Healthy Low-Carb or Low-Fat Diets Linked to Lower CVD Risk: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On June 2, 2025, we reported on new data presented at the American Society for Nutrition's annual meeting, NUTRITION 2025 that showed the quality of carbohydrates, fats, and proteins consumed as part of low-carbohydrate diets (LCD) or low-fat diets (LFD) may be more important for coronary heart disease (CHD) prevention than the macronutrient profile alone.

The study

To examine how the quality and food sources within LCDs and LFDs affect CHD risk and shape metabolic profiles, investigators followed 199 783 participants across 3 major US cohorts—the Health Professionals Follow-Up Study, Nurses’ Health Study, and Nurses’ Health Study II—for a combined total of more than 5.2 million person-years. They analyzed detailed questionnaires from the participants, assigning scores according to how healthy their food choices were within LFDs and LCDs. Healthy components included whole grains, fruits, vegetables, legumes, and nuts. Unhealthy components included refined grains, added sugars, and animal-derived fats and proteins.

In addition, associations between LCD/LFD indices and plasma metabolomics profiles were examined in 1146 participants, developing multi-metabolite scores using elastic net regression, according to the study abstract.

The findings

Researchers documented 19 407 cases of CHD and reported that healthy versions of both diet patterns were associated with reduced CHD risk, while unhealthy versions were associated with increased risk. Specifically, the hazard ratios (HRs) for CHD per 1-standard deviation increment in dietary scores were:

• 1.02 (95% CI 1.00-1.04) for overall LCD

• 0.94 (95% CI 0.93–0.96) for healthy LCD

• 1.05 (95% CI 1.04–1.07) for unhealthy LCD

• 0.94 (95% CI 0.93–0.96) for healthy LFD

• 1.04 (95% CI 1.03–1.06) for unhealthy LFD

Multimetabolite scores derived from plasma metabolomics showed consistent associations with CHD risk, further supporting the diet-disease relationships identified through dietary questionnaires.

Authors' comments

“Regardless of whether someone follows a low-carbohydrate or low-fat diet, emphasizing whole, minimally processed and plant-based foods and limiting refined grain, sugar and animal foods, can significantly reduce the risk of coronary heart disease."

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