Macro partitioning
Carbohydrate-restricted diets (≤45% energy) significantly improve cardiovascular health by reducing triglycerides, blood pressure, and inflammatory markers, despite modest increases in LDL and total cholesterol.
Adopting a diet with less than 45% of calories from carbs improves heart health markers like blood pressure and triglycerides. Even if your LDL cholesterol rises slightly, your overall cardiovascular risk likely decreases because your triglycerides drop, inflammation goes down, and your cholesterol ratios improve. This is especially true if you replace carbs with a mix of fats and proteins.
CRDs significantly reduced triglycerides [SMD: –15.11 mg/dL; 95% CI: –18.76, –11.46], systolic (SMD: –2.05 mmHg; 95% CI: –3.13, –0.96) and diastolic blood pressure (SMD: –1.26 mmHg; 95% CI: –1.94, –0.57), various lipid profile ratios, and inflammatory markers (C-reactive protein, tumor necrosis factor-alpha), whereas increasing high-density lipoprotein (SMD: 2.92 mg/dL, 95% CI: 2.10, 3.74). Low-density lipoprotein (LDL) and total cholesterol increased modestly (SMD: 4.81, 95% CI: 2.58, 7.05; and SMD: 4.32 mg/dL, 95% CI: 1.66, 6.97, respectively).
Why this rating
Large-scale meta-analysis of 174 randomized controlled trials with rigorous statistical methods (REML, Bonferroni correction).
Source
Effects of carbohydrate-restricted diets and macronutrient replacements on cardiovascular health and body composition in adults: a meta-analysis of randomized trials
Shuo Feng et al. · American Journal of Clinical Nutrition · 2025
DOI 10.1016/j.ajcnut.2025.09.012
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