Macro partitioning
Long-term adherence to a low-carbohydrate diet (LCD) starting in young adulthood is associated with an increased risk of coronary artery calcium (CAC) progression in middle age, particularly when carbohydrates are replaced by animal-based protein and fat rather than plant-based sources.
If you follow a low-carbohydrate diet, especially one that started in your 20s or 30s, be mindful of what replaces the carbohydrates. This study suggests that replacing carbs with animal proteins and fats (like red meat, butter, cheese) is linked to increased coronary artery calcium progression, a marker of heart disease risk. To mitigate this risk, consider replacing carbohydrates with plant-based proteins and fats (like nuts, seeds, legumes, vegetables) instead. Long-term animal-based low-carb diets should be approached with caution regarding cardiovascular health.
LCDs starting at a young age are associated with an increased risk of subsequent CAC progression, particularly when animal protein or fat are chosen to replace carbohydrates.
Why this rating
Large prospective cohort study (CARDIA, n=2226) with long follow-up (mean 8.3 years) and adjustment for multiple confounders, though observational design limits causal inference.
Source
Low-Carbohydrate Diet Score and Coronary Artery Calcium Progression
Jing‐Wei Gao et al. · Arteriosclerosis Thrombosis and Vascular Biology · 2020
DOI 10.1161/atvbaha.120.314838
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