Monday, June 18, 2012

Low-Carb Vs. Low-Fat and Heart Disease

"Lowering fat intake to reduce cardiovascular risk may not be the best advice for most people. Recent studies suggest that reducing carbyhydrate intake is a more effective way to reduce the risk of atherogenic dyslipidemia. For overweight or obese individuals who have trouble losing weight, a moderate reduction in carb intake can confer the same benefit as losing 15 to 20 pounds.

"'When we studied a low-fat diet thinking that would benefit individuals with an atherogenic lipid phenotype, we found something quite different,' said Ronald M. Krauss, MD, Senior Scientist and Director of Atherosclerosis Research at the Children's Hostpital Oakland Research Institute in California. 'A significant portion of healthy individuals who went on a low-fat, high-carbohydrate diet instead were converted to the high-risk atherogenic profile. That was quite a surprise.'
I'll bet that was quite a suprise.

Dr. Krauss is, among many other things, "founder and past Chair of the [American Heart Assocation] Council on Nutrition, Physical Activity, and Metabolism, and a National Spokesperson for the AHA."

The committee that came up with the "prudent diet" described here:
"After five years on their respective diets, 3.4% of the control (prudent diet) group and 1.3% of the intervention ("Mediterranean") group had died, a 70% reduction in deaths. Cardiovascular deaths were reduced by 76%. Stroke, angina, pulmonary embolism and heart failure were also much lower in the intervention group. A stunning victory for this Mediterranean-inspired diet, and a crushing defeat for the prudent diet!"
I find it prudent to test things before making recommendations, but at least Dr. Krauss has the integrity to correct his mistake.

Back to the American Diabetes Association Diabetes Dispatch:
"His interest in dietary effects on atherogenic dyslipidemia began when he and his research colleagues discovered that, when placed on a high-carbohydrate diet, a quarter of healthy individuals converted from a low-risk atherogenic profile with large LDL particles to a high-risk profile with small LDL particles without a change in LDL cholesterol, but with an increase in the total number of LDL particles."
The cholesterol hypothesis is basically dead. No wonder statins don't work. Lowering LDL cholesterol has no effect on atherogenic risk.
'Even though LDL cholesterol is the main lipid used to guide the evaluation and management of cardiovascular disease risk, atherogenic dyslipidemia is not commonly associated with elevated LDL cholesterol levels...'
H/T Dr. Eenfeldt, another skeptical doc.

(Here's the page from the Dispatch, just in case that link stops working...)