Low-Carbohydrate Diets

Frederick F. Samaha; Linda Stern

doi:10.7326/0003-4819-141-9-200411020-00023

Letters |2 November 2004

Low-Carbohydrate Diets

Frederick F. Samaha, MD; Linda Stern, MD

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IN RESPONSE:

We share Dr. Ornish's concerns that neither the conventional low-fat diet nor the low-carbohydrate diet in our study reduced total or LDL cholesterol levels. The scientific evidence that aggressive LDL cholesterol lowering reduces atherosclerosis and ischemic coronary events is strong, although complicated by concomitant beneficial effects on inflammatory markers such as C-reactive protein. The evolving data regarding the long-term benefits of increasing HDL cholesterol levels and lowering triglyceride levels, at least by pharmacologic means, are also promising with regard to impact on coronary heart disease (1). Moreover, abnormal levels of HDL cholesterol and triglycerides are core features of the metabolic syndrome, which has been strongly associated with atherosclerosis (2). Nevertheless, we agree that extrapolation of these findings to dietary effects on HDL cholesterol may be complicated by unknown effects on reverse cholesterol transport.

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2004 American College of Physicians

Letters |2 November 2004

Low-Carbohydrate Diets

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Letters |2 November 2004

Low-Carbohydrate Diets

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