Practice Short cuts

Heart disease and a diet low in carbohydrate aren't linked

BMJ 2006; 333 doi: (Published 16 November 2006) Cite this as: BMJ 2006;333:1065

Low carbohydrate diets can help people lose weight, but many observers worry that encouraging women to replace carbohydrate with protein and fat might increase their risk of heart disease. A large randomised trial would take decades, so researchers looked for evidence among the 82 802 nurses who have been filling in food frequency questionnaires every two years since 1980 for the nurses' health study.

Their findings were reassuring. Women with diets low in carbohydrate but relatively rich in proteins and fats were no more likely to get coronary heart disease than women who reported the opposite kind of diet (relative risk 0.94, 95% CI 0.76 to 1.18). In fact, a diet with a high glycaemic load was associated with an increased risk of heart disease, while a diet rich in vegetable fats and vegetable proteins was associated with a slightly lower risk (relative risk comparing top and bottom groups 0.70, 0.56 to 0.88). The study spanned 20 years.

Few of these women were dieting to lose weight, so the relative contribution of carbohydrates, fats, and proteins to their diet had little impact on body mass index. The researchers weren't able to look for other potentially damaging effects of Atkins-type diets such as reduced renal function and osteoporosis.


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