Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study
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OBJECTIVE: To study the long term consequences of low carbohydrate diets, generally characterised by concomitant increases in protein intake, on cardiovascular health. DESIGN: Prospective cohort study. SETTING: Uppsala, Sweden. PARTICIPANTS: From a random population sample, 43,396 Swedish women, aged 30-49 years at baseline, completed an extensive dietary questionnaire and were followed-up for an average of 15.7 years. MAIN OUTCOME MEASURES: Association of incident cardiovascular diseases (ascertained by linkage with nationwide registries), overall and by diagnostic category, with decreasing carbohydrate intake (in tenths), increasing protein intake (in tenths), and an additive combination of these variables (low carbohydrate-high protein score, from 2 to 20), adjusted for intake of energy, intake of saturated and unsaturated fat, and several non-dietary variables. RESULTS: A one tenth decrease in carbohydrate intake or increase in protein intake or a 2 unit increase in the low carbohydrate-high protein score were all statistically significantly associated with increasing incidence of cardiovascular disease overall (n=1270)--incidence rate ratio estimates 1.04 (95% confidence interval 1.00 to 1.08), 1.04 (1.02 to 1.06), and 1.05 (1.02 to 1.08). No heterogeneity existed in the association of any of these scores with the five studied cardiovascular outcomes: ischaemic heart disease (n=703), ischaemic stroke (n=294), haemorrhagic stroke (n=70), subarachnoid haemorrhage (n=121), and peripheral arterial disease (n=82). CONCLUSIONS: Low carbohydrate-high protein diets, used on a regular basis and without consideration of the nature of carbohydrates or the source of proteins, are associated with increased risk of cardiovascular disease.
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Prospective cohort studies have yielded conflicting findings on the link between low-carbohydrate dietary patterns and cardiovascular disease risk.
“Prospective cohort studies have produced conflicting results regarding the association between low-carbohydrate dietary patterns and risk for CVD (2, 3).”
From Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial (2014) · cites this paper as [3]
The cardiovascular effects of low-carbohydrate diets are not well established.
“Low-carbohydrate diets have become a popular strategy for weight loss and weight management in recent years; however, their cardiovascular effects are unknown.”
From Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial (2014) · cites this paper as [3]
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- Authors
- Lagiou, P., Sandin, S., Lof, M., Trichopoulos, D., Adami, H.-O., & Weiderpass, E.
- Affiliations
- Karolinska Institutet (SE)
- Harvard University (US)
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2012-06-26
- Volume
- 344
- Issue
- jun26 3
- Pages
- e4026-e4026
- ISSN
- 1756-1833 (ISSN-L)
- PMC
- PMC3383863
- OpenAlex
- W2120694326
- Cited by
- 254
- References
- 43
- Citations by year
- 2026: 7 · 2025: 15 · 2024: 17 · 2023: 8 · 2022: 14 · 2021: 19 · 2020: 25 · 2019: 16 · 2018: 16 · 2017: 14 · 2016: 22 · 2015: 30 · 2014: 21 · 2013: 16 · 2012: 14
- FWCI
- 17.37
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- DiVA (Linkoping University) (submittedVersion, other-oa)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Funders
- Cancerfonden
- Vetenskapsrådet
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- low-carbohydrate diet, high-protein diet, cardiovascular disease incidence, ischemic heart disease, ischemic stroke, hemorrhagic stroke, subarachnoid hemorrhage, peripheral arterial disease, protein intake, carbohydrate intake, women
- MeSH terms
- Adult, Cardiovascular Diseases, Dietary Proteins, Female, Follow-Up Studies, Humans, Middle Aged, Obesity, Prospective Studies, Surveys and Questionnaires, Sweden, Time Factors, Incidence, Women's Health, Diet, Carbohydrate-Restricted
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