Diet Rendah Karbohidrat dan Risiko Penyakit Jantung Koroner untuk Wanita

Diet rendah karbohidrat (low carb) banyak digunakan untuk menurunkan berat badan dan mencegah obesitas. Bagaimana efek diet low carb terhadap risiko penyakit jantung koroner (PJK)?

Penelitian yang melibatkan >82 ribu subyek dan difollow-up selama 20 tahun, menyimpulkan terhadap risiko terjadinya PJK, diet low carb ataupun diet low fat ternyata tidak berbeda. Kedua jenis diet - low carb maupun low fat - mempunyai kelebihan dan kekurangan masing2.

Temuan terpenting adalah bahwa dengan memperbanyak sayuran dalam diet (sebagai sumber protein nabati dan lemak nabati) risiko PJK dapat diturunkan sebesar 30%. Sebaliknya konsumsi karbohidrat ber-indeks glisemik rendah (misalnya gula) akan meningkatkan risiko PJK.

New England Journal of Medicine number 19, Volume 355:1991-2002. Low-Carbohydrate-Diet Score and the Risk of Coronary Heart Disease in Women. Thomas L. Halton, Sc.D., Walter C. Willett, M.D., Dr.P.H., Simin Liu, M.D., Sc.D., JoAnn E. Manson, M.D., Dr.P.H., Christine M. Albert, M.D., M.P.H., Kathryn Rexrode, M.D., and Frank B. Hu, M.D., Ph.D.

ABSTRACT

Background Low-carbohydrate diets have been advocated for weight loss and to prevent obesity, but the long-term safety of these diets has not been determined. Methods We evaluated data on 82,802 women in the Nurses' Health Study who had completed a validated food-frequency questionnaire. Data from the questionnaire were used to calculate a low-carbohydrate-diet score, which was based on the percentage of energy as carbohydrate, fat, and protein (a higher score reflects a higher intake of fat and protein and a lower intake of carbohydrate). The association between the low-carbohydrate-diet score and the risk of coronary heart disease was examined. Results During 20 years of follow-up, we documented 1994 new cases of coronary heart disease. After multivariate adjustment, the relative risk of coronary heart disease comparing highest and lowest deciles of the low-carbohydrate-diet score was 0.94 (95% confidence interval [CI], 0.76 to 1.18; P for trend=0.19). The relative risk comparing highest and lowest deciles of a low-carbohydrate-diet score on the basis of the percentage of energy from carbohydrate, animal protein, and animal fat was 0.94 (95% CI, 0.74 to 1.19; P for trend=0.52), whereas the relative risk on the basis of the percentage of energy from intake of carbohydrates, vegetable protein, and vegetable fat was 0.70 (95% CI, 0.56 to 0.88; P for trend=0.002). A higher glycemic load was strongly associated with an increased risk of coronary heart disease (relative risk comparing highest and lowest deciles, 1.90; 95% CI, 1.15 to 3.15; P for trend=0.003).

Conclusions Our findings suggest that diets lower in carbohydrate and higher in protein and fat are not associated with increased risk of coronary heart disease in women. When vegetable sources of fat and protein are chosen, these diets may moderately reduce the risk of coronary heart disease.

Source Information From the Departments of Nutrition (T.L.H., W.C.W., F.B.H.) and Epidemiology (W.C.W., J.E.M., F.B.H.), Harvard School of Public Health, Boston; the Department of Epidemiology, University of California, Los Angeles, School of Public Health, Los Angeles (S.L.); and the Division of Preventive Medicine (J.E.M., C.M.A., K.R.), the Channing Laboratory (W.C.W., J.E.M., K.R., F.B.H.), and the Cardiovascular Division (C.M.A.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston.