Association between a low–carbohydrate diet and macronutrient intake with the gut microbiome, and their interaction with dyslipidemia among Korean adults

Abstract Background The prevalence of dyslipidemia has increased in recent years; however, it remains a modifiable condition through diet and gut microbiome modulation. Yet, evidence from population-based studies remains limited. This study aimed to investigate the relationships among a low-carbohyd...

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Main Authors: Sangwon Chung, Ji-Hee Shin, Jung-Ha Kim, Ki Bae Kim, Young-Do Nam, Mi Young Lim
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Nutrition Journal
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Online Access:https://doi.org/10.1186/s12937-025-01188-4
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author Sangwon Chung
Ji-Hee Shin
Jung-Ha Kim
Ki Bae Kim
Young-Do Nam
Mi Young Lim
author_facet Sangwon Chung
Ji-Hee Shin
Jung-Ha Kim
Ki Bae Kim
Young-Do Nam
Mi Young Lim
author_sort Sangwon Chung
collection DOAJ
description Abstract Background The prevalence of dyslipidemia has increased in recent years; however, it remains a modifiable condition through diet and gut microbiome modulation. Yet, evidence from population-based studies remains limited. This study aimed to investigate the relationships among a low-carbohydrate diet (LCD), macronutrient intake, and the gut microbiome, and to evaluate their interaction effects on dyslipidemia in a Korean population. Methods Data were drawn from two population-based studies: the Korean Microbiome Study (KMS) and the Korea National Health and Nutrition Examination Survey (KNHANES). We included 2,178 participants aged 20–80 years from the KMS (2017–2019) and 12,938 participants from the KNHANES (2017–2019). The LCD score and percentage of energy intake from macronutrients were calculated using either a food frequency questionnaire or a 24-hour dietary recall. Dyslipidemia was assessed based on fasting blood tests. Gut microbiota was profiled by sequencing the V3-V4 region of the 16S rRNA gene in the KMS. Multivariate logistic regression models including interaction terms were used to evaluate the joint effects of diet and the gut microbiome on dyslipidemia. Results A higher LCD score was associated with lower odds of atherogenic dyslipidemia and low high–density lipoprotein (HDL) cholesterolemia in both studies. Although both studies showed a positive trend for fat intake and a negative trend for carbohydrate intake in relation to hypercholesterolemia, the level of significance differed slightly. We identified 38 microbial genera associated with LCD score and macronutrient intake. Notably, fat intake showed beneficial associations with triglyceride and HDL cholesterol levels in individuals carrying Bifidobacterium (p for interaction = 0.0017) and Lachnospiraceae UCG–004 (p for interaction = 0.0482), respectively. In contrast, low carbohydrate intake was associated with increased odds of hypercholesterolemia in individuals harboring Lachnoclostridium (odds ratio: 3.79; 95% confidence interval: 2.01–7.17; p for interaction < 0.0001). No significant associations were observed in individuals lacking these genera. Similar interaction effects were observed at the amplicon sequence variant level for Bifidobacterium and Lachnospiraceae UCG–004. Conclusions These findings provide population-based evidence for the interactive role of fat and carbohydrate intake with gut microbiota in influencing dyslipidemia among Koreans.
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spelling doaj-art-7c2f1b3769db4b3f86df555ebc131e812025-08-20T03:04:15ZengBMCNutrition Journal1475-28912025-07-0124111710.1186/s12937-025-01188-4Association between a low–carbohydrate diet and macronutrient intake with the gut microbiome, and their interaction with dyslipidemia among Korean adultsSangwon Chung0Ji-Hee Shin1Jung-Ha Kim2Ki Bae Kim3Young-Do Nam4Mi Young Lim5Precision Nutrition Research Group, Korea Food Research InstitutePrecision Nutrition Research Group, Korea Food Research InstituteDepartment of Family Medicine, Chung-Ang University Hospital, Chung-Ang University College of MedicineDepartment of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of MedicinePrecision Nutrition Research Group, Korea Food Research InstitutePrecision Nutrition Research Group, Korea Food Research InstituteAbstract Background The prevalence of dyslipidemia has increased in recent years; however, it remains a modifiable condition through diet and gut microbiome modulation. Yet, evidence from population-based studies remains limited. This study aimed to investigate the relationships among a low-carbohydrate diet (LCD), macronutrient intake, and the gut microbiome, and to evaluate their interaction effects on dyslipidemia in a Korean population. Methods Data were drawn from two population-based studies: the Korean Microbiome Study (KMS) and the Korea National Health and Nutrition Examination Survey (KNHANES). We included 2,178 participants aged 20–80 years from the KMS (2017–2019) and 12,938 participants from the KNHANES (2017–2019). The LCD score and percentage of energy intake from macronutrients were calculated using either a food frequency questionnaire or a 24-hour dietary recall. Dyslipidemia was assessed based on fasting blood tests. Gut microbiota was profiled by sequencing the V3-V4 region of the 16S rRNA gene in the KMS. Multivariate logistic regression models including interaction terms were used to evaluate the joint effects of diet and the gut microbiome on dyslipidemia. Results A higher LCD score was associated with lower odds of atherogenic dyslipidemia and low high–density lipoprotein (HDL) cholesterolemia in both studies. Although both studies showed a positive trend for fat intake and a negative trend for carbohydrate intake in relation to hypercholesterolemia, the level of significance differed slightly. We identified 38 microbial genera associated with LCD score and macronutrient intake. Notably, fat intake showed beneficial associations with triglyceride and HDL cholesterol levels in individuals carrying Bifidobacterium (p for interaction = 0.0017) and Lachnospiraceae UCG–004 (p for interaction = 0.0482), respectively. In contrast, low carbohydrate intake was associated with increased odds of hypercholesterolemia in individuals harboring Lachnoclostridium (odds ratio: 3.79; 95% confidence interval: 2.01–7.17; p for interaction < 0.0001). No significant associations were observed in individuals lacking these genera. Similar interaction effects were observed at the amplicon sequence variant level for Bifidobacterium and Lachnospiraceae UCG–004. Conclusions These findings provide population-based evidence for the interactive role of fat and carbohydrate intake with gut microbiota in influencing dyslipidemia among Koreans.https://doi.org/10.1186/s12937-025-01188-4Low–carbohydrate dietFat intakeCarbohydrate intakeHypertriglyceridemiaLow HDL cholesterolemiaHypercholesterolemia
spellingShingle Sangwon Chung
Ji-Hee Shin
Jung-Ha Kim
Ki Bae Kim
Young-Do Nam
Mi Young Lim
Association between a low–carbohydrate diet and macronutrient intake with the gut microbiome, and their interaction with dyslipidemia among Korean adults
Nutrition Journal
Low–carbohydrate diet
Fat intake
Carbohydrate intake
Hypertriglyceridemia
Low HDL cholesterolemia
Hypercholesterolemia
title Association between a low–carbohydrate diet and macronutrient intake with the gut microbiome, and their interaction with dyslipidemia among Korean adults
title_full Association between a low–carbohydrate diet and macronutrient intake with the gut microbiome, and their interaction with dyslipidemia among Korean adults
title_fullStr Association between a low–carbohydrate diet and macronutrient intake with the gut microbiome, and their interaction with dyslipidemia among Korean adults
title_full_unstemmed Association between a low–carbohydrate diet and macronutrient intake with the gut microbiome, and their interaction with dyslipidemia among Korean adults
title_short Association between a low–carbohydrate diet and macronutrient intake with the gut microbiome, and their interaction with dyslipidemia among Korean adults
title_sort association between a low carbohydrate diet and macronutrient intake with the gut microbiome and their interaction with dyslipidemia among korean adults
topic Low–carbohydrate diet
Fat intake
Carbohydrate intake
Hypertriglyceridemia
Low HDL cholesterolemia
Hypercholesterolemia
url https://doi.org/10.1186/s12937-025-01188-4
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