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.