A huge new Swedish study has found that the popular low carb, high protein weight loss diets are bad for your heart. . . .

This study looked at the long term effects of low carb, high protein diets on cardiovascular health by following 43,396 women (age 30-49) for an average of 15.7 years. When it looked at carbohydrates and protein separately, it found that a 10% decrease in carbs was associated with a 4% increase in cardiovascular disease and that a 10% increase in protein was also associated with a 4% increase in cardiovascular disease. When low carbs and high protein were combined, the study found that a two unit increase in the low carb-high protein score was associated with a 5% increase in cardiovascuar disease. All three of these increases in risk are statistically significant.

That means that the low carbohydrate-high protein diet that has become so popular as a weight loss diet is significantly associated with an increased risk of cardiovascular disease. In practical terms, it means that a 20 gram decrease in carbs and a 5 gram increase in protein per day corresponds to a 5% increase in overall risk of cardiovascular disease. And the more you cut your carbs and increase your protein, the worse it gets: the women who had the highest protein and the lowest carbohydrate intake in this study had a 60% higher risk of cardiovascular disease.

The researchers suggest that these results can be explained by vegetables, fruits, legumes and grains being both important sources of carbohydrates and the core of a healthy diet, while meat and high animal protein diets have been shown by many studies to be associated with an increased risk of cardiovascular disease.

There have been four previous studies on low carb-high protein diets and cardiovascular disease. Three found significant increases in cardiovascular disease and one did not. But in the one that did not, when the researchers took into account whether the protein came mainly from animal or plant sources, there was a statistically significant association with cardiovascular disease for low carb diets of animal origin, but a statistically non-significant protective effect for those of plant origin. For higher protein, a non-significant increase in cardiovascular disease became significant when they looked only at animal source proteins while becoming nonsignificantly protective when looking at plant source proteins. This study too found a suggestion (though not statistically significant) that risk was higher among women whose protein comes mainly from animal sources.  The researchers say, then, that increasing plant proteins and decreasing simple and refined carbs may be fine, but the general public often fails to recognize these distinctions.

(BMJ 2012;344:e4026)

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