Reducing your stroke risk…because I care

With all the upcoming excitement about Halloween, you may have overlooked the fact that yesterday was World Stroke Day.

This year, the global campaign to tackle stroke was highlighted with the slogan “Because I care…”.

The phrase showcases the role of caregivers in supporting people who have suffered a stroke and aims to correct misinformation about the disease, such as the misconception that stroke only happens later in life.

Every other second, stroke attacks a person, regardless of age or gender. Of the 15 million people who experience a stroke each year, six million do not survive. Worldwide about 30 million people have had a stroke and most have residual disabilities.

Overall approximately 55 000 more women have strokes than men each year, mainly because stroke occurs more frequently at older ages and women generally live longer than men. Of note, women are twice as likely to die from a stroke than breast cancer each year.

And recent data published in the Lancet, shows a striking 25% worldwide increase in the number of stroke cases in people aged between 20 and 64. This younger age group now accounts for a shocking 31% of strokes.

But, with greater awareness, these figures don’t have to continue their alarming trend.  Stroke can be prevented, treated and managed in the long term. The campaign theme “Because I care” emphasizes these areas.

The slogan was chosen as it can easily be adapted to all cultures and in any setting. It attempts to address prevailing misinformation about the disease, e.g., stroke only happens later in life. The campaign also celebrates the important contributions of caregivers and the role they play as conduits between the stroke community and the general public in correcting misinformation.

Because I care…

• I want you to know the facts about stroke
• I will work to break down the myths surrounding stroke
• I want you to learn how to minimize your risk of stroke
• I want you to have access to the best possible treatment
• I will ensure that you receive quality treatment, care and support
• I will be with you every step of the way towards your full recovery

Research presented at the recent European Society of Cardiology [ESC] Congress  showed that there are plenty of steps young obese women can take to reduce their risk of stroke. In young women without metabolic disorders such as high blood pressure, high cholesterol and high blood sugar  or abnormal glucose metabolism being overweight did not increase the chance of having a stroke compared to normal weight women without metabolic disorders. However, the risk of stroke increased by 3.5 times in women who were overweight and had metabolic disorders.

Study author, Dr Michelle Schmiegelow said: “Obesity puts young women at a major risk of developing high blood pressure, diabetes or high cholesterol, which dramatically increases their likelihood of having a stroke. Young women who are overweight or obese probably have a window of opportunity to lose weight and keep a healthy lifestyle so that they reduce their risk of getting high blood pressure, diabetes and high cholesterol. In this way they can protect themselves from having a stroke or heart attack.”

Awareness of important risk factors, such as atrial fibrillation  and hypertension, is crucial.

Professor Joep Perk, MD, a Swedish Cardiologist and spokesperson for the ESC says: “Women are at the same risk of stroke as men, and the level of risk is completely steered by the underlying risk factor pattern they have. The majority of people who have a stroke are disabled for the rest of their lives and may be paralyzed or lose their ability to speak. The devastating consequences of this disease for patients and their loved ones make prevention even more important.”

He adds: “Prevention for all cardiovascular disease follows the same pattern, be it stroke, heart attack, or peripheral arterial disease. Step one for women is absolutely to stop smoking – that beats everything. The second most important thing is to know your blood pressure to see if you are at risk. And finally, adopt healthy behaviors like eating heart healthy food and keeping the amount of salt you eat under control.”

The global campaign against stroke asks people to commit to six stroke challenges:
•    Know your personal risk factors: high blood pressure, diabetes, and high blood cholesterol
•    Be physically active and exercise regularly
•    Maintain a healthy diet high in fruit and vegetable and low in salt and keep blood pressure low
•    Limit alcohol consumption
•    Avoid cigarette smoke. If you smoke, seek help to stop now
•    Learn to recognize the warning signs of a stroke and how to take action.

Check, check, check, check, check and check!  I’m feeling up to the stroke challenge.  Are you?

Dying for an energy drink?

As someone who gets up at 4:30 am most days to go to the gym and who rarely, if ever, eats carbs, I know there is no easy way to stay fit and healthy.  But, there are others who may be tempted to look for an easier or quicker way…and to them we say- beware!

Before you reach for a weight loss supplement, or energy drink, you may want to think again. According to four separate case reports just presented at the American College of Gastroenterology’s 78th Annual Scientific Meeting in San Diego, consumption of some of these can lead to hepatitis, severe liver damage, liver failure and even death.

Use of herbal and dietary supplements is widespread for a variety of reasons. But many patients don’t disclose supplement use to their physicians, and as such important drug side effects can be missed.

The first case report documented a case over liver toxicity and fulminant liver failure associated with the use of SlimQuick™, a weight loss supplement containing green tea extract.

A 52-year old female patient was admitted to the emergency room after one week of vomiting and progressive jaundice. The patient reported she had ingested SlimQuick™ for two days, while fasting three weeks prior to admission. Her liver biopsy was consistent with hepatic necrosis She was started on steroids but these were discontinued after two days, as liver function worsened and mental status deteriorated to the point she needed to undergo liver transplantation two days later.

In the second paper, Khadija Haroon Chaudrey, MD, presented a rare case of black cohosh-induced hepatotoxicity leading to early cirrhosis. Black cohash is often used by menopausal women to control hot flashes and other associated symptons

A 44-year-old female had developed jaundice for one month, and initial lab work revealed elevated liver function tests (LFTs). The patient had no history of alcohol intake, IV drug use, unprotected sex, recent travel outside the United States, NSAID ingestion or blood transfusions. After an unsuccessful outpatient trial of steroids, she was referred for inpatient evaluation because of gradual progression of her symptoms.

The patient then reported she had started taking black cohosh about one month prior. “Her ultrasound abdomen showed nodular contour of liver consistent with cirrhosis,” said Dr. Chaudrey. “Given patient’s history of black cohosh use and the timing of her abnormal liver chemistries, it was clinically evident the culprit agent was black cohosh.”

Once the patient stopped taking black cohosh, her symptoms improved and her LFTs normalized.

The third case described acute liver failure following consumption of Rockstar® Sugar Free energy drink.

Brian Huang M.D., Chief Resident of the Internal Medicine Residency Program at Cedars Sinai Medical Center, presented a case involving a 36-year-old male without prior medical history. He sought medical attention after symptoms of right upper quadrant abdominal pain, jaundice and fatigue. After abnormal lab work, he was brought to the hospital. The patient admitted to binge drinking (10 beers in a three-hour period) prior to symptom onset. He denied consuming herbal supplements, but admitted to having three Rockstar® Sugar Free energy drinks, on a daily basis for the past year. He too, required a liver transplant.

According to Dr. Huang, “The patients’ pathology reports showed massive hepatocellular necrosis and parenchymal collapse consistent with drug-induced liver injury. We believe his prior history of binge drinking may have provided initial damage on his liver, making him more susceptible to develop liver failure. Although the patient had a history of weekend binge drinking, his liver biopsy was not consistent with alcoholic hepatitis. Thus, they determined that the liver failure was linked to the long-term energy drink consumption.

A fourth case of drug-induced liver injury was found to be associated with the advanced weight loss supplement, Ripped Fuel®. This supplement contains herbal extract with 60% flavinoids, caffeine and cacao.

A 36-year old female with history of depression and no prior liver disease was seen after having one week of abdominal pain, anorexia and nausea. On physical examination, she had jaundice and yellowing of her eyes. The patient had started to take Ripped Fuel® three weeks prior to developing these symptoms, to lose weight. She denied use of other herbal medicine, supplements or acetaminophen. There had been no recent changes in her depression medication.

“There is a lack of knowledge about the status of Food and Drug Administration regulation of dietary supplements,” said Dr. Halegoua-De Marzio, author of the first paper. “Currently, dietary supplements are not required to have safety or efficacy studies before they are marketed to the public, and they remain popular among consumers despite reports of hepatotoxicity. 

These cases serve as a reminder of how even minimal use of dietary supplements can lead to liver failure and liver transplant. It is important that patients talk with their doctors before starting any new dietary supplements.

Or better yet, stick with the old fashioned way of healthy diet and exercise.  So who wants to join me in the gym at 5am tomorrow?

A Call to End Religious Nutrition

Q: “How can you tell if a friend is on a gluten-free diet?”

A: “They’ll tell you.”

Again and again and again… Same joke goes for paleo, low-carb, vegan and pretty much any organized dietary strategy that has a defining name and movement behind it.

Along with politics, gun rights, religion and abortion, is one of those areas where people feel comfortable not only sharing their views but do so with incredible conviction, passion and certainty. And yet, nutrition is anything but certain.  Sure, we know there are patterns of eating that help in minimizing the risk of various chronic diseases, but those patterns are far broader and less drilled down than most nutrition gurus and zealots believe.

So, we were very interested in fellow blogger –Yoni Freedhoff’s – recent blog in which he calls for an end of nutrition as religion.  More so, because Yoni is not just another disillusioned dieter. No siree!  He is the Medical Director of the Bariatric Medical Institute and assistant professor of family medicine at the University of Ottawa.  Dr. Freedhoff has also been called Canada’s most outspoken obesity expert and his award winning blog, Weighty Matters, has at times been ranked the world’s top health blog by blog ranking service Technorati.

So what does Dr Freedhoff have to say?

First, he suggests that practitioners of dietary religion risk alienating friends through strict adherence to their religious commandments.  Second, he states that diet adherents tend to use their online platform to frown upon any and all dietary strategies beyond their house of worship. To question their program or guru’s plans is akin to questioning their religious beliefs; and yet, unlike actual religious questioning (which would almost certainly lead to a thoughtful discussion), question dietary dogma online, and you can bet it will lead to a highly heated debate where anger and indignation can easily descend into name calling and personal attacks.

And even if you religiously avoid all cyber nutrition nuts, you may still be at risk. According to Freedhoff, although you may not have a stranger’s zealous scrutiny to watch out for, you’ve still got yourself. Dietary dogma, almost by definition, dictates blind faith and absolute loyalty, where breaking a dietary commandment is akin to committing a sin. And with sin, comes guilt. And if you feel guilt often enough, you might well decide to abandon your entire healthier-living, guilt-inducing effort.

Nutrition as religion demands perfection, yet perfection is an impossible goal. Remember, food is not simply fuel. Since the dawn of humankind, food has been used for comfort and celebration, and if your newly found dietary religion forbids foods you enjoy, my bet is you’re not long for that diet.

So what’s the solution?  Freedhoff advises : the easiest question to evaluate any dietary plan or religion is simply, “Could I happily live like this for the rest of my life?” where the most important word in that question is “happily.” If the answer’s “No,” you’ve either got to get comfortable with adding in some sinning, or find another way to go.

Add in some sinning in the form of thoughtful, “worth-it,” dietary imperfections, and suddenly new lifestyles may transform from the merely tolerable to the actually enjoyable. Enjoy your lifestyle, albeit imperfectly, and maybe you’ll even stick with it.

Nutrition isn’t religion. Eat the healthiest diet that you can enjoy, because if you’re not enjoying it, it isn’t going to last, and tolerable isn’t good enough.

Go on, sin a little, on us. The good doctor will forgive you enough to forgive yourself.

Bypassing Genetic Obesity Genes?

Fact. Obese mothers tend to have kids who themselves will become obese.

Fact. In 2012, 35.7% of US adults and 16.9% of US children age 2 to 19 were obese, according to the CDC

Fact. Half of all U.S. adults will be obese by 2030 unless they change their ways, according to the Robert Wood Johnson Foundation.

Fact. Obesity raises the risk of numerous diseases, from type 2 diabetes to endometrial cancer, chronic heart disease and stroke.

So we were extremely interested to learn of new research that suggests the unhealthy cycle could be broken by weight-loss surgery.  In a first-of-a-kind study, Canadian researchers tested children born to obese women prior to weight loss surgery and their siblings conceived afterward.

The surprising results?  Kids born after mom lost lots of weight were slimmer than their siblings. They also had fewer risk factors for developing diabetes or heart disease.

Even more intriguing, the researchers discovered that numerous genes linked to obesity-related health problems worked differently in the younger siblings than in their older brothers and sisters.

Although diet and exercise will play a huge role in how fit the younger siblings will continue to be, the findings suggest the children born to mothers who have undergone weight loss surgery might have an advantage.

“The impact on the genes, you will see the impact for the rest of your life,” predicts lead researcher Dr. Marie-Claude Vohl of Laval University in Quebec City.

So why would there be a difference? Clearly weight loss surgery doesn’t change a womans’ genes.  However, it seems as if either the surgery or more likely the subsequent weight loss can change how certain genes operate in her child’s body. The researchers suggest that factors inside the womb seem to affect the chemical  ‘dimmer switches’ that make the fetus’ genes speed up or slow down or switch on and off.

Dr. Susan Murphy of Duke University wasn’t involved in the research says it makes biological sense that the earliest nutritional environment could affect a developing metabolism, although she cautions that healthier family habits after mom’s surgery may play a role, too.

The research has implications far beyond the relatively few women who undergo gastric bypass surgery before having a baby. According to the American College of Obstetricians and Gynecologists, more than half of pregnant women are overweight or obese. Tackling obesity before or during pregnancy can provide a lasting benefit for both mother and baby.

It’s not just a matter of how much moms weigh when they conceive, gaining too much weight during pregnancy increases the child’s risk of eventually developing obesity and diabetes. Overweight mothers have higher levels of sugar and fat in the bloodstream, which in turn makes it to the womb.

How much weight loss is needed to have a healthy baby?

In the study, researchers took blood samples from children born to 20 women before and after the complex gastric bypass surgery, who, on average, lost about 100 pounds. They compared differences in more than 5,600 genes between the younger and older siblings and found significant differences in the activity of certain genes clustered in pathways known to affect blood sugar metabolism and heart disease risk.

Only time will tell if the children born after mom’s surgery really get lasting benefits. Meanwhile, specialists urge women planning a pregnancy to talk with their doctors about their weight ahead of time. Besides having potential long-term consequences, extra pounds can lead to a variety of immediate complications such as an increased risk of premature birth and cesarean sections.

The Skinny on Childhood MS

As we’ve previously reported, childhood obesity is on the increase. Cases have more than doubled in children and tripled in adolescents in the past 30 years. The percentage of children and adolescents aged 6–18 years in the United States who are obese is now estimated to be >18%.

Childhood obesity can cause a number of health complications including diabetes, hypertension, high cholesterol, asthma  and emotional problems.  This is deeply troubling in and of itself, but now there’s a new cause for concern.

A new study has found that obese children and teenage girls may be more at risk for developing the chronic, debilitating central nervous system disorder – multiple sclerosis (MS).

Kaiser Permanente researchers studied 75 children aged 2 to 18 with pediatric MS, and compared them to more than 900,000 kids without the disease. Fifty percent of the kids with MS were overweight or obese, compared to 36% of the children who didn’t have the disease.

The study also found that the risk of developing multiple sclerosis was one-and-a-half times higher for overweight girls, almost two times higher for moderately obese girls and four times higher for extremely obese girls.

Mary Rensel, MD, who treats pediatric MS patients at Cleveland Clinic offers an explanation for the increased risk. “Fat increases the inflammation in the body. Multiple sclerosis is an auto-immune condition where the immune system is set too high. If there’s too much inflammation, it can increase the risk of having a disorder associated with inflammation – like MS.”

Lead author, Annette Langer-Gould, MD, PhD, with the Kaiser Permanente Southern California Department of Research & Evaluation in Pasadena  “Even though pediatric MS remains rare, our study suggests that parents or caregivers of obese teenagers should pay attention to symptoms such as tingling and numbness or limb weakness, and bring them to a doctor’s attention,”

The researchers also stress that parents of overweight or obese children should play an active role in controlling their kids’ weight by getting them into the habits of eating healthy and getting enough exercise.

Dr. Rensel agrees, saying, “The good news is now we know. We can educate parents and patients of the importance of maintaining a healthy weight to decrease the chance of having consequences of being overweight.”

Rethinking Resolutions

New Year’s resolutions. In previous years SRxA’s Word on Health has provided some great tips to help our readers improve their health. This year’s no different…except we’re telling you not to make resolutions.

Yes! We are officially letting you off the hook.  Why? Because according to new research, thinking of health and fitness goals as “New Year’s resolutions” can actually harm your health and have nasty emotional side effects.   For starters two-thirds of people end up ditching their New Year’s goals within weeks of starting them, less than 20% of people will stay with their resolutions for more than six months and less than 10% will keep them all year. This inability to stay on track, can lead to feelings of failure and inadequacy. Experiencing setbacks such as cheating on your diet or skipping a day at the gym can amplify those feelings, resulting in a downward spiral that can lead you back into old habits faster than if you hadn’t made resolutions in the first place.

Although cutting back on certain foods can be good for your health, completely depriving yourself of them can be a problem. While most New Year’s resolutions revolve around the idea of deprivation: eliminate fat or carbs or salt…these all have a place, in moderation, in your diet. The only time quitting a habit completely is really good for you is if it is dangerous to your health, like smoking or binge drinking. Even then, quitting cold turkey can be hard; it can take months to wean yourself from bad habits. The key is moderation, not deprivation.

Another problem with resolutions is that diet and fitness targets are often totally unrealistic. Setting over-ambitious goals for yourself can lead to perceived failure which means you’ll be more likely to give up and slip right back into old habits.  The key to improving your health habits is to gradually implement change and incorporate them as a part of your lifestyle.

Finally, remember that feeding and fueling your body mentally, physically and spiritually should be fun. You should never feel like taking care of yourself is work. New Year’s resolutions often take all of the enjoyment out of the process of change. Improving yourself is not just about the end goal, it’s about overcoming obstacles in between and becoming more confident and aware of who you are. Yes, the destination matters, but so does the journey.

So this year, you have our permission to ditch the resolutions, and forego the guilt.  Instead, why not focus on the present…and each day think of one thing you can do right now, towards your goal?

Spa Therapy

Uggghhh! Monday morning after a long holiday weekend. Not quite feeling the whole work thing today? Feeling guilty about those Thanksgiving pounds you packed on over the 4-day eating orgy?

Maybe what you need is a spa break! In case, you’re not yet in agreement – here’s another reason to consider swapping your business suit for a bathing suit.  According to a pilot study from the Jefferson-Myrna Brind Center of Integrative Medicine a weeks retreat at a spa is not only relaxing and nourishing, but can lead to marked changes in physical and emotional well-being.

The research evaluated 15 participants before and after their visit to a health and wellness spa in Desert Hot Springs, California.  The week-long program included meditation and colonic hydrotherapy, hatha and Vishnu flow-yoga programs, and a very low calorie diet of approximately 800 calories per day. Stress management was provided through daily structured meditation and personal meditation encouraging deep breathing, heightened awareness and a calming effect.

In preparation, participants were asked to modify their diet three to four days prior to arrival by replacing a normal diet with fruit, sprouts, raw and steamed vegetables, salads, vegetables, herbal teas, prune juice in the morning, laxative teas or herbal laxatives nightly and avoiding pasta, meat, cheese, caffeine, alcohol and processed foods.

The participants, 13 women and two men between the ages of 21 and 85, with no history of significant medical, neurological or psychological conditions each underwent a physical evaluation including weight, height, Body Mass Index (BMI), blood pressure and an EKG. They also received a complete blood count (CBC), liver function tests, tests measuring cholesterol and triglycerides, thyroid hormone testing, and the concentration of metals such as mercury and lead. In addition, psychological and spiritual measures before and after their arrival were measured.

An evaluation of the results showed that undergoing a spa program resulted in a weight decline of an average of 6.8 lbs., a 7.7% decrease in diastolic blood pressure as well as a decrease in mercury, sodium and chloride levels and a 5.2% decline in cholesterol level and mean BMI. Hemoglobin increased 5.9 percent. No statistically significant changes in liver or thyroid function and no EKG changes were noted.

No serious adverse effects were reported by any individual, but the study noted changes in the participants’ sodium and chloride concentrations, suggesting that those interested in going to a spa program should check with their physician to make sure they do not have any medical problems or medications that could put them at risk for electrolyte disturbances.

Improvements in anger, tension, vigor, fatigue and confusion were also noted as was a statistically significant improvement in anxiety and depression levels measured by the Speilberger Anxiety Scale and the Beck Depression Index.

Participants also reported significant changes in their feelings about spirituality and religiosity.

“Programs such as these have never before been formally evaluated for their safety and physiological effects,” says Andrew Newberg, MD,  lead author on the study.

While beneficial, it is not possible to differentiate the effects of each of the individual elements of the program to determine which components were responsible for the changes observed. “This,” says Newberg “will require an evaluation of one or more elements—such as yoga, very low calorie diet or colonics—in isolation to determine which elements have the most significant effects.”

In the future, Newberg and colleagues plan to study the effects of a spa stay on specific disease population, i.e. diabetics.

Complete findings will be available in the December issue of Integrative Medicine, A Clinician’s Journal.

In the meantime, it’s back to our desks. We can but daydream of downward dogs and diets!

Read Yourself Thin?

Need to lose some pounds before the holidays? Then start reading. Yes, yes, we know you’re already reading this blog (thank you)…but what you really need to start doing, according to a new study, is reading food labels while you shop.

You see, people, and women in particular, who read food labels while they grocery shop weigh, on average, 9 pounds less than people who don’t.

An international team of scientists led by Maria Loureiro, of the University of Santiago de Compostela, in Spain analyzed more than 25,000 observations on health, eating and shopping habits from the U.S. National Health Interview Survey.  Among the data collected were responses about reading nutritional information in supermarkets.

“First we analyzed who read the nutritional label when purchasing foods, and then we moved on to the relationship with their weight,” said Loureiro.

The study found big differences between the people who read food labels and those who did not. Interestingly, smokers paid little attention to the nutritional information on foods.

“Their lifestyle involves less healthy habits and, as a consequence, it could be the case that they are not so worried about the nutritional content of the food they eat, according to our results,” the researchers suggested.

People who live in cities were the most careful about reading food labels. People with high school and college educations also paid more attention to nutritional labels. Fifty-eight percent of men took the time to read labels, compared with 74% of women. And white women who lived in cities read food labels most often.

” On average, women who read the nutritional information have a body-mass index of 1.48 points lower, whereas this difference is just 0.12 points in men,” Loureiro said. “We know that this information can be used as a mechanism to prevent obesity.”

The researchers suggest that campaigns and public policy should be designed to promote the use of nutritional labeling, not just on the foods we buy in stores but also on menus at restaurants and other public establishments.

As someone, who lives the vida low-carb, I for one would fully support this move.  Would you?

Asthma drug helps shed pounds

According to new research, a drug commonly used to treat asthma and COPD may also burn fat.

When taken in pill form, the drug formoterol boosted fat burning while preserving protein metabolism, and muscle mass.

“Fat burning was increased up to 25%,” says researcher Paul Lee, MD, PhD, of the Garvan Institute of Medical Research and an endocrinologist at St. Vincent’s Hospital in Sydney, Australia.

Formoterol is used as an inhaled medication for asthma and chronic obstructive pulmonary disease (COPD) and is one of the ingredients in Symbicort and Dulera.

In this study, Lee used it in pill form, and gave it to 8 men at a dose of 160 micrograms a day for one week. Before and after the study, he measured the men’s energy rates, fat oxidation, and whole body protein metabolism.  Each time, the measurements were taken after the men drank a standardized, high-carbohydrate liquid meal.

Comparing their before and after rate, their overall energy rate increased by more than 10% and their fat burning by 25%.

Theoretically, an average person weighing 155 pounds could burn an extra 200 calories a day with the pill. Over time, that could translate to noticeable fat loss and maintained or gained muscle.

The inhaled form of the drug can cause tachycardia – an abnormally fast heartbeat, but Lee did not see this side effect in the patients who took the pill form. “Some had insomnia, but it was mild,” he says. It was also temporary. “Some reported loss of appetite.”

In addition to burning fat, the drug might prevent or treat muscle wasting that can accompany age. “It may potentially reverse or prevent this process and treat frailty,” Lee says.

”The report is certainly intriguing,” says Bruce Wolfe, MD, President of the American Society for Metabolic and Bariatric Surgery and Professor of Surgery at Oregon Health and Science University, Portland.  However, he cautions that the increase in fat burning is modest. Eating a couple of cookies, or drinking a small glass of wine could undo the benefit. Nevertheless, over time, taking the formoterol could make a noticeable difference.

SRxA’s Word on Health eagerly awaits the results of further studies.

Animal, Vegetable, or …Clinical Trial?

Several clinical trials in the past 10 years have demonstrated that a low-carbohydrate, high-fat, high-protein diet is at least as effective as a calorie-restricted, high-carbohydrate, low-fat diet for weight loss and improvement of risk factors such as blood pressure, blood sugar and lipid levels.

While older observational studies linked dietary fat with poor health outcomes, newer systematic reviews, have absolved fat, with the exception of trans-fat. Many such studies have implicated refined sugars and starches instead.

Yet, in contrast to the robust understanding we have about diet and risk factors, our knowledge about the effect of diet on mortality is much more sparse, A new study, just published in the Annals of Internal Medicine study attempts to address this gap.

Researchers found that an animal-based low-carbohydrate dietary pattern increased the risk for death, whereas a plant-based low-carbohydrate diet lowered the risk.

Having analyzed food frequency questionnaires from 85,000 women from the Nurses’ Health Study and 45,000 men from the Health Professionals’ Follow-Up Study over  20 years’ they found:

• People who had the highest scores for an animal-based low-carbohydrate diet were at increased risk for all-cause and cardiovascular mortality.
• Those with the highest plant-based low-carbohydrate diet scores had a reduced risk for all-cause and cardiovascular mortality.
• Men who more closely followed any low-carbohydrate diet had a higher cancer mortality risk.

The question is how to understand this new information in the context of the existing knowledge on diet and health and research design.

Observational studies have great strengths but also significant limitations.  For now, it seems that no one can legitimately claim that a low-carbohydrate diet is either harmful or safe with any degree of certainty.

Word on Health would love for you to weigh in on this.