Low Carb Diet And Heart Health

Comparing Diets For Heart Health

Is a Ketogenic (Low Carb) Diet Heart Healthy? Dr Bret Scher MD

I recently wrote about 50 years of diets to prevent heart disease. With these diet studies we learned that low-fat diets alone are not that helpful in preventing heart disease. A diet approach that is balanced is often optimal for long-term compliance and use.

Recently, low-carbohydrate, or low-carb, diets have become very popular. In regular diets we consume a lot of carbohydrates. Carbohydrates are abundant in potatoes, breads, pastas, cereals, some dried fruits, and of course candies and sweets. In low-carb diets, these carbohydrate dense foods are replaced with low-carbohydrate foods such as apples, carrots, lentils, etc. In some diets, low-carbohydrate foods are replaced by protein-dense foods such as meats. As I discussed in my prior column about diets, low fat diets simply try to reduce total intake of daily fat to a certain percentage of the total diet .

If you are looking to take something out of your diet, should it be the carbohydrates or the fats?

In Tightly Controlled Study Low

Low-carb diet did not raise LDL cholesterol, despite having high saturated fat levels

Boston Children’s Hospital

BOSTON September 28, 2021 – Low-carbohydrate diets are popular for weight loss and diabetes control. However, for most of the past 50 years, medical and public health experts have instead embraced low-fat diets, concerned about the health effects of saturated fats on cardiovascular risk factors like LDL cholesterol. As a result, low-fat and fat-free foods have proliferated many of them high in processed carbohydrates.

A clinical trial led by Boston Childrens Hospital, one of the largest and most rigorous study of its kind, now challenges that thinking. It demonstrates that low-carb diets even though higher in saturated fat produce better cardiovascular and metabolic profiles than low-fat, higher-carb diets. The findings were published online September 28 by the American Journal of Clinical Nutrition.

Surprisingly, the low-carb diet did not adversely affect LDL cholesterol, despite having saturated fat levels far in excess of current recommendations, says David Ludwig, MD, PhD, who led the study together with first author Cara Ebbeling, PhD.

Carbohydrates, insulin resistance, and disease

As people switch to low-fat diets, carbohydrates make up more and more of what we eat. This is one reason why metabolic syndrome is rising while obesity remains an epidemic.

Comparing low-carb and low-fat diets

What about children?

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How Low Carb High Fat Diets Improve Heart Health

Low carb high fat diets have been vilified as they can increase LDL. But the fact of the matter is that it does so only in a minority of people. The truth is that they can improve everything else!

These diets reduce blood pressure, reduce inflammation, improve HDL and triglycerides, and reverse diabetes and metabolic syndrome! Shouldnt that be the definition of heart healthy we seek? Instead of focusing on one isolated marker, shouldnt we define heart health by looking at the whole patient?

Only by opening our eyes and seeing the whole picture of heart healthy lifestyles can we truly make an impact on our cardiovascular risk and achieve the health we deserve.

Join me in demanding more. Demand better.

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Consult Your Doctor Before Starting A Keto Diet

Regardless of their health status, all patients should consult their doctor before going on the keto diet.

The reason: to rule out any existing concerns or ailments that could make the approach harmful to their heart or the rest of their body.

A small subset of people appears to experience increased cholesterol levels on a low-carb diet, so a family history of heart disease should be discussed.

Is Keto Bad For Your Heart

Heart Shape Of Ketogenic Low Carbs Diet Concept ...

It may only be four letters, but it is one trending diet program: keto.

As the most Googled diet in 2018, ketoshort for ketogenichas been adopted by celebrities such as Halle Berry, Kourtney Kardashian and Lebron James and has since gained traction on social media.

Now if your Instagram feed looks anything like mine, Im sure you cant go a day without scrolling past a picture of some kind of bacon-wrapped meat stuffed with cheeses accompanied by the hashtag #ketofriendly. With each post, though, my brain always ponders:

  • What is the science behind keto?
  • Is it really that healthy?
  • So, youre saying I can eat an entire block of cheese for dinner?
  • Isnt all of this fat a cardiologists nightmare?

Two Hackensack Meridian Health Medical Group physicians help to digest this fat-packed diet.

Also Check: 21 Day Metabolic Reset Diet

The Basics: What Is Cholesterol

Love Ketocist, love your body.

Cholesterol is absorbed from your digestive tract and circulated throughout your bloodstream, where it can be used by cells as needed. It then returns to the liver to be converted into bile acids or used for other purposes.

Importantly, cholesterol doesnt travel around your bloodstream on its own. As a hydrophobic substance. So that means when we talk about blood cholesterol levels, were referring to the amount of cholesterol contained in different lipoprotein particles. In addition to cholesterol, triglycerides and other compounds.

Many factors can affect your blood cholesterol, including genetics, hormonal changes, injury, and certain health conditions. For instance, people with untreated hypothyroidism often have elevated cholesterol.

A rise in cholesterol during keto or low-carb eating may be related to losing weight. Its been known for decades that major weight loss often leads to a temporary rise in LDL cholesterol. Lipidologist Dr. Thomas Dayspring has found that around a third of his patients experience increased LDL as a result of weight loss. For this reason, it could make sense to wait until your weight has been stable for a few months before assessing your cholesterol levels.

Low Carbohydrate Diets And Heart Disease

Research shows that a moderately low-carbohydrate diet can help the heart, as long as protein and fat selections come from healthy sources.

  • A 20-year prospective study of 82,802 women looked at the relationship between lower carbohydrate diets and heart disease a subsequent study looked at lower carbohydrate diets and risk of diabetes. Women who ate low-carbohydrate diets that were high in vegetable sources of fat or protein had a 30 percent lower risk of heart disease and about a 20 percent lower risk of type 2 diabetes, compared to women who ate high-carbohydrate, low-fat diets. But women who ate low-carbohydrate diets that were high in animal fats or proteins did not see any such benefits.
  • More evidence of the heart benefits from a lower-carbohydrate approach comes from a randomized trial known as the Optimal Macronutrient Intake Trial for Heart Health . A healthy diet that replaced some carbohydrate with protein or fat did a better job of lowering blood pressure and bad LDL cholesterol than a healthy, higher-carbohydrate diet.
  • Similarly, the small EcoAtkins weight loss trial compared a low-fat, high-carbohydrate vegetarian diet to a low-carbohydrate vegan diet that was high in vegetable protein and fat. While weight loss was similar on the two diets, study subjects who followed the low-carbohydrate EcoAtkins diet saw improvements in blood lipids and blood pressure.

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Overweight People On Fewer Carbs And More Fat At Lower Risk Of Cardiovascular Disease

A new study, one of the largest and most rigorous trials of the subject to date, suggests that eating a diet low in carbohydrates and higher in fats may be beneficial for your cardiovascular health if you are overweight. Photograph: (Linda Xiao/The New York Times

Going on a low-carb diet has long been a popular weight-loss strategy. But some doctors and nutrition experts have advised against doing so over fears that it could increase the risk of heart disease, as such diets typically involve eating lots of saturated fats, the kind found in red meat and butter.

But a new study, one of the largest and most rigorous trials of the subject to date, suggests that eating a diet low in carbohydrates and higher in fats may be beneficial for your cardiovascular health if you are overweight.

The new study, which was published in the American Journal of Clinical Nutrition, found that overweight and obese people who increased their fat intake and lowered the amount of refined carbohydrates in their diet while still eating fibre-rich foods like fresh fruits, vegetables, nuts, beans and lentils had greater improvements in their cardiovascular-disease risk factors than those who followed a similar diet that was lower in fat and higher in carbs. Even people who replaced healthy wholegrain carbs like brown rice and wholewheat bread with foods higher in fat showed striking improvements in a variety of metabolic-disease risk factors.

  • Topics:

Previously Experts Have Warned That Low Carb And Keto Diets High In Saturated Fat May Be Risky For Health

Prof. Tim Noakes – ‘Hiding Unhealthy Heart Outcomes in Low-Fat Diet Trials’

Low carb and keto diets have been controversial as they’ve grown in popularity in recent years, as dietitians and doctors have voiced concerns about the health risks of eating too much fat. Saturated fat, in foods like butter, bacon, eggs, full-fat dairy, and red meat has been linked to higher levels of LDL or “bad” cholesterol and a higher risk of heart disease.

Still, growing evidence has found low-carb diets can be effective for weight loss and diabetes control.

The researchers wanted to test whether the benefits of low-carb came at the cost of higher risk of heart problems, potentially because of the high fat content of the diet.

Participants on the low-carb diet consumed 21% of their daily calories from saturated fat, and still saw improvements in heart health, suggesting that the benefits of low-carb may outweigh the proposed risks, at least in some cases.

However, researchers noted that it’s not clear from the study whether more restrictive low-carb diets, such as those with 10% or less of daily calories from carbs, may be risky for heart health. The study also didn’t examine how a low-carb diet may affect some high-risk populations, since participants were relatively healthy and had low cholesterol from the start.

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What Are The Different Types Of Fats

Not all fats are created equal, advises Dr. Dougherty. Fats are broken down into three main categories: unsaturated fats, saturated fats and trans fats.

A clean keto diet incorporates more of a Mediterranean diet filled with unsaturated fats, such as vegetable oils, nuts and seeds and some fish, says Dr. Hollywood.

There are two main types of unsaturated fats: monounsaturated fats, which help lower cholesterol and blood sugar , and polyunsaturated fats, which are necessary for proper body functioning .

Conversely, saturated fats are found in red meats and dairy products, such as butters and cheeses. A diet high in these bad fats, like the dirty keto, can increase cholesterol and ultimately lead to heart disease, says Dr. Hollywood. Ive stumbled on blog articles discussing how people eat salami, pork rinds and cheeses and have lost weight through ketosisbut this is extremely detrimental to health in the long-run.

Then theres trans fats, which are found in processed snacks and baked goods, adds Dr. Hollywood.

An increase in fatsthough both Dr. Dougherty and Dr. Hollywood agree should be mostly goodand decrease in carbohydrates puts your body into a metabolic state of ketosis.

Does Keto Work For Weight Loss

Dr. Hollywood says that she did notice weight loss while following the diet, but once she started to reincorporate carbs, she gained the weight back.

Id encourage those following a keto diet to consult his or her primary care doctor or nutritionist for a transition plan to sustain this weight loss and welcome back proteins and carbs, she recommends.

However, Dr. Hollywood warns that it is important to be mindful of these extreme diet programs, like an aggressive carb-conscious keto. The all or nothing phenomenon Ive found is not that practical and not that sustainableand individuals can develop unhealthy relationships with food, she says.

Read Also: 4 Day Diet Plan To Lose 10 Pounds

Being That There Is Such An Emphasis On Fat Is This Diet Heart Healthy

Because the diet relies heavily on fat consumption, there may be an increased risk in cardiovascular disease for those consuming large amounts of saturated and trans fat, notes Dr. Dougherty.

However, with an emphasis on good fats, Dr. Hollywood says that a clean keto diet in the short-term can jumpstart a diet programwhich can ultimately reduce risk factors of heart disease.

When you pull carbs and sugars from your diet, you end up pulling a lot of water weight which results in weight loss, shares Dr. Hollywood. Weight loss can lead to improvements in blood pressure, cholesterol and lowering the risk of diabetes. All of these modifiable factors interconnect, which can help boost your heart health.

A Sensible Approach To Carbs

Heart Shape Of Ketogenic Low Carbs Diet Concept ...
Sort the good from the bad and the ugly with this advice from our dietitian

Low carb. High carb. Good carb. Bad carb. It sounds like the beginning of something by Dr. Seuss. If only dietary carbohydrates were as simple as a childrens book! The reality? Carb is one of those nutrition buzzwords that leads to a lot of confusion.

Understanding the role of carbohydrates can help you eat a healthy diet and maintain a healthy weight both important ways to reduce your risk of heart disease and stroke. Heres what you need to know.

Carbs 101

There are only three nutrients that contribute calories to the diet: fat, protein and carbohydrates. Yup, thats it. Just three. Most foods contain a mix of these nutrients for example, yogurt contains carbs, protein and fat. Carbs are the bodys main source of energy carbs from food turn into fuel for the body. Some nutrition textbooks divide carbs into simple and complex . Simple carbs, like jam and honey, are broken down quickly by the body, causing a faster rise in blood sugar levels. Complex carbs, such as oatmeal, have more fibre, so are digested more slowly and dont raise blood sugar levels as much. This keeps you full for longer and keeps blood sugar more stable.

Carbs are found in:

  • grains bread, pasta, rice, quinoa, oats
  • sugary foods: candy, ice cream, pastries
  • snack foods: chips, pretzels, crackers
  • sweet beverages: soda, juice
  • sweeteners: jam, honey, syrups.
Good vs. bad carbs
Are low carb diets OK?

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The Healthy Eating Hub

This article was written by an Accredited Practicing Dietitian from The Healthy Eating Hub. The Healthy Eating Hub is a team of university-qualified nutritionists and dietitians who are passionate about helping people develop long term healthy eating habits through offering evidence-based and practical nutrition advice that people can put into practice straight away.

How Does Ldl Cholesterol Affect Heart Health

Unfortunately, most of our current definitions center around LDL cholesterol concentration. While LDL cholesterol plays a role in heart health, it by no means defines heart health in totality.

In fact, in many cases it is the least important factor.

Our healthcare system has simplified things too much, so as a result we focus on one bad guy, one demon to fight. In reality heart disease is caused, and made more likely to occur, by a constellation of contributing issues.

Elevated blood sugar, elevated insulin levels, inflammation, high blood pressure, poor nutrition, and yes, lipids all contribute to heart health. It does us all an injustice to over simplify it to one single cause.

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The Heart Of The Matter

Your diet must be tailored to you. The problem with fad diets is that they are tailored to an ideal, while you are an individual. A few months ago, researchers from Yale University published a fascinating article in the Annual Review of Public Health. The article is entitled Can We Say What Diet is Best? In the article, the researchers compare many of the most currently popular diets, including low-carb, high-protein diets. Their conclusion: Efforts to improve public health through diet are forestalled … … our failure to convert what we reliably know into what we routinely do. Knowledge in this case is not, as of yet, power would that it were so.5

Cutting Carbs Raising Risks

heart healthy low carb diet plan

The study, presented by the American College of Cardiology, analyzed the health records and diets of nearly 14,000 people spanning a period of more than two decades. Its the first and largest to look at the relationship between carbohydrate intake and AFib.

The researchers divided the participants into three groups:

  • Low carb intake
  • Moderate carb intake
  • High carb eaters

They found that of all of the groups, the people who ate low-carb diets were the most likely to develop AFib. In fact, they were 18 percent more likely to end up with AFib than moderate carb eaters and 16 percent more likely to have an AFib diagnosis than the high carb group.

If youre like me and you love eating low carb, you may be thinking like I did that the AFib issue was probably caused by the type of protein the low-carbers chose. After all, if they ate fatty, non-grass fed meats that could be why they were having heart problems, right?

Well, think again

Read Also: Can You Outrun A Bad Diet

What Food Is Heart Healthy

Our superficial definition of cardiac risk is how industrial seed oils containing polyunsaturated fatty acids became known as heart healthy.

Studies show that they can lower LDL. But they can also increase inflammation and have no clinical benefit and even increase risk of dying. According to our simplified definitions, that doesnt stop them from being defined as heart healthy.

Thats right! Something that increases our risk of dying is still termed heart healthy. Hows that for a backwards medical system?!

Same for blood sugar. If you have a diagnosis of Type 2 Diabetes that is a risk for cardiovascular disease. If you dont have the diagnosis, you are fine. That ignores the disease of insulin resistance that can predate diabetes for decades and increases the risk of heart disease and possibly even cancer and dementia.

Cereal can also be called heart healthy as they may minimally lower LDL. But is that a good thing if they contain grains that also worsen your insulin resistance and metabolic syndrome? I say definitely not.

Time has come to stop this basic, simplified evaluation and start looking at the whole picture.

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