Earlier studies didn't address the source or quality of proteins and fats consumed in low-carb diets. This analysis confirmed the researchers' earlier findings: Low- and high-carb diets were linked with a 20 percent increase in the risk of death during the study, compared with moderate-carb diets.
Trials to compare low-carb and high-carb diets directly are not possible, because they have to be carried out over many years and people find it hard to stick to a diet over any length of time.
This might be because eating large amounts of animal fat and protein but few fresh plant-based foods can increase inflammation in the body.
"There is nothing to be gained from long-term adherence to low-carbohydrate diets rich in fats and proteins from animal origins", said Ian Johnson, a nutrition researcher at Quadram Institute Bioscience in Norwich, England, commenting on the research, in which he did not take part.
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To address this uncertainty, researchers began by studying 15,428 adults aged 45-64 years from diverse socioeconomic backgrounds from four U.S. communities (Forsyth County, NC; Jackson, MS; Minneapolis, MN; and Washington County, MD) enrolled in the ARIC cohort between 1987 and 1989.
"Low-carbohydrate dietary patterns favoring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favored plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain breads, were associated with lower mortality", the team wrote.
The "cult of low carb high fat eating" was based on a lifestyle choice and the flimsiest of evidence, she said.
The study authors noted, however, that the participants' eating habits were self-reported and only assessed at the start of the study and six years later.
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"Low-carb diets that replace carbohydrates with protein or fat are gaining widespread popularity as a health and weight loss strategy", said study leader Dr Sara Seidelmann, Clinical and Research Fellow in Cardiovascular Medicine from Brigham and Women's Hospital, Boston.
In fact, the researchers concluded that a 50-year-old who eats within the 50-55% carbs margin could expect to live for another 33.1 years, while someone the same age who gets just 30% of their calories from carbs would be expected to live roughly 29.1 more years.
This revealed similar trends, with participants whose overall diets were high and low in carbohydrates having a shorter life expectancy than those with moderate consumption.
Government guidelines in countries like the United Kingdom already recommend at least a third of the diet should consist of starchy foods. "If nothing else, this study provides some redress to this one-sided debate, and adds caution to such practice for long term management". Essential nutrients should be consumed above a minimal level to avoid deficiency and below a maximal level to avoid toxicity. In other words, a "sweet spot".
The questionnaires relied upon people remembering what they ate, and it is this information that scientists used to estimate the proportion of calories they received from carbohydrates, fats and protein.
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