{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:37:37Z","timestamp":1787773057015,"version":"build-2784847793"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["ATVB"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>To investigate whether low-carbohydrate diets (LCDs) were associated with coronary artery calcium (CAC) progression.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results:<\/jats:title>\n            <jats:p>\n              We included the participants who completed computed tomography assessment of baseline CAC in 2000 to 2001 (year 15) and follow-up (year 20 or 25) and food frequency questionnaire (years 0, 7, and 20) in the CARDIA study (Coronary Artery Risk Development in Young Adults). CAC progression was defined as CAC &gt;0 at follow-up among participants with baseline CAC of 0 and an annualized change of 10 or percent change of \u226510% for those with 0&lt;baseline CAC&lt;100 or baseline CAC\u2265100, respectively. Among 2226 included participants (age, 40.4\u00b13.5 years; 45.4% men), the carbohydrate intake accounted for 47.8\u00b16.5% of total energy, and 204 (9.2%) had CAC at baseline (year 15). Over a mean follow-up of 8.3 years, 591 (26.5%) participants had CAC progression. After adjustment for traditional cardiovascular risk factors and other dietary factors, carbohydrate intake as a percentage of total energy was inversely associated with the risk of CAC progression (hazard ratio, 0.731 [95% CI, 0.552\u20130.968];\n              <jats:italic>P<\/jats:italic>\n              =0.029). Furthermore, the animal-based but not plant-based LCD score was significantly associated with a higher risk of CAC progression (animal-based LCD score: hazard ratio, 1.456 [95% CI, 1.015\u20132.089];\n              <jats:italic>P<\/jats:italic>\n              =0.041; plant-based LCD score: hazard ratio, 1.016 [95% CI, 0.821\u20131.257];\n              <jats:italic>P<\/jats:italic>\n              =0.884; both comparing extreme groups).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>LCDs starting at a young age are associated with an increased risk of subsequent CAC progression, particularly when animal protein or fat are chosen to replace carbohydrates.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT00005130.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/atvbaha.120.314838","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T09:00:27Z","timestamp":1603962027000},"page":"491-500","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Low-Carbohydrate Diet Score and Coronary Artery Calcium Progression"],"prefix":"10.1161","volume":"41","clinical-trial-number":[{"clinical-trial-number":"nct00005130","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Jing-Wei","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Cardiology (J.-W.G., Q.-Y.H., H.-F.Z., X.-Z.L., J.-F.W., P.-M.L.), Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing-Yun","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.-W.G., Q.-Y.H., H.-F.Z., X.-Z.L., J.-F.W., P.-M.L.), Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9670-2642","authenticated-orcid":true,"given":"Hai-Feng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.-W.G., Q.-Y.H., H.-F.Z., X.-Z.L., J.-F.W., P.-M.L.), Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiong-Zhi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.-W.G., Q.-Y.H., H.-F.Z., X.-Z.L., J.-F.W., P.-M.L.), Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi-Min","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition (Z.-M.Y.), Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology (Y.G., S.-L.Z.), Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.-W.G., Q.-Y.H., H.-F.Z., X.-Z.L., J.-F.W., P.-M.L.), Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao-Ling","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology (Y.G., S.-L.Z.), 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