaches. This can be achieved by either restricting carbohydrates initially and then adding back healthy carbohydrate choices until the individual's carbohydrate threshold is achieved or by eliminating carbohydrate foods one at a time from the diet until carbohydrates are limited enough to achieve weight loss and improve clinical parameters. One diet approach does not fit all patients. Some individuals might do best on a very-low-fat, high-carbohydrate diet, whereas others may respond to lowering carbohydrate intake. Identifying specific needs and health conditions of each individual is key to successful application of the best approach and management for long-term success of weight loss in conjunction with improved health.     

Comparison of the effects of dried peas with those of potatoes in mixed meals on postprandial glucose and insulin concentrations in patients with type 2 diabetes

BACKGROUND: Data on the blood glucose response of diabetic patients to mixed meals containing food both rich in fiber and with a low glycemic index, such as dried peas, is scarce. Thus, the extent to which type 2 diabetic patients should take into account low-glycemic, high-fiber foods for their daily carbohydrate intake is uncertain. OBJECTIVE: We compared the glycemic and insulinemic responses to 3 different meals based on dried peas, potatoes, or both in patients with type 2 diabetes undergoing dietary treatment. DESIGN: The meals, prepared according to local recipes and consumed at weekly intervals in random order at lunchtime, contained comparable amounts of carbohydrate, fat, protein, and water. The carbohydrate source of the meals differed and was supplied from either dried peas (meal 1), potatoes (meal 3), or a combination thereof (meal 2). Peripheral and venous blood was sampled over 180 min. RESULTS: The increases in postprandial plasma glucose and insulin concentrations were delayed and significantly smaller after the pea meal than after the potato meal. The areas under the glucose curve were 164 +/- 40, 257 +/- 57, and 381 +/- 40 mmol x 180 min/L for meals 1, 2, and 3, respectively (P < 0.01). The areas under the insulin curve were 13.8 +/- 4.3, 15.4 +/- 3.9, and 31.2 +/- 6.9 nmol x 180 min/L, respectively (P = 0.0514). CONCLUSION: These findings suggest that carbohydrates in dried peas may be largely disregarded in carbohydrate counting and that type 2 diabetic patients should probably increase their consumption of low-glycemic, high-fiber foods at the expense of high-glycemic, low-fiber foods.     

Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature

A number of reviewers have examined studies investigating the relationship between coronary heart disease and stroke prior to 2000. Since then, several key studies have been published. Five studies have examined the relationship between wholegrain consumption, coronary heart disease (CHD) and cardiovascular (CVD) disease and found protection for either or both diseases. The researchers concluded that a relationship between wholegrain intake and CHD is seen with at least a 20% and perhaps a 40% reduction in risk for those who eat wholegrain food habitually vs those who eat them rarely. Notwithstanding the fact that fibre is an important component of wholegrains, many studies have not shown an independent effect of fibre alone on CHD events. Thus in terms of CHD prevention, fibre is best obtained from wholegrain sources. Wholegrain products have strong antioxidant activity and contain phytoestrogens, but there is insufficient evidence to determine whether this is beneficial in CHD prevention. Soluble fibre clearly lowers cholesterol to a small but significant degree and one would expect that this would reduce CHD events. There have been a small number of epidemiological studies showing soy consumption is associated with lower rates of heart disease. Countering the positive evidence for wholegrain and legume intake has been the Nurses Health Study in 2000 that showed women who were overweight or obese consuming a high glycaemic load (GL) diet doubled their relative risk of CHD compared with those consuming a low GL diet. Although the literature relating GL with CHD events is somewhat mixed, the relationship with risk factors such as HDL cholesterol, triglyceride and C reactive protein is relatively clear. Thus, carbohydrate-rich foods should be wholegrain and, if they are not, then the lowest glycaemic index (GI) product should be used. Promotion of carbohydrate foods should be focused on wholegrain cereals because these have proven to be associated with health benefits. There is insufficient evidence about whether the addition of other components of wholegrains such as polyphenolics or minerals (such as magnesium or zinc) would improve the health benefits of refined grain foods and this needs investigation. Whether adding bran to refined carbohydrate foods can improve the situation is also not clear, and it was found that added bran lowered heart disease risk in men by 30%. This persisted after full adjustment (including GL) suggesting, at least in men, that fibre may be more important than GI. Thus there are two messages: The intake of wholegrain foods clearly protects against heart disease and stroke but the exact mechanism is not clear. Fibre, magnesium, folate and vitamins B6 and vitamin E may be important.The intake of high GI carbohydrates (from both grain and non-grain sources) in large amounts is associated with an increased risk of heart disease in overweight and obese women even when fibre intake is high but this requires further confirmation in normal-weight women.Recommendation: Carbohydrate-rich foods should be wholegrain and if they are not, then the lowest GI product available should be consumed. Glycemic index is largely irrelevant for foods that contain small amounts of carbohydrate per serve (such as most vegetables).     

Fructose, glycemic load, and quantity and quality of carbohydrate in relation to plasma C-peptide concentrations in US women

BACKGROUND: Circulating C-peptide concentrations are associated with insulin resistance and the development of type 2 diabetes. However, associations between fructose and the quantity and quality of total carbohydrate intake in relation to C-peptide concentrations have not been adequately examined. OBJECTIVE: We assessed the association of dietary fructose, glycemic load, and carbohydrate intake with fasting C-peptide concentrations. DESIGN: Plasma C-peptide concentrations were measured in a cross-sectional setting in 1999 healthy women from the Nurses' Health Study I and II. Dietary fructose, glycemic load, and carbohydrate intake were assessed with the use of semiquantitative food-frequency questionnaires. RESULTS: After multivariate adjustment, subjects in the highest quintile of energy-adjusted fructose intake had 13.9% higher C-peptide concentrations (P for trend = 0.01) than did subjects in the lowest quintile. Similarly, in the multivariate model, subjects in the highest quintile of glycemic load had 14.1% (P for trend = 0.09) and 16.1% (P for trend = 0.04) higher C-peptide concentrations than did subjects in the lowest quintile after further adjustment for total fat or carbohydrate intake, respectively. In contrast, subjects with high intakes of cereal fiber had 15.6% lower (P for trend = 0.03) C-peptide concentrations after control for other covariates. CONCLUSIONS: Our results suggest that high intakes of fructose and high glycemic foods are associated with higher C-peptide concentrations, whereas consumption of carbohydrates high in fiber, such as whole-grain foods, is associated with lower C-peptide concentrations. Furthermore, our study suggests that these nutrients play divergent roles in the development of insulin resistance and type 2 diabetes.     

Food Preferences of Patients with Citrin Deficiency

Citrin deficiency is characterized by a wide range of symptoms from infancy through adulthood and presents a distinct preference for a diet composed of high protein, high fat, and low carbohydrate. The present study elucidates the important criteria by patients with citrin deficiency for food selection through detailed analysis of their food preferences. The survey was conducted in 70 citrin-deficient patients aged 2–63 years and 55 control subjects aged 2–74 years and inquired about their preference for 435 food items using a scale of 1–4 (the higher, the more favored). The results showed that the foods marked as “dislike” accounted for 36.5% in the patient group, significantly higher than the 16.0% in the controls. The results also showed that patients clearly disliked foods with 20–24 (% of energy) or less protein, 45–54% (of energy) or less fat, and 30–39% (of energy) or more carbohydrate. Multiple regression analysis showed carbohydrates had the strongest influence on patients’ food preference (β = −0.503). It also showed female patients had a stronger aversion to foods with high carbohydrates than males. The protein, fat, and carbohydrate energy ratio (PFC) of highly favored foods among patients was almost the same as the average PFC ratio of their daily diet (protein 20–22: fat 47–51: carbohydrates 28–32). The data strongly suggest that from early infancy, patients start aspiring to a nutritional balance that can compensate for the metabolism dissonance caused by citrin deficiency in every food.     

Effect of Glycemic Carbohydrates on Short-term Satiety and Food Intake

We examine the relationships between glycemic carbohydrate and its effects on short-term satiety and food intake. Both high- and low-glycemic carbohydrates have an impact on satiety, but their effects have different time courses. High-glycemic carbohydrates are associated with a reduction in appetite and food intake in the short term (e.g., one hour), whereas the satiating effects of lower-glycemic carbohydrates appear to be delayed (e.g., 2 to 3 hours). There is no consistent evidence that an increase in blood glucose, either acute or sustained, is the primary determinant of their effects on food intake and satiety. Many other preabsorptive and postabsorptive signals for satiety exist and may be the determining factors. Further studies are needed to delineate the role of glycemic carbohydrates and their mechanisms of action in determining satiety.     

The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010?

Current dietary recommendations advise reducing the intake of saturated fatty acids (SFAs) to reduce coronary heart disease (CHD) risk, but recent findings question the role of SFAs. This expert panel reviewed the evidence and reached the following conclusions: the evidence from epidemiologic, clinical, and mechanistic studies is consistent in finding that the risk of CHD is reduced when SFAs are replaced with polyunsaturated fatty acids (PUFAs). In populations who consume a Western diet, the replacement of 1% of energy from SFAs with PUFAs lowers LDL cholesterol and is likely to produce a reduction in CHD incidence of ≥2-3%. No clear benefit of substituting carbohydrates for SFAs has been shown, although there might be a benefit if the carbohydrate is unrefined and has a low glycemic index. Insufficient evidence exists to judge the effect on CHD risk of replacing SFAs with MUFAs. No clear association between SFA intake relative to refined carbohydrates and the risk of insulin resistance and diabetes has been shown. The effect of diet on a single biomarker is insufficient evidence to assess CHD risk. The combination of multiple biomarkers and the use of clinical endpoints could help substantiate the effects on CHD. Furthermore, the effect of particular foods on CHD cannot be predicted solely by their content of total SFAs because individual SFAs may have different cardiovascular effects and major SFA food sources contain other constituents that could influence CHD risk. Research is needed to clarify the role of SFAs compared with specific forms of carbohydrates in CHD risk and to compare specific foods with appropriate alternatives.     

Glycemic index in chronic disease: a review

AIM: The intent of this review is to critically analyze the scientific evidence on the role of the glycemic index in chronic Western disease and to discuss the utility of the glycemic index in the prevention and management of these disease states. BACKGROUND: The glycemic index ranks foods based on their postprandial blood glucose response. Hyperinsulinemia and insulin resistance, as well as their determinants (eg high energy intake, obesity, lack of physical activity) have been implicated in the etiology of diabetes, coronary heart disease and cancer. Recently, among dietary factors, carbohydrates have attracted much attention as a significant culprit, however, different types of carbohydrate produce varying glycemic and insulinemic responses. Low glycemic index foods, characterized by slowly absorbed carbohydrates, have been shown in some studies to produce beneficial effects on glucose control, hyperinsulinemia, insulin resistance, blood lipids and satiety. METHOD: Studies on the short and long-term metabolic effects of diets with different glycemic indices will be presented and discussed. The review will focus primarily on clinical and epidemiological data, and will briefly discuss in vitro and animal studies related to possible mechanisms by which the glycemic index may influence chronic disease.     

Nutritional correlates of dietary glycaemic index: new aspects from a population perspective

The role of dietary glycaemic index (GI) and glycaemic load (GL) in disease aetiology is of increasing interest. However, nutritional factors related to dietary GI and GL are not well understood from a population perspective. We aimed to investigate the relation ship between GI and GL and dietary intake at the food and nutrient level. Study subjects were 1071 non-diabetic adults from the Insulin Resistance Atherosclerosis Study, Exam I, 1992-4. Usual dietary intake was assessed with a 114-item modified Block food frequency questionnaire. Published GI values were assigned to food line items. Correlation and regression analyses were conducted. Intake of white bread, beer, meats and fries/fried potatoes was positively associated with average GI, as was fat, starch and alcohol intake (before and after energy adjustment). Intake of fruits and low-fat milk was inversely associated with GI, as were intakes of mono- and disaccharides, and fibre. GL was positively correlated with carbohydrate foods and inversely with non-carbohydrate foods. Gender-specific regression models identified eight food groups explaining 63% (men) and 55% (women) total GI variation after adjusting for demographics; 70% of variation in GL was explained by eleven (men) and nine (women) food groups, respectively. Although the GI of a food is an indicator of the ability of carbohydrates to raise blood glucose, dietary GI, unlike GL, appears to reflect more dimensions of diet than just carbohydrates, such as the combination of foods consumed. This may have implications for the interpretation of dietary GI in epidemiologic studies.     

Dietary patterns based on carbohydrate nutrition are associated with the risk for diabetes and dyslipidemia

Several studies have been conducted on dietary patterns based on carbohydrate nutrition in Asian populations. We examined the cross-sectional associations in dietary patterns based on carbohydrate nutrition, including the glycemic index (GI) with dyslipidemia and diabetes among the Korean adult population. We analyzed 9,725 subjects (3,795 men and 5,930 women, ≥ 20 years) from the Fourth Korea National Health and Nutrition Examination Survey. Dietary information was collected using single 24-hour recall. Reduced rank regression was used to derive dietary patterns from 22 food groups as predictor variables and four dietary factors related to the quantity and quality of carbohydrates as response variables. Two dietary patterns were identified: 1) the balanced pattern was characterized by high intake of various kinds of foods including white rice, and 2) the rice-oriented pattern was characterized by a high intake of white rice but low intake of vegetables, fruits, meat, and dairy products. Both patterns had considerable amounts of total carbohydrate, but GI values differed. The rice-oriented pattern was positively associated with hypertriglyceridemia in men and low high density lipoprotein-cholesterol in both men and women. The balanced pattern had no overall significant association with the prevalence of dyslipidemia or diabetes, however, men with energy intake above the median showed a reduced prevalence of diabetes across quintiles of balanced pattern scores. The results show that dietary patterns based on carbohydrate nutrition are associated with prevalence of dyslipidemia and diabetes in the Korean adult population.