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Which diet will help prevent heart attacks or strokes – low-fat or low-carb?

In the United States, 65% of adults and 16% of children 6 to 19 years old are overweight or obese, increasing their risks for many chronic health conditions. Scientists agree that your diet has a huge impact on your health. But what do scientists say about the health benefits and safety of low-fat vs. low-carb diets? This brief article compares available evidence on the Atkins low-carb diet and the diet recommended by the American Heart Association, the low-fat, balanced diet.

If you look at both diet’s effectiveness at helping loose weight, there are surprising similarities. Studies show that even though there is a more rapid weight loss on a low-carb diet, at one year the amount of weight lost was similar regardless of the plan followed. The other similarity is very disappointing. No matter which plan was used, the percentage of people able to maintain their weight loss is very low. The main reason for this is that people cannot adhere to their dietary regimen.

So what effects do each of these diets have on our health, primarily our cardiovascular system? To date, no studies have been done on the long term health effects of low-carb diets, such as Atkins. But many studies have shown that low-fat diets help to keep weight under control and prevent health problems such as high blood pressure, heart attacks, strokes, diabetes, arthritis and cancer.

Low-fat diets improve lipid levels, raising the ‘good’ lipids and lowering the ‘bad’ lipids. If, along with the low-fat, you increase your intake of complex carbohydrates like whole grain foods, fruits, and fresh vegetables, your lipid levels are improved even more.
Since no studies have been done on the extreme low-carb diets, we have to look at what effect ketosis has on the body. The Atkins diet induces a state of ketosis, which is an acidotic condition caused by, among other things, inadequate carbohydrate intake. Ketosis causes the body to release calcium stores in an attempt to neutralize the ketones, which increases the risk for kidney stones and osteoporosis. High protein intake can also adversely effect kidney filtration rates leading to renal impairment. Animal proteins contain high concentrations of purine, which the body converts to uric acid, which could lead to gouty arthritis and, again, kidney stones.

So what’s the bottom line? Our diets should contain a proper balance of healthy fats, proteins, carbohydrates, vitamins, minerals, and fiber. Because long-term adherence is a problem, a diet must be flexible enough to fit with a person’s lifestyle, food preferences, background and culture. Even though it is not the subject of this article, any weight loss program must have an element of exercise. If you have been inactive for some length of time or have medical problems, you should consult with your health care provider before starting an exercise program.

Here are some tips to help you achieve this seemingly complex goal of healthy eating:
· Eat different kinds and colors of food.
· Eat at least 5 servings of fruits and vegetables a day, preferably fresh.
· Eat at least 6 servings of grain products a day, preferably whole grain.
· Read labels and avoid saturated fats, trans-fat, and cholesterol.
· Use nonfat or low-fat dairy products.
· Try to eat fish at least twice a week, preferably baked, broiled, or grilled.
· Avoid ‘empty calorie’ food, like colas, sugar, candy bars and chips. Treat yourself to them occasionally so you don’t feel deprived.
· Avoid alcohol, but if you do drink, women should have no more than 1 drink per day and men should have no more than 2.
· Eat less than a total of 1 teaspoon of salt a day, including the salt used in the preparation of food.
· Be aware of serving size, especially with meats. One serving of protein from meat, poultry or fish is about the size of a deck of cards.

We may not be able to avoid our genetics, but with diet and exercise we can have a huge impact on our long-term health. And diet and exercise is totally within our own control. So get off of the sofa and start paying attention to what you put in your mouth. Your life may depend on it!

Leah Costello, RN, is the Nurse Manager for ICU at HSC Medical Center.