Low carb diets and heart health.

[Rhia2021]

I'm a 70 year old man. I have been low BMI and physically active all my life, and have always been interested in healthy eating, endeavoring to keep abreast of the latest trends and recommendations.

I’ve been following a low carb diet for a number of years now; ever since my doctor told me I needed to get my LDL down or go onto statin therapy. Before taking statins, I thought I would first try going low carb and also increase my exercise regime. My LDL didn’t come down much but my HDL did go up and triglycerides came down. In some quarters that is considered good. My TG/HDL ratio is now around 1. My weight dropped by a few kg and my BMI is 20.

I’ve enjoyed a lot of benefits on the diet, but (out of the blue, feeling physically very well) in December 2024 had a small heart attack (with minimum symptoms) which resulted in angioplasty and placement of one stent.

I would like to remain on the low carb diet because I believe it improves metabolic health and lowers the risk of getting Alzeimers. I experienced both of my parents passing away in an Alzeimer's ward and don't want to go down that awful path.

However, low carb diets are not mainstream and I'm finding it difficult to get medical advice or support on what tests I can do and what I need to monitor to prevent or reduce plaque going forward. I did manage to persuade my cardiologist to perform a CIMT but the results were ambiguous (big difference between left and right) and received no advice from the cardiologist bar "change to a low fat diet and take statins".

[Hidden]

I’m unsure what you mean by “low carb diets not mainstream”. I can’t see anything wrong with a low carb diet, as long as you eat plenty of freshly prepared fruit and vegetables and your diet has plenty of protein.

[Lowerfield_no_more]

One of my sons has been on a low carb diet for some months. Coincidentally today told me he felt better for being on the diet especially since he had lost weight, and it has brought other benefits for him. It seems that provided you replace the fibre, nutrients and energy which you have lost from the carb sources you have cut out or cut down on it is fine for most people, and apart from weight loss there may be other health benefits as you have found in a healthier cholesterol profile and for some a reduction in Type 2 diabetes risk. But although a nutritious low carb diet might not suit everyone, it seems to have been of benefit to you, just like my son, and so I suggest you just carry on as before, and continue to enjoy life

[Popepaul]

It sounds to me like you are taking all reasonable steps to maximise your health in general and yor heart health in particular. I think that the evidence base suggests that a statin will help to stabilise your plaque. I am not aware of any treatment or lifestyle choice that will actually reduce any deposits of existing plaque. I do believe that your current dietary approach plus regular exercise is likely to minimise the progression of further atherosclerosis. I personally would not go for a low fat diet but I would avoid saturated fat whenever possible.

[Goonerboy6661]

I would personally continue with the low carb diet as the biggest health risk is metabolic syndrome cased by excessive carbs and sugar. Nowadays I only eat things that come from the ground or have mothers or fathers.

[MoretonCross in reply to Goonerboy6661]

Yep, that sounds good to me. A good way of putting it 👌 too. But certainly don't go down the low fat route, with all the low fat products with extra dubious ingredients that entails. It's eating the fat that keeps you slim, it's counter intuitive I know, but that's the way it is. I'm semi Keto and semi Mediterranean myself, more or less. Sugar and carbs are the enemies. Cut them out as much as you can and you're on your way to healthy eating. Loads of information available online or in proper 📚 books.

[Goonerboy6661 in reply to MoretonCross]

100%

[Rlc8799]

can any body recommend a low fat diet?

[DWizza in reply to Rlc8799]

It’s not difficult , it’s just creating a calorie deficit by excluding a food group. You get the same result if you cut down on starchy carbohydrates at meals . For instance , how much bread , potatoes , pasta , rice do you serve yourself at a meal ? Do you measure it dry before cooking ? If you know these numbers then you can reduce the amount. You dint have to cut them out of your diet.

Fruit & veg all contain carbohydrates, as does sugar . So you could leave the starchy carbs (rice, potatoes, bread, pasta) out of a meal and have more fibrous veg. Check any causes that you use , the labels will show how much carbohydrates are contained in them , usually by added starches and sugars (main culprit for extra calories). Ultra processed foods generally contain a lot of salt, sugar and fat and therefore lots of calories and water retaining features. Salty and carbohydrate laden food make the body retain water . People who lose weight quickly lose the water weight first, not fat.

Try a simple method of cutting your carb and fat portions down to create a calorie deficit in the first instance . Everyone enjoys carbs , No need to cut them out totally. Happy to help further if you need it.

[TasteLessFood4Life]

it is an interesting school of thought. Question how do you separate the effect of weight loss vs low carb? Is the benefit the result of the low carb diet? Or is the weight loss from low carb? What is the causal relationship?

[DWizza in reply to TasteLessFood4Life]

It’s very simple , by cutting out foods it’s just creating a calorie deficit .

[Sid_Arthur]

Hi Rhia,

1) what do you believe your TG/HDL ratio should be to indicate health ? ( - which is dependent on the units of measurement of these, I'm sure).

2) you should be able to find info on lowering LDL by supplementing with high dose vitamin B3 ( niacin - in one of its various forms ... ), - & consider trialling that for a period ??? ( - simply a pointer, . . . & certainly not advice !). I don't yet know how effective this is, or can be overall.

However, a rise in HDL, & a fall of TG with a low carb/keto type diet is as would be expected given the experience of this - see for instance 'The Glucose Revolution' (book) by J ?Inchauspe, . . . who's also on Instagram, @glucosegoddess - perhaps you've already found her views ? The TG/HDL ratio she quotes is based on the units of measurement used in the US.

AtB,

Sid 😐

Friday 21 March 2025, . . . on a mild enough, dark UK night.

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