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LOW-CARB DIET AND RISK OF DEATH
The debate regarding the potential health benefits of low-carbohydrate diets has gone on for over four decades now. During this period, the pendulum has swung, repeatedly, back and forth between “low-carb” and “high-carb” diets, combined with controversies regarding low-fat versus high-fat diets, as various diet and health gurus have weighed in with their recommendations. (Witness one of the more popular and enduring of these “have it your way” dietary fads, the now discredited Atkins Diet, which advocated a reduction in carbohydrate intake combined with a free pass on meat consumption, and other animal-based sources of fat and protein.)
Currently, there is really no meaningful controversy regarding the linkage between meat consumption and an increased risk of cardiovascular disease and cancer. However, the impact of dietary carbohydrate intake on health continues to be the subject of some debate. Unfortunately, as is often the case regarding debates about lifestyle- and diet-related health factors, there is very little high-level clinical research data evidence available to support the more ambitious claims made by “experts” at either spectrum of the carbohydrate debate. Now, a newly published study, which appears in the current issue of the Annals of Internal Medicine, offers a fresh, evidence-based assessment of the impact of carbohydrate and meat intake on the risk of early death.
In this prospectively conducted cohort study, which was funded by the National Institutes of Health, the results of two very large prospective public health studies were combined. More than 85,000 women who participated in the vast Nurses’ Health Study, and nearly 46,000 male physicians who participated in the Health Professionals Follow-up Study, were included in this analysis. These healthy female and male volunteers were without clinical evidence of cardiovascular disease, diabetes, or cancer when they entered into these studies. An almost unprecedented duration of clinical follow-up was available for these two enormous groups of research volunteers, which makes this combined cohort study extremely powerful. On average, the male study volunteers have already been followed for 20 years, while the women volunteers have been followed for an average of 26 years. All of these 129,716 men and women completed multiple validated diet questionnaires at various time points in these two clinical studies, and the data collected from these questionnaires was then used to analyze the impact of diet on mortality (death) risk among this huge group of nurses and physicians.
Two sub-groups of volunteers were assessed, based upon their dietary preferences, and these two sub-groups of men and women were then compared with the remaining study volunteers. The first dietary preference sub-group consisted of men and women who preferred a low-carbohydrate diet associated with the frequent intake of meat and other animal-based foods (along the lines of the Atkins Diet), while the second sub-group consisted of men and women who routinely consumed a low-carbohydrate diet that emphasized vegetable and fruit sources of protein (instead of animal sources of protein).
Over the very long duration of the two combined studies, 12,555 deaths occurred among the women (including 2,458 deaths due to cardiovascular disease). Among the men, there were 8,678 deaths (including 2,746 deaths due to cardiovascular disease).
In the group of men and women who favored an Atkins-like diet, emphasizing a low carbohydrate intake but liberal meat consumption (and other animal-based foods, as well), the risk of premature death from any cause (when compared to a low-carb, low-meat diet) was elevated by 23 percent. This same dietary preference was also associated with a 14 percent increase in the risk of death due to, specifically, cardiovascular disease.
In contrast, the men and women who consumed a diet low in both carbohydrates and animal products appeared to significantly reduce their risk of death due to all causes, as well as their mortality due to cardiovascular disease, specifically. In this group of research volunteers, mortality due to any cause was reduced by 20 percent, while death due to cardiovascular disease, specifically, was reduced by 23 percent.
The findings of this very large prospective public health study, with its extremely long duration of clinical follow-up, confirms the findings of other recent (and less powerful) small clinical studies that a diet rich in vegetables, but low in both carbohydrates and animal-derived foods, confers a very significant benefit in terms of the overall risk of death, and the risk of death from cardiovascular disease, in particular.
Excessive carbohydrate intake has been previously shown to increase the risk of diabetes, obesity, cardiovascular disease, cancer, and other serious illnesses. At the same time, increased meat intake has also been clearly shown to raise the risk of many of these same life-threatening illnesses, as well. From this huge prospective cohort clinical study, we can see highly significant health benefits associated with long-term adherence to a healthy diet rich in vegetables and low in carbohydrates and animal-derived foods. (And there are not many health benefits that can trump a significant reduction in your risk of premature death!)
For an evidence-based review of the critical importance of diet in a cancer prevention lifestyle, watch for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” later this month.
Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity
Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author
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