Atkins diet ‘dangerous to heart health’

By Piriya Mahendra

Women who follow an Atkins-style diet have a significantly increased risk for cardiovascular disease (CVD), experts warn.

Pagona Lagiou (University of Athens, Greece) and team estimate that an extra four to five cases of CVD occur per year for every 10,000 women who follow a low-carbohydrate, high-protein diet.

This translates to a 28% higher risk for ischemic heart disease, stroke, and peripheral arterial disease among such women, relative to those who do not follow this diet.

The researchers measured diet on the low carbohydrate-high protein (LCHP) score where a score of 2 corresponded to very high carbohydrate and low protein consumption and a score of 20 corresponded to very low carbohydrate and high protein consumption.

They found that each one-tenth decrease in carbohydrate intake or increase in protein intake was associated with a significantly increased risk for CVD overall, at an incidence risk estimate of 1.04. The equivalent 2-unit increase in LCHP score was associated with a 1.05-fold increased CVD incidence.

As reported in the BMJ, unadjusted analysis revealed that compared with an LCHP score of 6 or less, CVD risk increased by 13% for women who had a score of 7-9, 23% for those with a score of 10-12, 54% for those with a score of 13-15, and 60% for those with a score of 16 or higher.

After adjustment for other CV risk factors, there was a 5% increase in the likelihood for a CV event or death with each 2-point increase in the LCHP score. The authors say that this 5% increase was attributed to a daily reduction in carbohydrates of 20 g, which is equivalent to a small bread roll, and a daily increase in protein of 5 g, which is equivalent to one boiled egg.

The study involved 43,396 Swedish women aged 30-49 years who completed an extensive dietary questionnaire and were followed up for an average of 15.7 years.

Lagiou and team say that LCHP diets used on a regular basis "and without consideration of the nature of carbohydrates or the source of proteins" are associated with CV risk. However, they say that the possible benefit of short-term effects of LCHP diets to control weight or insulin resistance needs further investigation.

In a related commentary, Anna Floegel and Tobias Pischon, both from the Max Delbrück Center for Molecular Medicine in Germany, say that the discrepancies between conclusions from different previous studies in this area "need to be resolved before low carbohydrate-high protein diets can be safely recommended to patients."

In the meantime, they suggest that any benefits gained from Atkins-style diets in the short term "seem irrelevant in the face of increasing evidence of higher morbidity and mortality from CVD in the long term."

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