Accepted Manuscript Low carbohydrate diets not always benign Peter Clifton , Professor of Nutrition PII:

S0939-4753(14)00164-1

DOI:

10.1016/j.numecd.2014.05.002

Reference:

NUMECD 1294

To appear in:

Nutrition, Metabolism and Cardiovascular Diseases

Received Date: 28 April 2014 Revised Date:

13 May 2014

Accepted Date: 15 May 2014

Please cite this article as: Clifton P, Low carbohydrate diets not always benign, Nutrition, Metabolism and Cardiovascular Diseases (2014), doi: 10.1016/j.numecd.2014.05.002. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

ACCEPTED MANUSCRIPT Letter to the editor

Dear Editor,

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In the Hu and Bazzano viewpoint paper, The low-carbohydrate diet and cardiovascular risk factors: Evidence from epidemiologic studies (1) the authors fail to distinguish between the various fat types that might replace carbohydrate in intervention studies. Atkins style diets with a high saturated fat clearly elevate LDL cholesterol despite weight loss (2) while diets with high unsaturated fat (eg South Beach ) do not have this effect (3). In the Direct study weight loss on all three diets reduced carotid IMT and there was no special effect of a lower carbohydrate diet (3). Wycherley et al (4) clearly showed that endothelial function was worse on a very low carbohydrate, high saturated fat diet after 12 months despite very good falls in weight, blood pressure and glucose on the diet. Buscemi et al (5) showed that a very low carbohydrate diet had adverse effects on endothelial function in the first 5-7 days of the diet. All of this data above was misquoted in the section on “carotid endothelial function” which covered either carotid IMT or brachial endothelial function and needs correction. Fortunately in the last paragraph the authors addressed the issue of a healthy low carbohydrate diet with a high unsaturated fat. Legumes are recommended as indeed they should but they are not low carbohydrate although they are low GI.

Peter Clifton Professor of Nutrition,

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Yours sincerely

EP

University of South Australia

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1. T. Hu, L.A. Bazzano The low-carbohydrate diet and cardiovascular risk factors: Evidence from epidemiologic studies *Nutrition, Metabolism & Cardiovascular Diseases (2014) 24, 337e343 2. Brinkworth GD, Noakes M, Buckley JD, Keogh JB, Clifton PM.Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. Am J Clin Nutr. 2009 Jul;90(1):23-32. doi: 10.3945/ajcn.2008.27326. Epub 2009 May 13. 3. Miller M1, Beach V, Sorkin JD, Mangano C, Dobmeier C, Novacic D, Rhyne J, Vogel RA.Comparative effects of three popular diets on lipids, endothelial function, and Creactive protein during weight maintenance. J Am Diet Assoc. 2009 Apr;109(4):7137. doi: 10.1016/j.jada.2008.12.023.

ACCEPTED MANUSCRIPT 4. Shai I, Spence JD, Schwarzfuchs D, Henkin Y, Parraga G, Rudich A,et al. DIRECT Group: dietary intervention to reverse carotid atherosclerosis. Circulation 2010;121:1200e8. [27] Wycherley TP, Brinkworth GD, Keogh JB, Noakes M, Buckley JD, Clifton PM. Long-term effects of weight loss with a very low carbohydrate and low fat diet on vascular function in overweight and obese patients. J Intern Med. 2010 May;267(5):452-61. doi: 10.1111/j.1365-2796.2009.02174.x. Epub 2009 Oct 6.

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6. Buscemi S1, Verga S, Tranchina MR, Cottone S, Cerasola G. Effects of hypocaloric very-low-carbohydrate diet vs. Mediterranean diet on endothelial function in obese women .Eur J Clin Invest. 2009 May;39(5):339-47. doi: 10.1111/j.13652362.2009.02091.x.