6-month low-carb diet high in fat does not adversely affect endothelial function

JenniferM55 said:

I'm not 'scientific', I always skip to the 'Conclusion'. The worm surely has turned?

"Conclusion
A LCD high in fat for six months does not adversely affect endothelial function or selected markers of low-grade inflammation, which suggests that this nutritional approach does not increase the risk of cardiovascular disease.

Trial registration ClinicalTrials.gov (NCT03068078)."

A six-month low-carbohydrate diet high in fat does not adversely affect endothelial function or markers of low-grade inflammation in patients with type 2 diabetes: an open-label randomized controlled trial - Cardiovascular Diabetology

Background While a low-carbohydrate diet (LCD) reduces HbA1c in patients with type 2 diabetes (T2D), the associated high intake of fat may adversely affect cardiovascular risk factors. To address this, we examined the effect of a non-calorie-restricted LCD high in fat on endothelial function and...

cardiab.biomedcentral.com

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Very interesting study. but is it very confusing since they use LCD for their low carb diet, but elsewhere refer to LCD and VLCD interventions done by others, which I think may be calorie restricted diets. so are they comparing like for like or not?

There is a paragraph in the results section where they give an overview of changes noted between their intervention group vs the control group such as HbA1c , weight loss, waist reduction, and also the changes to medications that seem to occur with the LCD arm but not in the control arm. The text has embedded references galorev, and I cannot be botherd to deactivate the links.

I have to accept that their use of FMD and NID to correlate heart health are valid markers . But the increase in sat fat not making these worse is good news, Presumably these markers are a measure of atherosclerosis restriction. So my question is "Is 6 months long enough for changes to show anyway?" I thought atherosclerosis took years to develop. I know TNT is a treatment causing vasodilation for easing angina, so NID may be similarly fast acting. Its outside my pay grade though.

Edit to clarify: my reference to TNT is actually to glycerine trinitrate which is closely related.

I have thought a bit more on this. They are using the brachial artery for their measurements. This is convenient and non invasive, but is it really giving a clean slate for the heart issues we normally associate with MI and thrombosis. My research seems to show a concentration of research is on the aorta feeding the heart, the valves, and also the lungs as being the dangerous ones, and in my case the neck arteries for my strokes. But I am not sure if the brachial artery has a close correspondence to those in the torso that are carrying fresher blood (fresher oxygenated) and possibly more ca;lcium . I am not yet convinced that this study is bulletproof.

Here is another article on endothelial mesurement, and it is not describing the method used by the LCD study, so again I wonder if their methodology is sound.

JenniferM55 said:

Your thoughts are really interesting, the article certainly confused me.

It interested me as 10 months ago I had open heart surgery to replace my aortic valve (due to genetic fault I believe), I was lucky that no heart disease was found despite me being 'three score years and ten' next week, being classed as diabetic (probably for decades before diagnosis), used to be morbidly over weight, and now being unafraid of saturated fats in my diet. I've haven't the wherewithal to question the science in the study, so I trusted the conclusion. At least there are discussions taking place in scientific circles now.

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You may be interested in reading Dr Aseem Maholta, who is an eminent cardiologist who used to work in Surrey General Hospital. Be aware that he is an advocate for Low Carb dieting, and he strongly supports the Pioppi diet, which I follow. But he is looking at the diet from the heart health POV rather than the diabetes angle. He is also co-author on a recipe book for LCD followers.

His diet plan was followed by Tom Watson (now Baron Watson of Wye) when he was labour deputy leader.

NB IMHO Pioppi Diet is basically The Mediterranean Diet, but in a low carb form. It is named after the coastal town of Pioppi, which is where Ancel Keys lived and did his 7 countries study. Interesting that they both have different interpretations of the same info, but we have tried the Ancel Keys variant for more than 30 years and find it to be unhelpful for us (Eatwell et al).

OK just read some studies basrd on post mortem reports for patients passing due to cardiovascular events. The post mortem found that the brachial artery did have some atherosclerosis that was significant in those patients who were under 50 at time of death, but had no significance with those over 50 years old.

Seeing that atherosclerosis and hardening of the arteries is normally an age related problem, then it would point to possible lifestyle causes in the younger people, but was largely irrelevant in older folk

so it seems the LCD study may have an inbuilt systemic error by their data collection method. The correlations for the carotid or anterior descending arteries were significant for all ages so the Cedar - Mt Sinai study methods seem to be more reliable.

JenniferM55 said:

Yes I've seen Dr Aseem's seminars on YouTube. I like him a lot, thanks for the reminder. I must revisit those seminars.

Ancel Keys, least said about him! Just 10 years ago my husband was given a diet sheet from a University Hospital that quoted Ancel Keys' as if he was a guru. No wonder people are so confused.

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Ancel Keyes was indeed a Guru. He advised the US war department what diet to feed the troops, and was responsible for inventing K Rations. He was the US Gov chief advisor for nutrition, and the food pyramid (which became ADA and then the US SAD diet (i.e. Eatwell in America) Everybody listened to him. there were some lawsuits that tried to debunk him, but those were fighting the US government who backed their spokesperson. His 7 Countries study was a work of Art, and deceit.