Carbohydrate Food Structure Before Sugar Dose in Metabolic Ageing After Hypertension or Diabetes

Hypertension and diabetes are prevalent conditions that necessitate dietary counseling. However, current carbohydrate advice tends to focus solely on reducing sugar intake. A recent study aimed to investigate whether assessing carbohydrate food structure before sugar dose could provide a more comprehensive approach to addressing metabolic ageing and renal risk in individuals with hypertension or diabetes. The UK Biobank dataset was utilized to examine the relationship between carbohydrate food structure and biological ageing, as well as renal risk. In this cohort of adults with hypertension (n = 34,179), diabetes (n = 5768), or both (n = 3772), higher whole-grain/fiber/lower-refined-grain matrix quality was found to be associated with lower PhenoAge acceleration and CardioMetAge-marker burden. These findings suggest that evaluating carbohydrate food structure before sugar dose may offer a more effective approach to addressing metabolic ageing and renal risk in individuals with hypertension or diabetes. Furthermore, the study's results indicate that low-matrix/low-sugar profiles remain biologically older than high-matrix/low-sugar profiles, highlighting the importance of considering the overall quality of carbohydrate intake rather than solely focusing on sugar content. The findings also translate to significant reductions in chronic kidney disease risk, with 0.8, 1.8, and 3.1 percentage-point 10-year absolute-risk differences observed across different anchors. These results support the implementation of a public-health assessment sequence that prioritizes carbohydrate food structure as the starting point for nutrition review, followed by interpretation of reported sugars within that context.