Low-Carbohydrate Diets and All-Cause Mortality:

[Sid Bonkers]

A new study recently out suggests that long term low carb diets are far from safe and are actually shown to increase all causes of mortality.

Low-carbohydrate diets tend to result in reduced intake of fibre and fruits and increased intake of protein from animal sources, cholesterol and saturated fat. In their conclusion they write: "Our meta-analysis supported long-term harm and no cardiovascular protection with low-carbohydrate diets. … Our findings underscore the imminent need for large-scale trials on the complex interactions between low-carbohydrate diets and long-term outcomes."

More information here http://www.plosone.org/article/info%3Ad ... ne.0055030

Its long been said that the effectiveness of low carb diets are only beneficial in the short term, somewhere between 6 months to 1 year. Lets hope that more long term trials are undertaken to prove this one way or the other or some diabetics could find themselves doing more harm than good.

 

[Maitland]

This is my concern. I have been on a low carb diet since the 17th of April and should by tomorrow have lost my first stone with one more to go.

I Know that this diet is a short term diet and is not sustainable in the long term.

What I need to look at is a dietary plan that will stabilise my weight yet keep my blood sugars at an acceptable level.

M...

 

[Luna21]

I agree, more information is desperately needed about this.

I'm moderately low-carbing at the moment, I still eat bread, new potatoes, and brown rice,all small portions, but I wouldn't feel comfortable about going any lower, although things are looking good at the moment.
I don't however follow the high-fat regime that many people use alongside low-carbing though.

I too am concerned about a long-term dietary plan to keep diabetes, and weight in check.

 

[SamJB]

I agree that more research is needed, but high carbohydrate diets have been proven to be inefficacious and therefore unsafe. The results of the recent National Diabetes Audit showed that 94% of Type 1s aren't achieving the 6.5% HbA1c target; which, incidentally, is scandalous. What advice are they given? You can guarantee it's not low carb. Consequently they have a high risk of developing complications. Therefore high carb diets are both inefficacious and unsafe. At least low carbing in efficacious.

 

[SamJB]

After having a quick read of the paper, the CVD mortality risk they give is slight compared to what having a high HbA1c will give you.
The CVD risk they give in their paper is < 2. Take a look at this:

http://img.medscape.com/slide/migrated/editorial/cmecircle/2004/3036/images/gerich/slide018.gif

If you are on carbs and can, at best, achieve an HbA1c in the 7s then your risk of CVD can be up to 5 times that of the non-diabetic population. If you low carb and get an HbA1c in the 6s, then your risk is significantly less and similar to the risk given in the paper quoted by Sid. Of course, if you have an HbA1c in the 6s then your risk of all the other complications is reduced too.

So, if you achieve HbA1c targets by low carbing then you have a better CVD (and all the other complications) risk that you would do if you cannot achieve the HbA1c target by eating carbs.

What would be best is if you could achieve the HbA1c target by eating carbs. I couldn't though!

 

[initforlove]

the emphasis is on starches and avoiding them whilst having carbs in the form of veggies which are not starchy. when compared to a so-called normal weight reducing diet the emphasis is also on veggies that are not starchy. there is no difference.

 

[Andy12345]

nooooooooo i just made it to 30g a day and now its bad????

 

[SamJB]

Andy, if you achieve the target HbA1c of 6.5% by low carbing then your risk of CVD is less than it would be if your HbA1c was in the 7s. The CVD risks given in this paper are less than the CVD risks of having a high HbA1c.

 

[Andy12345]

it was 12.6 just had it done again and its 7.4 i assume it will go lower next time but if it dosent does that mean low carbing isnt good for me? sorry if im thick, but im thick

and what is cvd pls?

 

[SamJB]

Sorry, CVD is Cardiovascular Disease aka heart disease.

If low carbing is bringing down your HbA1c then it's obviously working. An HbA1c tells you how well you've done over 4 months, so I'd give low carbing a full 4 months before deciding. You'd then have to judge what carbs would do to your HbA1c if you decided to start eating them again.

 

[mo1905]

Any restrictive diet is not good long term. The body is designed to be fuelled by a mixed healthy diet, including carbs ! Mr Atkins made a fortune out of low carb regime but didn't do him much good !! Eat healthy, exercise and fingers crossed lol !


Sent from the Diabetes Forum App

 

[Sarah69]

It's all very well saying diabetics should eat low carb but if you don't like the food that's supposed to be good for you, what are you meant to do? I know I couldn't live that way, veg every day I don't like much to start with only have them once a week and salad I only ever eat a few times during the summer with bbq's.

 

[hanadr]

i have been low carb for many years and don't have any markers [found by blood tests!] that would suggest I'm putting my life at risk.
In addition, I don't load up on protein, I'm fairly high fat. They talk about high protein diet.
Lastly If you quote correctly, but I didn't find the relevant statement when I read the article. I have serious doubts about the accuracy of work done by anyone who uses the word "imminent " incorrectly, when what was meant was either "immanent or "inherant"
To use only 18 out of 400+ studies, makes me distrustful [shades of the 7 countries study!] and nowhere did Isee the actual amount of carb in the selected diets.
Hana

 

[Daibell]

I agree with SamJB. If you are one of the T2s that has an increasing HBa1C beyond 7 and having several meds already then you have no choice but to go low-carb otherwise your sugars and HBa1C will go thru the roof and the long-term harm is really serious. Mo1905, it would be nice if diabetics could have a 'healthy' diet but many of us can't because we have the inability to process carbs properly so have no choice but to low-carb and have small portion sizes. Now I'm on insulin as well I've been able to relax my low-carbing but prior to that and on max tablets I had no choice. The paper the OP referred to didn't take account of diabetes and the implications of carbs on blood sugar and organ damage. The survey also focussed on low-carb/high protein and didn't include low-carb high protein and fat. I wonder what that would have shown. The research also assumed CVD results from saturated fat intake but many web forums question the real evidence for that.

 

[AMBrennan]

Of course the benefits and risks of any intervention should be weighed to make an informed decision, and it is quite possible that the benefits from an intervention justify the risks and side effects. Problem is the lack of evidence to support the effectiveness - the NHS isn't stupid, and if there was evidence that changing dietary advice could save them millions in treatment costs then they would do so.

The results of the recent National Diabetes Audit showed that 94% of Type 1s aren't achieving the 6.5% HbA1c target; which, incidentally, is scandalous. What advice are they given? You can guarantee it's not low carb

That claim is unproven - they also drive on the left side of the road and drink water so why not blame that? Unless you can find RTCs that prove otherwise kindly stop peddling your low car diets to T1 diabetics.

After having a quick read of the paper, the CVD mortality risk they give is slight compared to what having a high HbA1c will give you.

Brilliant. Now prove hat low-carb is effective at lowering HbA1c.

So, if you achieve HbA1c targets by low carbing then you have a better CVD (and all the other complications) risk that you would do if you cannot achieve the HbA1c target by eating carbs.

That's begging the question. Where is your RTC that proves your claim?

 

[SamJB]

Good morning AMBrennan, nice to find you so cheerful and non-antagonistic for a change.

the NHS isn't stupid, and if there was evidence that changing dietary advice could save them millions in treatment costs then they would do so.

Agreed. What they're doing is inefficacious and unsafe. Go and argue with the 94% of diabetics that they are failing. Is 94% acceptable to you? Does that suggest to you that their advice is working?

That claim is unproven - they also drive on the left side of the road and drink water so why not blame that?

Driving on the left and drinking water do not affect sugar levels. Eating carbohydrate does. Do you need me to explain why eating high amounts of carbohydrate could be toxic for a diabetic?

Unless you can find RTCs that prove otherwise kindly stop peddling your low car [sic] diets to T1 diabetics.

Now prove hat low-carb is effective at lowering HbA1c.

Where is your RTC that proves your claim?

Here's some quantitative evidence, hope you enjoy the read:

http://www.dmsjournal.com/content/pdf/1 ... 6-4-23.pdf

Qualitative evidence also comes from the many people on here who have found low carbing to be more efficatious than consuming high quantities of carbs, including myself.

 

[Sid Bonkers]

Go and argue with the 94% of diabetics that they are failing. Is 94% acceptable to you?

Where you are getting your figurers from? That is totally incorrect, like most statistics that that are posted on forums by low carbers, do you really believe that only 6% of diabetics are not failing?

 

[SamJB]

The National Diabetes Audit 2010-2011:

https://catalogue.ic.nhs.uk/publication ... rep-V4.pdf

Table 13. Apologies, it's 93.1% that aren't getting the 6.5% HbA1c target, not 94%. This table is for Type 1s in England only, for Wales it's worse. There is a complete breakdown in the audit of diabetes performance across the UK for both types. Pretty reputable source if you ask me.

 

[Superchip]

Well done SamJB....!

[Mod Edit Removed- Opinions are fine but aggressiveness and argumentative posts are not]

Evening S....

S

 

[Dillinger]

Guys,

If you are low-carbing and your HbA1c is improving that is the key thing. Keep doing it; do not let this sort of thing scare you.

This study is not saying that if you eat a low carb diet you increase your risk of dying. It is saying that there is an (apparent) association between a slight rise in all cause mortality and a low-carb diet; that is a different thing entirely. This is an observational study and they are used to develop ideas that can then be properly studied. Association does not equal causation. The difference could be down to some completely different issue.

It says "The risk of all-cause mortality among those with high low-carbohydrate score was significantly elevated: the pooled RR (95% CI) was 1.31 (1.07–1.59)". I.31 as percentage figure is 31%. The bracketed figures are the possible error margins; so if you are an optimistic low-carber then the increased risk is a trifling 0.7%

Importantly that looks to me like a relative risk; and it is pretty meaningless if we don't know the absolute risk, the number of people that this applies to (number needed to treat/harm) or the time period; is this per year, per day, per 100 years?

If the absolute risk of dying young is 1% and you do something that increases that to 1.3% then the relative risk of death has increased by 30% (yikes!) but the absolute risk has increased by 0.3% to 1.3% (pffffft).

Also, we don't know the levels of carbohydrate included in the reviewed studies, we don't know the make up of that all cause mortality (could include being eaten by sharks or struck by lightning) we don't know a huge amount, we do see that heart disease isn't effected though - so there you are naysayers - low carb has no bad effects on your heart!

Something we do know though is that if you do not control your blood sugars then you will suffer the consequences and as many will attest the easiest way to control your blood sugars is to avoid the primary culprit; carbohydrate. As the mighty Lux Interior said 'you don't need it; so don't eat it'.*

Have a nice carb free weekend.

Dillinger

*Lux Interior was the lead singer of The Cramps and it's never too late to start listening to them