Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study - PubMed (original) (raw)
Comparative Study
Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study
Pagona Lagiou et al. BMJ. 2012.
Abstract
Objective: To study the long term consequences of low carbohydrate diets, generally characterised by concomitant increases in protein intake, on cardiovascular health.
Design: Prospective cohort study.
Setting: Uppsala, Sweden.
Participants: From a random population sample, 43,396 Swedish women, aged 30-49 years at baseline, completed an extensive dietary questionnaire and were followed-up for an average of 15.7 years.
Main outcome measures: Association of incident cardiovascular diseases (ascertained by linkage with nationwide registries), overall and by diagnostic category, with decreasing carbohydrate intake (in tenths), increasing protein intake (in tenths), and an additive combination of these variables (low carbohydrate-high protein score, from 2 to 20), adjusted for intake of energy, intake of saturated and unsaturated fat, and several non-dietary variables.
Results: A one tenth decrease in carbohydrate intake or increase in protein intake or a 2 unit increase in the low carbohydrate-high protein score were all statistically significantly associated with increasing incidence of cardiovascular disease overall (n=1270)--incidence rate ratio estimates 1.04 (95% confidence interval 1.00 to 1.08), 1.04 (1.02 to 1.06), and 1.05 (1.02 to 1.08). No heterogeneity existed in the association of any of these scores with the five studied cardiovascular outcomes: ischaemic heart disease (n=703), ischaemic stroke (n=294), haemorrhagic stroke (n=70), subarachnoid haemorrhage (n=121), and peripheral arterial disease (n=82).
Conclusions: Low carbohydrate-high protein diets, used on a regular basis and without consideration of the nature of carbohydrates or the source of proteins, are associated with increased risk of cardiovascular disease.
Conflict of interest statement
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi\_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
Comment in
- Low carbohydrate-high protein diets.
Floegel A, Pischon T. Floegel A, et al. BMJ. 2012 Jun 19;344:e3801. doi: 10.1136/bmj.e3801. BMJ. 2012. PMID: 22718914 No abstract available. - Why did the BMJ publish such a biased article?
Campillo-Soto Á. Campillo-Soto Á. BMJ. 2012 Aug 6;345:e5104; author reply e5112. doi: 10.1136/bmj.e5104. BMJ. 2012. PMID: 22868952 No abstract available. - Advice to avoid low carbohydrate-high protein diets is not evidence based.
Freedhoff Y. Freedhoff Y. BMJ. 2012 Aug 6;345:e5106; author reply e5109, e5112. doi: 10.1136/bmj.e5106. BMJ. 2012. PMID: 22868953 No abstract available. - Increased incidence of cardiovascular disease: are low-carbohydrate-high-protein diets truly to blame?
Rolland C, Rolland-Harris E. Rolland C, et al. Evid Based Med. 2013 Aug;18(4):e37. doi: 10.1136/eb-2012-100962. Epub 2012 Nov 15. Evid Based Med. 2013. PMID: 23154673 No abstract available.
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References
- Li Z, Bowerman S, Heber D. Health ramifications of the obesity epidemic. Surg Clin North Am 2005;85:681-701. - PubMed
- Ogden CL, Yanovski SZ, Carroll MD, Flegal KM. The epidemiology of obesity. Gastroenterology 2007;132:2087-102. - PubMed
- Bessesen DH. Update on obesity. J Clin Endocrinol Metab 2008;93:2027-34. - PubMed
- Paddon-Jones D, Westman E, Mattes RD, Wolfe RR, Astrup A, Westerterp-Plantenga M. Protein, weight management, and satiety. Am J Clin Nutr 2008;87:1558-61S. - PubMed
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