Low-carbohydrate diet may lead to common heart rhythm disorder
CHINA: Low‐carbohydrate diets which restrict carbohydrate intake is a popular weight control method because of their ability to induce short‐term weight loss. However, a new study has indicated that the low-carbohydrate diet should be recommended cautiously as it can lead to atrial fibrillation -- the most common heart rhythm disorder.
Findings of the study were presented at the ACC 2019 Scientific Session (ACC.19) and subsequently published in the Journal of the American College of Cardiology (JACC).
The long‐term effect of carbohydrate restriction is controversial, especially in the influence on cardiovascular disease. Few studies have examined the relationship of carbohydrate intake and risk of incident atrial fibrillation (AF). Xiaodong Zhuang, Cardiology Department, First Affiliated Hospital of Sun Yat‐Sen University, Guangzhou, China, and colleagues conducted the study to evaluate the association between carbohydrate intake and the risk of incident AF in the ARIC (Atherosclerosis Risk in Communities) Study.
"Low‐carbohydrate diets were associated with increased risk of incident AF, regardless of the type of protein or fat used to replace the carbohydrate," write the authors. "To the best of our knowledge, it is the first large prospective cohort study to assess the relationship of carbohydrate intake with risk of incident AF."
The prospective cohort study included 13,385 participants (age: 54.2 ± 5.8 years) from the ARIC Study. The participants had completed a dietary questionnaire at baseline (1987–1989) and were followed-up for a median of 22.4 years.
The primary outcome was incident AF, which was identified by ECG performed during study examinations, hospital discharge codes, and death certificate.
Also Read: Very low-carbohydrate diet associated with increased mortality : Lancet
Key findings of the study include:
- During a median follow‐up of 22.4 years, 1808 cases (13.5%) of AF occurred.
- Participants with low carbohydrate intake were 18% more likely to develop AF than those with moderate carbohydrate intake and 16% more likely to do so than those with high carbohydrate intake after multivariable adjustment.
- The adjusted risk for incident AF was 18% higher with a 1-standard deviation (9.4%) increase in carbohydrate intake as a percentage of energy intake.
- Participants with the lowest carbohydrate intake were 21% more likely to develop AF than those in the second quartile, 23% more likely to do so than those in the third quartile, and 36% more likely to develop AF than those in the highest quartile.
- No association was found between the type of protein or fat used to replace the carbohydrate and risk of incident AF.
Also Read: Low-carbohydrate breakfast keeps blood sugar in limits for 24 hours in diabetes
Several potential mechanisms could explain why restricting carbohydrates might lead to AFib, Zhuang said. One is that people eating a low-carbohydrate diet tend to eat fewer vegetables, fruits, and grains -- foods that are known to reduce inflammation. Without these foods, people may experience more inflammation, which has been linked with AFib. Another possible explanation is that eating more protein and fat in lieu of carbohydrate-rich foods may lead to oxidative stress, which has also been associated with AFib. Finally, the effect could be related to an increased risk of other forms of cardiovascular disease.
"We found that a low‐carbohydrate intake was associated with increased risk of incident AF, regardless of the type of protein and fat used to replace the carbohydrate. A low‐carbohydrate diet, a way to control weight, should be cautiously recommended, especially considering the potential influence on arrhythmia," concluded the authors.
For detailed study follow the link: https://doi.org/10.1161/JAHA.119.011955