Tag Archives: Swedish

Is Low-Carb Killing Swedish Women?

MPj04384870000[1]A recent Swedish study suggests that low-carbohydrate/high protein diets increase the risk of cardiovascular disease in women.  I’m not convinced, but will keep an eye on future developments.  This is a critical issue since many women eat low-carb/high protein for weight loss and management.

Researchers followed 43,000 women, 30-49 years of age at enrollment, over the course of 16 years.  In that span, they had 1270 cardiovascular events: ischemic heart disease (heart attacks and blocked heart arteries), strokes, subarachnoid hemorrhages,  and peripheral arterial disease.  Food consumption was estimated from a questionnaire filled out by study participants at the time of enrollment (and never repeated).

In practical terms, … a 20 gram decrease in daily carbohydrate intake and a 5 gram increase in daily protein intake would correspond to a 5% increase in the overall risk of cardiovascular disease.

So What?

To their credit, the researchers note that a similar analysis of the Women’s Health Study in the U.S. found no such linkage between cardiovascular disease and low-carb/high protein eating.

The results are questionably reliable since diet was only assessed once during the entire 16-year span.

I’m certain the investigators had access to overall death rates.  Why didn’t they bother to report those?  Your guess is as good as mine.  Even if low-carb/high protein eating increases the rate of cardiovascular events, it’s entirely possible that overall deaths could be lower, the same, or higher than average.  That’s important information.

I don’t want to get too far into the weeds here, but must point out that the type of carbohydrate consumed is probably important.  For instance, easily digested carbs that raise blood sugar higher than other carbs are associated with increased heart disease in women.  “Bad carbs” in this respect would be simple sugars and refined grains.

In a 2004 study, higher carbohydrate consumption was linked to progression of blocked heart arteries in postmenopausal women.

It’s complicated.

Steve Parker, M.D.

PS: I figure Swedish diet doctor Andreas Eenfeldt would have some great comments on this study, but can’t find them at his blog.

Reference: Lagiou, Pagona, et al.  Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study.  British Medical Journal, June 26, 2012.  doi: 10.1136/bmj.e4026

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Filed under Carbohydrate, coronary heart disease, Heart Disease, Protein

Low-Carb Diet Helps Obese Swedes With Diabetes

Swedish boyObese people with type 2 diabetes following a 20% carbohydrate diet demonstrated sustained improvement in weight and blood glucose control, according to two Swedish physicians.  These doctors also have research experience with traditional low-fat diets in overweight diabetics, having demonstrated that a 20% carbohydrate diet was superior to a low-fat/55–60% carb diet in obese diabetes patients over six months.

What Was the Intervention?

Proportions of carbohydrates, fat, and protein were 20%, 50%, and 30% respectively.  Total daily carbs were 80–90 g. 

Recommended carbs were vegetables and salads. 

Rather than ordinary bread, crisp/hard bread was recommended (3.5 to 8 g carb per slice).  Starchy breads, pasta, potatoes, rice, and breakfast cereals were excluded. 

They were instructed to walk 30 minutes daily, take a multivitamin with extra calcium daily, and to not eat between meals. 

At the outset, diabetic medications were reduced by 25–30% to avoid low blood sugars.   

Results

The doctors followed 23 patients over the course of  44 months.  Average initial body weight was 101 kg (222 pounds).  After 44 months, average body weight fell to 93 kg (205 pounds).  Hemoglobin A1c, a measure of diabetes control,  fell from 8% to 6.8%. 

My Comments

In these pages over the last few months, we’ve seen the effectiveness of low-carb diets in people with type 2 diabetes in widespread populations: Japanese, U.S. blacks and caucasions, and, now, Swedes. 

The standard Western diet derives 55–60% of its energy from carbohydrates.  If you’ve been following this blog, we’ve looked at diets containing 40%, 30%, 20%, and 10% carbs.  Have you noticed the trend? 

Reducing the percentage of carbohydrates in the diet improves diabetic control and loss of excess weight.  And the more you reduce carbs, the greater the degree of diabetic control and weight loss.   

Steve Parker, M.D.

Reference:  Nielsen, Jörgen and Joensson, Eva.  Low-carbohydrate diet in type 2 diabetes: stable improvement of body weight and glycemic control during 44 months follow-upNutrition & Metabolism, 5:14   doi:10.1186/1743-7075-5-14

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Filed under Carbohydrate, Overweight and Obesity, Weight Loss