A new study looks at low carb diets and heart disease risk and reveals more health-promoting low carb patterns.
low carb diets are popular, but there’s a concern about heart disease. people on low-carb often see their weight go down but their cholesterol go up
new study split people according to carbohydrate intake and measured heart disease risk
the group eating the least carbohydrate had the highest risk
People who don’t like low-carb gloated, and people who love low-carb tried to dismiss the study. who’s right?
If less carbohydrate = higher risk, is it due to the lower carbohydrate or what I ate instead? when carbohydrates were replaced mainly with animal foods, meat dairy eggs, risk went up 50% but if replaced with plant foods, there was no change. so it may be less about the carbs and more about the replacement
but most people focus on whether cutting carbs is good or bad. “high carb” and “low-carb” says very little. Low carb can be designed to be healthy or unhealthy. Same for high carb. And same for low fat. the key is the type of carbs and types of fat.
The carb vs fat wars are a distraction. even a study screaming that its not about the carbs per se only led to people arguing more… about carbs
so many people condemn low-carb diets or low fat diets, adding to the confusion. a new report on people on low carb diets with high cholesterol was titled ‘keto is not for everyone’. But the problem is not keto or low carb, it’s how it is designed
people are being told carbs are bad so they run to low carb diets then they’re told low carb diets are bad and they’re confused. if someone does better on lower carbohydrate, or fat, I don’t see a problem. keys for health: fruits and vegetables, unprocessed plant foods, easy on the ultraprocessed and the saturated fat and salt. If they want to do that with a bit more carb or less carb, high fat or intermediate fat, fine.
The drop in carbohydrates in the study here was modest. Between 58 and 40% of calories from carbs. What happens in more extreme ranges? We don’t know
Also, maybe the people eating more plants and less animal foods also had other healthy behaviors that couldn’t be completely adjusted for.
do other studies generally agree? people on low carb diets high in animal protein and fat have higher risk of heart disease and overall death than if the low carb diet is plant-rich and people who start a low carb diet after a heart attack tend to die more, but only if it’s high in animal protein and fat, not if it’s low carb but plant-rich
eating a high amount of animal foods rich in saturated fat lowers LDL receptor, risk of heart disease goes up
In controlled trials, people who replaced saturated fat with unsaturated fat (predominant in plant foods) had less heart attacks and were less likely to die of heart disease. a low carb diet that is plant-rich can improve blood markers like cholesterol, etc
some people may want to play it safe but are still interested in low carb. as the new study shows you can do low carb without your risk going up by replacing the carbs with more unsaturated fats, more plant foods. key is to not go overboard on saturated fat
The turkana get 75% of their calories from animal products and yet have an average LDL cholesterol of 60, values we normally only see in vegans or people on cholesterol-lowering meds. The average LDL-c in the US is 130
so for most of us going easy on the saturated fat rich foods is the safest bet, whether that’s low carb, high carb or anything in between
Another video on keto vs vegan diets, and one on different fats and their effect on health
Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author’s knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.
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Content
0.16 -> low carb diets are super popular but there's
a common concern about heart disease. it's not
4.88 -> uncommon for people on low carb to see their
weight go down while their cholesterol levels
9.2 -> go up. a new study just came out looking at this
question. they took a population of 2,000 people,
14.32 -> split them according to how much carbohydrate
they ate and measured calcium in their coronary
18.96 -> arteries, which is an indicator of heart disease
risk. the group eating the least carbohydrate
24.24 -> had the highest risk. now, as you can imagine this
created a frenzy on social media. people who don't
30 -> like low carb we're gloating, "we told you, the
diet is terrible", and people who like low carb
34.72 -> were trying to dismiss the study entirely. i
think both sides missed the point. when you
38.88 -> take something out of your diet, you end up with
two variables: what you took out and whatever
43.92 -> you ate instead. so this study addressed exactly
that question. when i reduce my carbohydrate and
49.28 -> i see a higher risk of something, is it because
of the lower carb or is it what i ate instead?
54.8 -> they found that when carbohydrates
were mainly replaced with animal foods
58.8 -> (meat, dairy, eggs), risk of heart disease went up 50%, but if they were replaced with plant foods
65.84 -> there was no change. this was true even after
the authors adjusted for some common confounders
70.64 -> like BMI, blood pressure, smoking etc. so this is saying that it's less about the carbs and more
76.4 -> about the replacement. ironically, most of the
reaction on social media ignored this result
82.16 -> and people just kept arguing about whether cutting
carbs is good for you or bad for you. i've said
86.88 -> this before in several videos, the labels 'low carb'
and 'high carb' tell me very little about the health
92.8 -> value of a diet. low carb can be designed to be
very healthy or very unhealthy. the same for high
99.68 -> carb and the same for low fat for that matter.
it depends on the type of carbs and the type of
104.64 -> fats much more than the amount. the 'carb versus fat'
wars are a distraction, but it's so polarizing and
111.84 -> people are so invested in these camps that even
a study screaming that it's not about the carbs
118.48 -> only led to people arguing more about
carbs. the problem with a distraction
123.44 -> is it diverts attention away from factors that
are actually crucial for health. i see so many
128.32 -> people, including scientists and doctors, condemning
low-carb diets or low-fat diets for that matter
134.88 -> but this only adds to the confusion. just this week,
a group of doctors reported a series of cases of
140.48 -> people on low carb with sky-high cholesterol.
the title of their report was 'keto is not for
146 -> everyone'. but the problem is not keto or low carb,
it's how it was designed in those cases. people are
152.32 -> being told on one hand that carbs are bad, which
is inaccurate, so they run away to low carb diets.
157.84 -> then on the other end they're being told low carb
diets are bad and they don't know where to turn
161.92 -> the oversimplifications just propagate confusion.
if someone does a little better or prefers a diet
167.28 -> that is a little lower in carb or higher in carb
or intermediate or low fat i don't see a reason
173.52 -> to try and talk them out of it. what we should
emphasize is what factors are critical for health,
178.88 -> an abundance of fruits and vegetables, unprocessed
plants and easy on the ultraprocessed products,
184.64 -> saturated fat and salt. if people want to do
that with a little higher carb or lower carb
189.52 -> or lower fat or intermediate fat, fine. whatever
works for them. now, the drop in carbohydrates
196 -> seen in this study was pretty modest. the three
groups averaged 58%, 48% and 40% of calories
203.04 -> from carbs whereas some people go much lower,
in some cases under 5% of calories
207.52 -> from carbohydrate. some people have argued that
this makes the results even more impressive
211.36 -> because even with a modest variation you can
already see a substantial increase in risk but
215.76 -> it leaves the question open: what happens
in those extreme ranges, under 10%, under 5%,
220.8 -> long term, 10-20 years? we don't really know because
there aren't any long-term studies in these ranges
227.04 -> so we could always say, 'well, they haven't
tested the exact proportions that i'm eating
231.28 -> so they haven't shown that it's a problem for me
specifically'. and in all rigor that's true. the risk
236.56 -> could keep going up higher and higher as we get
to those extreme ranges if it follows the trend
241.6 -> or it could improve. both are theoretically
possible. also, important to bear in mind, this
246.08 -> is a population study. the investigators didn't
tell people what to eat, they just observed
250.72 -> the natural tendencies in that population, so there
could be other confounders. maybe the people eating
255.76 -> more plants and less animal foods also had other
healthy behaviors that couldn't be completely
261.12 -> adjusted for, and that's always true of this type
of population study, they point to potential risks
267.28 -> but they can't establish them with 100% certainty. okay, but we can't wait 20 years
272.24 -> for more data to come in so we can finally go have
dinner. so, with the information we have right now,
277.76 -> how can we know if we should be worried about this
or not? we can look at the rest of what's known.
282.08 -> the context. in a recent video, we talked about this
idea of the three bags, the three types of evidence.
288.48 -> we gotta look at everything. no study stands alone
in a vacuum. so do other studies generally agree?
294.72 -> people on low carb diets high in animal protein
and fat have higher risk of heart disease and
300.4 -> overall death than if the low carb diet is
plant rich. this has been shown consistently,
304.8 -> but these are still population studies, same
bag, so maybe all of those are confounded. what
309.6 -> about the other two bags? the first bag is lab
experiments. now, they weigh less than human trials
316 -> but if they suggest a candidate mechanism, that's
good to know. so do we have an idea of how these
321.92 -> foods could cause heart disease? sure, eating a high
amount of animal products rich in saturated fat
327.52 -> lowers what's called the LDL receptor, basically
a docking station for LDL. and if LDL can't dock,
334.08 -> it stays in circulation longer and the risk of
heart disease goes up. We covered the details in
339.12 -> this video. there are other candidate mechanisms,
but that would probably be at the top of the list
343.68 -> okay, what about the last bag, clinical trials?those
are usually the most compelling. in controlled
348.32 -> trials, people who replaced saturated fat with
unsaturated fat, predominant in plant foods,
354.4 -> had less heart attacks and were less likely to
die of heart disease. we also know a low-carb
360.24 -> diet that is plant-rich can improve blood
markers like cholesterol, triglycerides etc
365.36 -> so when we put everything together, some people
are still going to be willing to run the risk,
369.84 -> that's totally fine, as long as we're
making informed decisions. other people
373.2 -> are going to want to play it safe but might still
be interested in low carb. that's fine too, you can
378.56 -> have them both, you don't have to choose. as the new
study shows, you can do low carb without your risk
383.12 -> shooting up by replacing carbohydrates with more
unsaturated fats. you don't have to go 100% plants
389.12 -> if you don't want to, that's up to you, the key
is to not go overboard on saturated fat. what's
394.24 -> overboard? official guidelines will tell you to
keep it under 7-10% of calories
398.56 -> but as always, there's individual variation. some
people can get away with more than others. this
402.88 -> fascinating study just came out on the Turkana, a
people in Kenya who get 75% of their calories from
409.28 -> animal products and yet have an average LDL-cholesterol of 60 mg/dL. if you can pull that off,
414.8 -> you probably have more wiggle room than most,
but those values are rare in the West, normally
419.36 -> you only see them in vegan populations or people
on cholesterol-lowering meds. the average LDL-cholesterol
424.16 -> in the US is 130 mg/dL, more than double the
level in the Turkana. so, for most of us who didn't
430.48 -> win the genetic lottery, alas, the safest bet
is to go easy on the saturated fat-rich foods,
436.64 -> whether that's high carb, low carb or anything
in between. here's a look at keto and vegan and
442.8 -> whether it even makes sense to ask which one
is better? (it doesn't). and here's more on the
447.12 -> different types of fats and their effects on
health. thanks for watching, see you next week
