Heart Disease Risk on Low Carb Diets
Reports of Heart Disease on Low Carb Diet Plan

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6. Heart Disease Risk on Low Carb Diets

Extract from "Updated Analysis of Health Problems Associated with High-Protein, High-Fat, Carbohydrate-Restricted Diets Reported via an Online Registry" by the Physicians Committee for Responsible Medicine (PCRM) (Dec, 2003)

Note: Numbers in brackets refer to research references. See Low Carb Eating References

Cardiovascular disease, including heart attack, atrial fibrillation, coronary arteriosclerosis, and high serum cholesterol, was reported by 33 percent of the registrants.

One registrant who had a heart scan that revealed no plaque or occlusions prior to starting a high-fat, high-protein, carbohydrate-restricted diet began experiencing angina after two years on the diet. An angiogram performed at that time showed a severe artery blockage; the registrant underwent angioplasty and stent placement. He said the diet “gave me heart disease.” Another described feeling as if “someone [was] boxing my ears with a very strong throbbing in my neck.” That registrant checked into the emergency room to learn that she had a heart rate of 210, which was slowed down with medication. She had developed atrial fibrillation, a condition in which disorganized electrical conduction in the atria (upper chambers of the heart) results in ineffective pumping of blood.

Typical high-protein diets are extremely high in dietary cholesterol and saturated fat. The effect of such diets on serum cholesterol concentrations is a matter of ongoing research. However, 714 percent of registrants reported high serum cholesterol concentrations. Other biochemical measures of heart disease risk may be affected. In a small study, individuals following high-protein diets against medical advice showed increases in fibrinogen, lipoprotein (a), and C-reactive protein, and demonstrable progression of coronary artery disease, suggesting that high-protein diets may precipitate progression of CAD through increases in lipid deposition and inflammatory and coagulation pathways. (24) Such diets pose additional cardiovascular risks, including increased risk for cardiovascular events immediately following a meal. Evidence indicates that meals high in saturated fat impair arterial compliance, increasing the risk of cardiovascular events in the postprandial period. A recent study showed that the consumption of a high-fat meal (a ham and cheese sandwich, whole milk, and ice cream) reduced systemic arterial compliance by 25 percent at three hours and 27 percent at six hours. (25)

In a study comparing individuals on four different weight-loss diets (a moderate-fat diet without calorie restriction; a low-fat diet; a moderate-fat, calorie-controlled diet; and a high-fat diet), only patients following high-fat diets for weight loss showed a worsening of each cardiovascular disease risk factor (LDL-C, TG, TC, HDL-C, TC/HDL ratio, Ho, Lp(a), and fibrinogen), despite achieving statistically significant weight loss. (26)

Researchers at the Framingham Heart Study have become concerned that users of high-protein, high-fat diets are at high risk of heart disease because frequent fatty meals increase levels of two of the most atherogenic (plaque-promoting) fatty particles in the blood stream: chylomicrons, which are the body’s main fat-transporting particles; and free fatty acids, small fat particles that move freely in the blood stream. The research group has been studying the carotid arteries, a key artery in the neck that moves blood from the heart to the brain, of women in the Framingham Study for 12 years.

The women who have chosen to consume a high-fat, carbohydrate-restricted diet have roughly double the deposits in their arteries as those on a higher-carbohydrate, lower-fat diet, clearly indicating an increased risk of stroke and heart disease (Wm. Castelli, personal communication, 2003).

A sudden cardiac death of an adolescent while using a high-protein, carbohydrate-restricted diet has been reported. The report’s authors explain that, upon examination, the young woman was found to be severely hypokalemic (low in potassium). Severe blood mineral imbalances are possible on a high-protein, restricted-carbohydrate diet, especially when used in combination with low energy intake (as might occur during a weight-loss regimen). Potassium, calcium, and magnesium are all used by the body to neutralize acidity and balance blood pH levels. When ketone bodies are produced in a carbohydrate-restricted diet, metabolic acidosis results. The ketone bodies are paired with one of these minerals before being excreted in the urine. A prolonged ketotic state can thus result in depletion of blood minerals. (23) Mineral losses may also be compounded by the use of laxatives (to control problems with constipation associated with high-protein, low-carbohydrate diets) or diuretics. Low blood mineral levels can result in arrhythmias and even cardiorespiratory arrest. The onset of arrhythmias that required medical treatment were reported by 26 (6 percent) of the registrants while on high-protein, low-carbohydrate diets.

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