Low-carbohydrate, high-fat diet is inversely associated with the triglyceride–glucose index: evidence from NHANES 1999–2018
Year: 2026
Type: article
Abstract: BACKGROUND: The association of the triglyceride-glucose index, a validated marker of insulin resistance, with specific dietary patterns is unclear. METHODS: This cross-sectional analysis of NHANES 1999-2018 included 19,016 adults. Logistic regression, restricted cubic splines, and interaction analyses were used to evaluate associations between macronutrient intake and the triglyceride-glucose index. This analysis was designed a priori to evaluate whether a low-carbohydrate, high-fat macronutrient distribution (captured by PEC, PEF, and carbohydrate-to-fat energy ratio) is associated with the TyG index. RESULTS: Higher quartiles of percentage energy from carbohydrates and carbohydrate-to-fat energy ratio were associated with higher odds of an elevated TyG index, whereas higher quartiles of percentage energy from fat were associated with lower odds. Restricted cubic splines showed a positive linear association for carbohydrate energy and an inverse linear association for fat energy with TyG. Interaction analyses supported that a low-carbohydrate, high-fat pattern correlated with lower fasting triglyceride levels, and mediation analysis indicated that fasting triglycerides explained ~ 49% of the association between carbohydrate-to-fat energy ratio and TyG. CONCLUSIONS: A low-carbohydrate, high-fat diet was significantly associated with a lower triglyceride-glucose index; this association was primarily mediated by reductions in fasting triglyceride levels.
Authors: Wenya Zhu, Qianqian Chen, Dawei Li, Yi Li
Institution: Chinese PLA General Hospital
Language: English
Topic: Diet and metabolism studies
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,190
OpenAlex ID: W7133548952