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Conclusion A low-carbohydrate plant-based diet has lipid-lowering advantages over a high-carbohydrate, low-fat weight-loss diet in improving heart disease risk factors not seen with conventional low-fat diets with animal products. The Effect of a Plant-Based Low-Carbohydrate ("Eco-Atkins") Diet on Body Weight and Blood Lipid Concentrations in Hyperlipidemic Subjects David J. A. Jenkins; Julia M. W. Wong; Cyril W. C. Kendall; Amin Esfahani; Vivian W. Y. Ng; Tracy C. K. Leong; Dorothea A. Faulkner; Ed Vidgen; Kathryn A. Greaves; Gregory Paul; William Singer Arch Intern Med. 2009;169(11):1046-1054.

Dietary cholesterol from eggs increases plasma HDL cholesterol in overweight men consuming a carbohydrate-restricted diet. Mutungi G, Ratliff J, Puglisi M, Torres-Gonzalez M, Vaishnav U, Leite JO, Quann E, Volek JS, Fernandez ML. J Nutr. 2008 Feb;138(2):272-6. PMID: 18203890 Carbohydrate-restricted diets (CRD) significantly decrease body weight and independently improve plasma triglycerides (TG) and HDL cholesterol (HDL-C) . [..] Eighteen subjects were classified as having the metabolic syndrome (MetS) at the beginning of the study, whereas 3 subjects had that classification at the end. These results suggest that including eggs in a CRD results in increased HDL-C while decreasing the risk factors associated with MetS.

Researchers at the University of California, Berkeley, have identified a gene that plays a critical regulatory role in the process of converting dietary carbohydrates to fat. In a new study, they disabled this gene in mice, which consequently had lower levels of body fat than their normal counterparts, despite being fed the equivalent of an all-you-can-eat pasta buffet. The authors of the study, to be published in the March 20 issue of the journal Cell, say the gene, called DNA-PK, could potentially play a role in the prevention of obesity related to the over-consumption of high-carbohydrate foods, such as pasta, rice, soda and sugary snacks.

This week sees the publication of yet another study showing the superiority of the low-carbohydrate diet as compared to the low-fat diet. This study, published in the prestigious American Journal of Clinical Nutrition, demonstrates that subjects following the low-carb diet experience a decrease in triglyceride levels and an increase in HDL-cholesterol (HDL) levels; and that these changes are accompanied by a minor increase in LDL-cholesterol (LDL), which prompts the authors to issue a caveat. Yes, although just about all the parameters that lipophobes worry about improved with the low-carb diet, the small increase in LDL has caused great concern and has prompted the authors to gravely announce that this small increase is troublesome and should be monitored closely in anyone who may be at risk for heart disease. Since most people who go on low-carb diets do so to deal with obesity issues, and since obesity is a risk factor for heart disease, it would appear that this small increase in LDL often seen in those following a low-carb diet could put these dieters at risk. Does it? We'll see.

ScienceDaily (June 9, 2009) - Overweight individuals who ate a low-calorie, low-carbohydrate diet high in plant-based proteins for four weeks lost weight and experienced improvements in blood cholesterol levels and other heart disease risk factors, according to a report in the June 8 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. A high-carbohydrate, low-fat vegetarian diet also resulted in weight loss but without the additional cardiovascular benefits.

Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. Brinkworth GD, Noakes M, Buckley JD, Keogh JB, Clifton PM. Am J Clin Nutr. 2009 May 13. [Epub ahead of print] PMID: 19439458 doi:10.3945/ajcn.2008.27326

How Carbohydrates effect Diabetes

An isoenergetic very low carbohydrate diet improves serum HDL cholesterol and triacylglycerol concentrations, the total cholesterol to HDL cholesterol ratio and postprandial pipemic responses compared with a low fat diet in normal weight, normolipidemic women. Volek JS, Sharman MJ, Gómez AL, Scheett TP, Kraemer WJ. J Nutr. 2003 Sep;133(9):2756-61. PMID: 12949361

Conclusion: The associations suggest that replacing SFAs with PUFAs rather than MUFAs or carbohydrates prevents CHD over a wide range of intakes. Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Jakobsen MU, O'Reilly EJ, Heitmann BL, Pereira MA, Bälter K, Fraser GE, Goldbourt U, Hallmans G, Knekt P, Liu S, Pietinen P, Spiegelman D, Stevens J, Virtamo J, Willett WC, Ascherio A. Am J Clin Nutr. 2009 May;89(5):1425-32. Epub 2009 Feb 11. PMID: 19211817 doi:10.3945/ajcn.2008.27124

Scientists in Canada reviewing the research so far on links between different diets and heart disease found strong evidence that diets high in vegetables and nuts, and those that follow a Mediterranean pattern rich in fruit, vegetables and fish were strongly associated with lower heart disease risk than those that rely on food with a high glycemic index or high in trans-fatty acids. High glycemic index food includes rice, pasta and refined carbohydrates like white bread, and foods high in trans-fatty acids include fried foods, baked goods and snacks.

[Egg intake and cardiovascular risk] Schärer M, Schulthess G. Ther Umsch. 2005 Sep;62(9):611-3. Review. German. PMID: 16218496 The egg - rich in proteins, unsaturated fatty acids, vitamins and minerals - should be part of our nutrition, and it is not justified to recommend a general limitation of egg intake. However, we do not advice unbalanced high egg consumption. A cardioprotective diet is characterized by high variability and contains plenty of fruits, vegetables, and complex carbohydrates.

Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Jakobsen MU, O'Reilly EJ, Heitmann BL, Pereira MA, Bälter K, Fraser GE, Goldbourt U, Hallmans G, Knekt P, Liu S, Pietinen P, Spiegelman D, Stevens J, Virtamo J, Willett WC, Ascherio A. Am J Clin Nutr. 2009 Feb 11. [Epub ahead of print] PMID: 19211817 doi:10.3945/ajcn.2008.27124

I imagine most readers of this blog would expect a group of subjects to do better on a Paleolithic diet as compared to a standard American diet, but there are few studies actually making the comparison. One was posted yesterday in the Advance-0nline-Publication section of the European Journal of Clinical Nutrition that shows subjects following a Paleolithic diet made major metabolic changes, and made them rapidly

If wheat is so bad, what about all the other grains? First of all, I demonize wheat because of its top-of-the-list role in triggering: --Appetite--Wheat increases hunger dramatically --Insulin --Blood sugar--Wheat is worse than table sugar in triggering a rapid, large rise in blood sugar --Triglycerides --Small LDL particles--the number one cause for heart disease in the U.S. --Reduced HDL --Diabetes --Autoimmune diseases--Most notably celiac disease and thyroiditis. Most other "healthy, whole grains" aren't quite as bad. It's a matter of degree.