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Cholesterol

Updated 17 July 2020

High cholesterol? Study says you should rather cut carbs than saturated fat

A recent study calls out the lack of evidence that surrounds traditional dietary recommendations for those suffering from familial hypercholesterolaemia.

  • A recent study challenges the tradition that saturated fats are a big no-no for those suffering from familial hypercholesterolaemia.  
  • It says that carbohydrates are a bigger culprit than saturated fats in increasing risk of heart disease.
  • They add that different biomarkers should be used to assess heart health. 

Since the 1930s, it's been recommended all over the world that to lower your risk of heart disease you need to say goodbye to red meat, cheese and butter.

This reduction of saturated fats has, therefore, been the go-to diet recommendation for those who suffer from inherited high cholesterol, in order to reduce their risk of coronary heart disease (CHD). 

However, a recent analysis of current evidence published in BMJ Journals is disputing this ancient advice, highlighting that little scientific evidence actually supports the theory. 

READ: Sugar-sweetened drinks wreak havoc with cholesterol levels, harming the heart 

Low-carb diet is key

In fact, the researchers believe that a low carbohydrate diet is more effective in helping cholesterol sufferers protect their heart. 

They say that people diagnosed with familial hypercholesterolaemia (FH) – an inherited condition – are more at risk of CHD because of its association with an insulin-resistant phenotype and a susceptibility to a bleeding disorder.

"The insulin-resistant phenotype, also referred to as the metabolic syndrome, manifests as carbohydrate intolerance, which is most effectively managed by a low carbohydrate diet," write the authors.

Fallacy of the diet-heart hypothesis

Previously, there was a hyperfocus on the diet-heart hypothesis, which held that cholesterol from food and saturated fats raises serum cholesterol, negatively affecting the heart. By cutting out those foods from your diet, it was postulated that you'd lower your low-density lipoprotein cholesterol (LDL-C) levels – considered an effective marker of heart health.

But this study says instead that a different biomarker needs to be used, like lipoprotein a, which has more of a direct link to diet than LDL-C and is positively affected by a low carbohydrate diet. There are studies showing that those with high LDL-C don't automatically rate low on heart health.

In another study, subjects on a low carbohydrate diet significantly lowered their risk of CHD compared to those on a low-fat diet, even though the no-carbs group consumed three times more saturated fat. 

"Overall, these findings provide strong evidence that a subset of FH individuals are at increased risk of CHD because they are susceptible to diet, lifestyle, metabolic and genetic risk factors which are independent of their high LDL-C levels."

The researchers conclude by calling on the scientific community to take note that, based on this evidence, there's an urgent need to explore this further so that changes to official diet recommendations can be made for those living with FH. 

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