Could Low Carb Diets Be Driving Cardiac Events?

This one goes out to my acute and cardiac PTs! The debate about low carb vs high carb (or just balanced carbs) continues to rage on social media and podcasts. A new study highlights some potentially harmful data for those on a low carb / high fat diet and higher rates of cardiac events. Enjoy the video, the transcript is below, and here's the publication. 

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   Transcript:

Good afternoon, everyone. I am Dr. Wells from Nutritional Physical Therapy. I'm here in St. Augustine Beach.

Just had a beautiful rainstorm and now it's finally (0:08) cooled off. Anyhow, just wanted to give you guys an update on a new research article that I read (0:13) about. This one is titled Low Carbohydrate High Fat Diets and Their Associated Cardiovascular (0:21) Risks.

It's published by Iotin et al. in the Journal of the American College of Cardiology. (0:27) It's a mouthful.

About 1,500 patients. This was a prospective cohort study. (0:34) The pool of data was from the Biobank out of the UK.

These individuals were not on statins and (0:42) what they were looking at were something called MACEs or Major Adverse Cardiac Events, so MIs, (0:50) CBAs, that sort of thing. Effectively, the way they defined low carb in this was less than 100 (0:55) grams of carbohydrates per day. They also did a subgroup analysis with very low carb population (1:01) and that was individuals less than 50 grams of carbohydrates.

Interestingly, what they found, (1:09) kind of no surprise, is that the LDLs were up significantly compared to people that were not (1:14) on the low carb diets from 3.6 up to 3.8. APOB, also a marker of inflammation and cardiovascular (1:22) heart disease risk, was also elevated from 1.04 to 1.10. Now, when they looked at the risk factor (1:31) of developing a MACE, that cardiac event, it was increased 118%. So, the authors went a step (1:38) further and said, okay, let's get rid of those patients that have diabetes. We'll do a subgroup (1:43) analysis just to see if maybe there was an influence of diabetics or diabetic conditions (1:50) on the overall outcomes.

Well, they still found a 101% increase. So, they further analyzed, well, (1:58) let's see how strong the effect is if it's just the low carb diet or the very low carb diet is (2:02) more dangerous. And what they found was that the low carb diet, there was still a 50% increase in (2:08) MACEs, but when they looked at the very low carbohydrate diet, it was 105% increase.

 (2:14) So, effectively, these authors found that the lower the carbohydrate diet, the higher the risk (2:21) of major cardiac events. And in some way, this makes sense because the LDL was elevated, APOB was (2:27) elevated, and those usually go up when there is lacking fiber. When people cut carbohydrates out, (2:32) they typically target your fruits and vegetables.

We already know that most Americans aren't eating (2:37) high amounts of fruits and vegetables in the first place, right? The most common vegetable (2:41) is usually a potato, it's usually fried, and fruits are usually consumed as fruit juices. So, (2:46) usually when they go, quote, low carb, that means they're effectively getting no fruits, (2:50) no vegetables, which means no fiber and very little phytochemicals to help (2:55) with lowering lipids and with reducing inflammation. So, it's kind of no surprise.

 (3:01) Unfortunately, what I'd love to see is really the quality of the diet because we know that low carb (3:04) diets can be a very high quality, high fiber. So, that's one big drawback of this study. So, (3:11) I'd love to see like a further analysis of like quality of that low carb diet versus these maces, (3:18) but more to come.

Hopefully, you like this article and you like more content like this. (3:23) Check out our courses at nutritionalphysicaltherapy.com. If you have signed up, (3:28) great. Share it with a friend, share it with a PT.

Also, like and comment below. Love to hear (3:33) your thoughts and arguments on low carb diet.

Keywords: Cardiac Rehabilitation, Low Carb Diet, Exercise Prescription, Cardiovascular Health, Metabolic Health, Glycemic Control, Nutrition For PTs, Patient Education, CEUs, APTA