Very low-carb diets may INCREASE mortality

[ouroborous 519]

New study in the Annals of Internal Medicine (with a very large cohort ~120k participants).

Results: The overall low-carbohydrate score was associated with a modest increase in overall mortality in a pooled analysis (hazard ratio

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comparing extreme deciles, 1.12 [95% CI, 1.01 to 1.24]; P for trend = 0.136). The animal low-carbohydrate score was associated with higher all-cause mortality (pooled HR comparing extreme deciles, 1.23 [CI, 1.11 to 1.37]; P for trend = 0.051), cardiovascular mortality (corresponding HR, 1.14 [CI, 1.01 to 1.29]; P for trend = 0.029), and cancer mortality (corresponding HR, 1.28 [CI, 1.02 to 1.60]; P for trend = 0.089). In contrast, a higher vegetable low-carbohydrate score was associated with lower all-cause mortality (HR, 0.80 [CI, 0.75 to 0.85]; P for trend ≤ 0.001) and cardiovascular mortality (HR, 0.77 [CI, 0.68 to 0.87]; P for trend < 0.001).

Limitations: Diet and lifestyle characteristics were assessed with some degree of error. Sensitivity analyses indicated that results were probably not substantively affected by residual confounding or an unmeasured confounder. Participants were not a representative sample of the U.S. population.

Conclusion: A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates.

Note that it looks like the higher mortality was due to higher animal Protein intake, which is associated with various risk factors. However, it does seem to indicate caution when recommending very low-carb diets as a panacea for health and weight loss.

It seems like the best diet recommendations to date ('diet' in its original meaning of 'what you eat,' as opposed to 'how to lose weight quickly') don't restrict carbohydrates, but rather recommend against refined carbohydrates, as well as too much animal protein. Vegetable protein (Beans, Beans, the magical fruit...) seems to be fairly safe.

Edit: link to study abstract here.

Edited September 7, 2010 by ouroborous

[chilo1 62]

I think this is key to our success, having a balanced diet, including carbs, but as little as possible refined ones, but we can't go without slow energy releasing carbs(oats, wholemeal, grains, Beans etc) that's our major source of energy. Thanks for sharing!

[Lisalu 89]

I looked at this article. It seems the increase in mortality was very small--it hardly reached statistical significance.

[mp8btpc 32]

I know that people that do low carb diets often have an increase in their blood pressure, especially if they are not eating lean Proteins. It scares the pants off me because my hubby is now trying to lose weight and he is doing very low carbs but he will chow on meat all day long. Things like smoked sausages, polska kilbolsa, carne asada, sausage and eggs along with tons of cheese. I told him the point was to eat lean Proteins and low carb it for a healthier way to do it. He has lost weight this way before though his doctor appt showed a higher bp. He just turned 40 last week and I am afraid of him having a coronary. Though right now the doc said he is one healthy guy...other then the weight.

I agree with Chilo moderation is the key. After I get close to goal or at goal I want to have a well rounded diet and exercise program. For now I know that carbs go down way to easy for me and they are my weakness so I do best to stay away from anything with white flour in it.

[thinoneday 445]

Yup, well balanced and within moderation. . . even throw in a snack or two, healthy of course. . . I eat everything now but in tiny portions, after i have my "meal" I do not eat anymore, if i am strongly needing a snack, I peel a apple or peach (can't do the peel, hurts) and enjoy that! Good luck

[ouroborous 519]

There was a statistically significant mortality increase in the high animal-Protein diets (P = 0.051, which is definitely enough to infer a correlation).

However, I'd again like to point out that it's likely that the increased mortality is from the increased animal Proteins, not from the carb restriction. Carb restriction on its own is still net neutral, according to the bulk of research.

So I guess the best diet choices are mostly vegetarian, high plant Protein and maybe some supplementation with lower-fat animal protein sources like whey, etc.

Still, I think it's important to keep abreast of current research, and not just blindly follow what the crash diet books tell you.

[Eureka-C 20]

There was a statistically significant mortality increase in the high animal-Protein diets (P = 0.051, which is definitely enough to infer a correlation).

However, I'd again like to point out that it's likely that the increased mortality is from the increased animal Proteins, not from the carb restriction. Carb restriction on its own is still net neutral, according to the bulk of research.

So I guess the best diet choices are mostly vegetarian, high plant Protein and maybe some supplementation with lower-fat animal protein sources like whey, etc.

Still, I think it's important to keep abreast of current research, and not just blindly follow what the crash diet books tell you.

Although it's important that we look at these things, other factors than the measured correlation may factor into the results. My first thought when reading headlines like this is did they factor healthy lifestyle? I would think that people who are overall more health conscious ( not post wls, but regular people) would be more likely to follow the recommendations and eat lots of veggies. Also it has been shown that people who make "healthy" choices are more likely to control alcohol intake, be more likely to use vitamin/health supplements, and get regular exercise. Did the study control for these factors. I too think research is important, but headlines often don't tell the whole story.

[ouroborous 519]

Although it's important that we look at these things, other factors than the measured correlation may factor into the results. My first thought when reading headlines like this is did they factor healthy lifestyle? I would think that people who are overall more health conscious ( not post wls, but regular people) would be more likely to follow the recommendations and eat lots of veggies. Also it has been shown that people who make "healthy" choices are more likely to control alcohol intake, be more likely to use vitamin/health supplements, and get regular exercise. Did the study control for these factors. I too think research is important, but headlines often don't tell the whole story.

I posted the study link, not just the headline :thumbup:

The journal that the original study was published in would be VERY unlikely to let a study slip by peer review that had ignored these easy confounding factors.

Again, I posted this more to fight against the "less carbs is better" meme than anything else. The study itself makes clear that the mechanism of causation is still unclear.

[chilo1 62]

I frogot now the details of this study but it does makes sense, to me at least. If you have consume a very low carb diet for a very long period of time, you wil automatically consume much more fat, Protein and even salt than advised, which will , in time, lead to coronary heart disease, high blood pressure, liver disease, the list goes on and on. One of the main reasons I decide to have this surgery is to be able to consume a "norma" varied diet. More unrefined slow release carbs, more "good" fats, less junk!

[ouroborous 519]

I frogot now the details of this study but it does makes sense, to me at least. If you have consume a very low carb diet for a very long period of time, you wil automatically consume much more fat, Protein and even salt than advised, which will , in time, lead to coronary heart disease, high blood pressure, liver disease, the list goes on and on. One of the main reasons I decide to have this surgery is to be able to consume a "norma" varied diet. More unrefined slow release carbs, more "good" fats, less junk!

Absolutely! That was one of the appeals of VSG for me -- the ability to lose weight without having to follow some sort of super-restrictive diet. Not only are those diets almost impossible to maintain in the long term, but they can be harmful to your health.

[Lila21 36]

There was a statistically significant mortality increase in the high animal-protein diets (P = 0.051, which is definitely enough to infer a correlation).

However, I'd again like to point out that it's likely that the increased mortality is from the increased animal Proteins, not from the carb restriction. Carb restriction on its own is still net neutral, according to the bulk of research.

So I guess the best diet choices are mostly vegetarian, high plant Protein and maybe some supplementation with lower-fat animal Protein sources like whey, etc.

Still, I think it's important to keep abreast of current research, and not just blindly follow what the crash diet books tell you.

Great point. Michael Pollan (sp?) a leading food expert says his food advice boils down to this:

"Eat food. Mostly plants, not too much."

Pretty sane advice :-)

Here's a link to one of his articles: http://michaelpollan.com/articles-archive/unhappy-meals/