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Poor-quality paper on low-carbohydrate high-protein diets in BMJ

The current issue of the BMJ (7 July 2012) has a research paper by Pagona Lagiou and others on the incidence of cardiovascular disease in over 43,000 Swedish women who were following low-carbohydrate high-protein diets. They found a dose-related association, with those following the diet most strictly being at biggest risk.

An accompanying editorial points out that most studies of diets of this kind have been short-term. They have found improvements in risk factors for heart disease and this has encouraged the idea that these diets are safe. But their long-term safety is questionable, the editorial suggests, and low-carb high-protein diets should therefore not be advised to patients at present.

This contradicts what Gary Taubes famously advocates in The Diet Delusion. But if you have been persuaded by him to follow a low-carb diet and are finding it suits you (as I am), don't immediately rush off and start stuffing yourself with carbohydrates. Instead, go to the BMJ site ( and read the rapid responses to the article. So far there are 12 all unfavourable or downright dismissive.

The correspondents give numerous reasons for these unfavourable opinions. I'll cite just one: the average duration of the diet period was 15 years yet the nature of the women's diet was established simply by a single questionnaire given at the outset. Yes, that's right: no folllow-up assessment!. Can you honestly say you've eaten the same diet for the last 15 years? Could we believe you if you did? I could scarcely believe that this was what the paper is based on when I first read it, but it is.

Several commentators say that the article should not have been published, let alone endorsed by an editorial. One, a (Swedish) paediatrician, describes it simply as a total disaster.

If you are following a low-carb diet there is no need to panic just yet.


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