Open AccessLow Carbohydrate Diet From Plant or Animal Sources and Mortality Among Myocardial Infarction Survivors
Author(s) -
Li Shanshan,
Flint Alan,
Pai Jennifer K.,
Forman John P.,
Hu Frank B.,
Willett Walter C.,
Rexrode Kathryn M.,
Mukamal Kenneth J.,
Rimm Eric B.
Publication year - 2014
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.114.001169
Subject(s) - medicine , myocardial infarction , hazard ratio , low carbohydrate , cause of death , mortality rate , cardiovascular health , obesity , disease , weight loss , confidence interval
Background The healthiest dietary pattern for myocardial infarction ( MI ) survivors is not known. Specific long‐term benefits of a low‐carbohydrate diet ( LCD ) are unknown, whether from animal or vegetable sources. There is a need to examine the associations between post‐ MI adherence to an LCD and all‐cause and cardiovascular mortality. Methods and Results We included 2258 women from the Nurses' Health Study and 1840 men from the Health Professional Follow‐Up Study who had survived a first MI during follow‐up and provided a pre‐ MI and at least 1 post‐ MI food frequency questionnaire. Adherence to an LCD high in animal sources of protein and fat was associated with higher all‐cause and cardiovascular mortality (hazard ratios of 1.33 [95% CI : 1.06 to 1.65] for all‐cause mortality and 1.51 [95% CI : 1.09 to 2.07] for cardiovascular mortality comparing extreme quintiles). An increase in adherence to an animal‐based LCD prospectively assessed from the pre‐ to post‐ MI period was associated with higher all‐cause mortality and cardiovascular mortality (hazard ratios of 1.30 [95% CI : 1.03 to 1.65] for all‐cause mortality and 1.53 [95% CI : 1.10 to 2.13] for cardiovascular mortality comparing extreme quintiles). An increase in adherence to a plant‐based LCD was not associated with lower all‐cause or cardiovascular mortality. Conclusions Greater adherence to an LCD high in animal sources of fat and protein was associated with higher all‐cause and cardiovascular mortality post‐ MI . We did not find a health benefit from greater adherence to an LCD overall after MI .