Health authorities in Europe and North America recommend eating more fruits and vegetables while curtailing consumption of fatty foods, advice also adopted by the United Nations and globally.
But people in poor nations cutting back on fat may wind up piling on more carbohydrates -- such as potatoes, rice or bread -- because fruits and vegetable are more expensive, the authors point out.
"The current focus on promoting low-fat diets ignores the fact that most people's diets in low- and middle-income countries are very high in carbohydrates, which seem to be linked to worse health outcomes," said Mahshid Dehghan, a researcher at McMaster University in Ontario, Canada and lead author of a study in The Lancet.
Dehghan and colleagues sifted through the health data of 135,000 volunteers from 18 countries across six continents, aged 35-70, who were monitored for a seven-and-half years.
People who met three-quarters or more of their daily energy needs with carbs were 28 percent more likely to die over that period that those who ate fewer starchy foods (46 per cent or less of energy needs).
"Contrary to popular belief, increased consumption of dietary fats is associated with a lower risk of death," Dehghan told AFP.
That covered a mix of saturated fats (from meats and milk products), along with monounsaturated and polyunsaturated fats (from vegetable oils, olive oil, nuts and fish), she added.
The study did not look at so-called "trans fats" from processed foods because "the evidence is clear that these are unhealthy," Dehghan said.
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