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A diet consisting more than 60% of energy from carbohydrates (including refined) was related to higher mortality, although not with the risk of cardiovascular disease. The research on dietary fats found that they are not associated with major cardiovascular disease, but higher fat consumption was associated with lower mortality; this was seen for all major types of fats (saturated fats, polyunsaturated fats, and monounsaturated fats), with saturated fats being associated with lower stroke risk. The data are from the Prospective Urban Rural Epidemiology (PURE) study which followed more than 135,000 people from 18 low-income, middle-income, and high-income countries. The study asked people about their diet and followed them for an average of seven and half years. The data was adjusted for age, sex, energy intake, current smoking status, urban or rural location, physical activity, baseline diabetes, education, and other dietary variables (white meat, red meat, bread, and cereal intake). However, this is a prospective study which means causation cannot be established.
Weekly News Digest is very valuable. On this study I think it would clarify the findings to look closely at the data. On the surface, it seems to conflict with Blue Zone and China Study results. Was a sub-group of high carb, but low or no simple carbs, with varying amounts of fat and protein evaluated? I suspect that over the last 40 to 50 years, with the explosion of fast foods and packaged crap in the grocery stores, that sugar AND fat consumption has gone up, at least in the US, because the pseudo-foods are engineered that way. Americans are not obese and diabetic because of an increase in complex carbs and, as a group, don’t eat a truly low fat diet (<20 % of calories).
No doubt that these types of studies are riddled with confounders. Almost impossible to draw definitive conclusions from a prospective study. Higher total fruit, vegetable, and legume intake was inversely associated with major cardiovascular disease, myocardial infarction, cardiovascular mortality, non-cardiovascular mortality, and total mortality.