Intake of macronutrients as predictors of 5-y changes in waist circumference.

BACKGROUND: The diet may influence the development of abdominal obesity, but the few studies that have prospectively examined the relations between diet and changes in waist circumference (WC) have given inconsistent results. OBJECTIVE: Associations between total energy intake, energy intake from macronutrients, and energy intake from macronutrient subgroups based on different food sources and 5-y differences in WC (DWC) were investigated. DESIGN: A Danish cohort of 22 570 women and 20 126 men aged 50-64 y with baseline data on WC, diet, BMI, and potential confounders reported their WC 5 y later. Associations of baseline diet with DWC were assessed by multiple linear regression analysis. RESULTS: Neither total energy intake nor energy intake from each of the macronutrients was associated with DWC, except for an inverse association with protein, especially animal protein. In women, positive associations with DWC were seen for carbohydrate from refined grains and potatoes and from foods with simple sugars, whereas carbohydrate from fruit and vegetables was inversely associated and significantly different from any other carbohydrate subgroup. The results for men resembled those for women, although none were significant. Vegetable fat was positively associated with DWC for both men and women in a combined analysis. A U-shaped association between alcohol from wine and DWC was present for both sexes, and alcohol from spirits was positively associated with DWC in women. CONCLUSIONS: Although no significant associations with total energy or energy from fat, carbohydrate, or alcohol were observed, protein intake was inversely related to DWC, and some macronutrient subgroups were significantly associated with DWC.