Article High carbohydrate intake increases risk of coronary heart di...

Article Associations of fats and carbohydrate intake with cardiovasc...

Dear Mohan Lal Sir,

The available data shows a  conclusion that low-carbohydrate diets are less safer than other dietary approaches for people who are obese, overweight or suffer from the metabolic syndrome. Lessen the saturated fat and cholesterol were a conclusion from the published epidemological research, this is the initial prospect. In fact, replacement of saturated fats with refined carbohydrate can worsen blood lipids when insulin resistance is present, by increasing triglycerides, the number of small LDL particles, and by decreasing HDL-cholesterol. 

Dear mr. Patil.

Can I please ask for the references you base your last sentence on? Especially regarding HDL. Thank you in advance.

The risk factors for cardiovascular diseases are Type 2 Diabetes Mellitus , Hypertension , Lipid disorders , smoking & Obesity . These disorders are due to genetic factors & life style changes . Lower socioeconomic communities consume diets containing more carbohydrates than other nutritious substances primarily due to economic reasons . It would be preferable , if they are screened for the risk factors & given necessary advice on dietary modifications . This is essential because rising morbidity & mortality due to non communicable diseases is a serious concern & both high & low socioeconomic groups are both vulnerable .

May I recommend the following article

Hu, T., Mills, K. T., Yao, L., Demanelis, K., Eloustaz, M., Yancy, W. S., Jr., . . . Bazzano, L. A. Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: a meta-analysis of randomized controlled clinical trialsl. Am J Epidemiol 2012; 176 Suppl 7: S44-54.

Tanja I am curious about that too. Thanks for asking about those references. @Mithun, do not feel like we want proofs. The idea here is to learn more and share our experiences. We are on the same side, which is the road of learning and sharing.

Dear all i have mentioned taht from a blog of  Axel F. Sigurdsson MD.

http://www.docsopinion.com/2013/03/17/low-carb-diets-and-heart-disease-what-are-we-afraid-of/

Dear Mithun,

Just to start with, Dr. Sigurdsson mentions the seven countries studies performed by Ancel Keys. Actually that study was made with 22 countries. Seven satisfied his thesis and he started calling it seven countries study.

The same Ancel Keys declared later (1997),

“There’s no connection whatsoever between the cholesterol in food and cholesterol in the blood. And we’ve known that all along. Cholesterol in the diet doesn’t matter at all unless you happen to be a chicken or a rabbit.”

Dr. Sigurdsson also recommends the Mediterranean diet, another master piece of Ancel Keys. It happens that the 10th biggest consumers of saturated fat in the world belong to the Mediterranean list and they have very low incidence of cvd.

In 1992, speaking to Time Magazine, William Castelli, the director of the world-famous Framingham Study for 14 years (And at that time we did not know who was who, Dr. Castelli and FHS were one) said the following:

“In Framingham, Mass., the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person’s serum cholesterol . . . we found that people who ate the most cholesterol, ate the most saturated fat, [and] ate the most calories weighed the least and were the most physically active.”

Dr. Sigurdsson has a very positive point when he recommends to view each case as unique. He also show other studies in his text. He recommends obese people or who suffers from metabolic syndrome to cut down on carbohydrates and increase fats. At this point he could not give any better advise, I believe.

I don't believe that the problem is explicitly high-carbohydrate diets. Carbohydrates are actually your body's preferred source of energy. HOWEVER, high-carbohydrate diets (especially in this day and age) often coincide with high amounts of REFINED products like white bread, pastries and other cheap grains. Those are the real problems. The energy content is directly available (without much, if any, further processing) and, as an artifact of evolution, our bodies still want to store excess energy in fear of being without it for an extended period of time. When your carbohydrates come with fiber and nutrients, they nourish both your self and the microbes that outnumber your own cells. Fiber is good for unclogging your GI tract as well as being a metabolic precursor to a variety of short-chain fatty acids (like butyric acid / butyrate) that also play vital roles in wellness. One of those important roles is in the production of bile salts.

Dr. Sigurdsson is also correct when he says that there should be observed other  approaches other than low fat, high carbs and energy deficient diet.

Dear Mithun,

It is a pity that someone anonimously decided to downvote you. Why that person does not come to the discussion? We have been respecting one another. No fights at all, just science. So if you, downvoter, likes science, be welcome. We have room for you too.

Taking the text of Dr. Sigurdsson home I could see that he practices good science. The questionable researches he cites are only historically. He says that he sometimes goes against the official guidelines because he is able to see with his pacienst that other approaches are more efficient.

I question his advise for monoinsaturated fat as good for the heart and the polyinsaturated fats as well, but it depends on what use he intends to give to the polyinsaturated fats. Other than that you cited a very good article. Thanks!!!

Many genetic and lifestyle factors are involved in the etiology of coronary heart disease and influence both the atherosclerotic and thrombotic processes underlying the clinical manifestations of this disease. Dietary factors may influence these processes directly or via a range of cardiovascular disease risk factors. Obesity is associated with an appreciable increase in the risk of coronary heart disease. There is also evidence implicating specific nutrients and, in particular, high intakes of some saturated fatty acids appear to be important promoters of coronary heart disease. On the other hand, there is increasing evidence of a strong protective effect by a range of antioxidant nutrients. Increasing carbohydrate intake can assist in the reduction of saturated fat and many fruits and vegetables rich in carbohydrates are also rich in several antioxidants. Cereal foods rich in non-starch polysaccharides have been shown to be protective against coronary heart disease in a series of prospective studies. There is no evidence for a causal role of sucrose in the etiology of coronary heart disease. The cornerstone of dietary advice aimed at reducing coronary heart disease risk is to increase the intake of carbohydrate-rich foods, especially cereals, vegetables and fruits rich in non-starch polysaccharide, at the expense of fat. Among those who are overweight or obese it is more important to reduce total fat intake and to encourage the consumption of the most appropriate carbohydrate-containing foods. There has been concern that a substantial increase in carbohydrate-containing food at the expense of fat, might result in a decrease in high-density lipoprotein and an increase in very low-density lipoprotein and triglycerides in the blood. 

Certain non-starch polysaccharides (for example beta-glucans) have been shown to have an appreciable effect in lowering serum cholesterol when consumed in naturally occurring foods, or foods which have been enriched by purified forms, or even when fed as dietary supplements. Such polysaccharides may be used in the management of patients with existing hypercholesterolemia but their role, if any, in the prevention of coronary heart disease remains to be established.

However, a study by Stanford University researchers and some others presumably showed that a diet higher in carbohydrate and lower in unsaturated fats alters blood lipids in such a way that the risk atherosclerosis is increased. 

Dear Vilemar Magalhaes sir

I respect you and I really thank you for giving a valuable answers.  discussion and sharing of  some scientific queries  always let us to improve our knowledge 

Thank you

MIthun V. K. Patil

Departmnet of pharmacology

Poona college of Pharmacy

Pune, India

I do  agree with  YOGESH CHANDRA TRIPATHI that  may  factors have to be considered regards cardiovascular disease

Cheap carbohydrates are one of the vices of modern society. The Obesity Epidemics

the increasing rate of Diabetes Mellitus Type 2 and Hyperlipidemia are all related to this  carbohydrate load and are all major risk factors for Coronary Heart  Dis.

Depends on the definition of "high" in high carbohydrate. Also depends on the type of carbohydrate.

Atherosclerotic disease is the patrimony of human beings and not another species of the animal kingdom. Type intake of carbohydrates has changed in the history and evolution of humanity and now the largest consumer of refined carbohydrates or simple carbohydrates when in ancient carbohydrate consumption was only slowly absorbed complex sugars. Therefore the level of pancreatic stimulation and insulin response with insulin resistance linked to sedentary been enhanced in the current era contributing to increased cardiovascular disease

Thanks Ana M Wägner  for valuable link

Too much carbohydrate-laden foods like white bread and corn flakes can be detrimental to cardiac health. Pl refer following thread -http://www.sciencedaily.com/releases/2009/06/090625133215.htm

With my late colleague Bill Stanley, my group tested this hypothesis directly in laboratory rats. We anticipated that high fat diets, especially with saturated fat, would impair cardiac function. To our surprise, we found that the high fat diets being villified at the time were actually beneficial and it was sucrose (which we had used as an "inert" filler in our test diets) that was most harmful. We published a series of papers. Here is one: http://www.ncbi.nlm.nih.gov/pubmed/18551017

Thanks for valuable link

Yogesh and Paul, you are both absolutely correct!

High carbohydrate diet is a positive CVD risk factor  because it is related with insulin resistance, abdominal fat distribution, high plasma triglycerides level , low HDL -cholesterol and oxidative stress.

I think we end to confuse low-carbohydrate with no carbohydrate. Obviously high carbohydrate diets, particularly refined carbohydrates, will cause weight gain and be bad for glycaemic control in type 2 patients, increase triglyceride levels  as well as possibly increase cardiovascular risk. No-one advocates "high-carbohydrate" diet, however, the book by Noakes as mentioned by Dr Makivic advocates a carbohydrate-free, high animal fat diet, which is possibly dangerous, causes ketosis and constipation, elevated total and LDL cholesterol and is  unacceptable, expensive and difficult to maintain. A modicum of common sense will tell us that a low (not "no") carbohydrate, balanced diet done in moderation is the best recommendation.

Dear Larry,

I agree with you about the confusion that we are lead ourselves into, which is to understand that low carb means no carbs at all. But I can not accept very well that high animal fat diets can be dangerous. I would appreciate if you posted here some of your sources that support that fat can cause constipation, elevates LDL and that LDL is really harmfull to us. It is almost a common sense what you say today, but every time I have asked for supporting material I have not found a trustworthy study. Ancel Key should not be one. Besides, LDL could not be synthetize from fat, neither is it a cholesterol. Please do not understand that as if I wanted to confront you, but I just want to learn more. And I will really read all the links you can supply here. Thanks.

The constipation is not due to the fat. It is due to a total lack of dietary fibre in carb-free diets.

The effect on lipids is due to a combination of animal fat and animal protein. Anecdotally, I have had a number of patients whose LDL has doubled on this diet. Furthermore, Noakes advises stopping statins on his diet, which compounds the problem.

excessive blood carbohydrate increases the formation of glycated-hemoglobin, and cardohydrate oxidation products which contribute to atherosclerosis and inflammatory reactions into the circulatory system. Those inflammatory reactions contribute to endothelial damage. Excessive refined carbohydrate intake contributes to overweight and obesity which increases the cardiovascular risk.    

When considering carbohydrates, one has to know whether consumed carbs have low glycemic index or high glycemic index (which are more harmful). The nature of carbohydrates consumed that is simple or complex carbohydrates is also important. Also, the time of the day at which it is consumed can drastically change the effect it has on the body. Consuming large amount of carbohydrates for a long period of time with nil to minimal physical activity is surely harmful. Increased carbohydrate consumption leads to obesity, dyslipidemia and increases the risk of associated risks such as cardiovascular problems. Constant exposure leads to overburdening of the pancreas increasing the risk of damage to the insulin producing cells (beta cells) leading to glucose intolerance and eventually type 2 diabetes. 

That  is exactly the point. No one ever claimed that refined carbohydrate was "good". My iissue is the differentiation between a "low-carbohydrate diet" and a "no-carbohydrate diet. Clearly, too much refine carbohydrate, or an overload of carbohydrate calories, will cause weight gain and is not recommended.

The effect of carbohydrates on health may depend to some extent on your genetic makeup. Low number of AMY1 copies leads to low salivary amylase synthesis which is associated with relative prevalence of obesity and diabetes, which are positive risk factors in cardiovascular disease.

Perry, G. H., Dominy, N. J., Claw, K. G., Lee, A. S., Fiegler, H., Redon, R., ... & Stone, A. C. (2007). Diet and the evolution of human amylase gene copy number variation. Nature genetics, 39(10), 1256-1260.

Falchi, M., Moustafa, J. S. E. S., Takousis, P., Pesce, F., Bonnefond, A., Andersson-Assarsson, J. C., ... & Froguel, P. (2014). Low copy number of the salivary amylase gene predisposes to obesity. Nature genetics, 46(5), 492-497.

Mandel, A. L., & Breslin, P. A. (2012). High endogenous salivary amylase activity is associated with improved glycemic homeostasis following starch ingestion in adults. The Journal of nutrition, 142(5), 853-858.

A healthy diet includes a balance of protein, carbohydrates and fats. Reducing or increasing any one of these nutrients can have major consequences on the body. Reducing carbohydrates to extremely low levels, for instance, causes the body to consume protein and fat for fuel, and is the key concept behind several popular diet plans. A diet high in carbohydrates, on the other hand, can cause a host of different effects.

A high-carb diet can produce quick energy for physical exertion. Carbohydrates metabolize quickly, providing the body's main source of fuel, which is why athletes often eat high-carb foods. Our digestive system breaks down carbohydrates into glucose molecules, which then flow through the bloodstream thus boosting blood sugar levels and prompting the pancreas to produce more insulin to handle the excess glucose. Over extended periods, a diet high in carbohydrates can cause cells to become resistant to insulin, a major cause in type 2 or adult-onset diabetes. In the condition of insulin resistance, the pancreas will compensate by making more and more insulin Excess insulin stimulates a wide variety of other metabolic systems: it encourages the kidneys to retain salt and fluid; it stimulates the production of cholesterol by the liver; it fuels an increase in triglyceride production; it thickens the muscular portion of the artery walls, increasing the risk for high blood pressure and heart problems.

Sir... 

1) Carbohydrates are the primary source of energy in one's diet. 

As long as the physical activity equals the intake of carbohydrates, the metabolism is balanced. But, more often than not, it is not the case.

Excess carbohydrates get stored or converted into lipids and definitely pose a threat to cardiovascular health.

2) As you have mentioned, in developing countries, where many people of the lower socio economic strata are physical labourers, their diet contains a lot of carbohydrates, comprising more than 60-70 %. This fact, with a background of genetic predisposition for insulin resistance etc, is an important contributory factor for diabetes, hypertension and CV disease. In fact, diabetes, itself is a "cardiovascular risk equivalent" {Haffner's hypothesis}. 

3) The post-prandial blood sugar levels (to which carbohydrates contribute much) possess a directly proportional linear relationship with CV morbidity, even before the cut-off blood sugar value of diabetes is reached.

3) As others have mentioned here, refining of carbohydrate-rich food items... consumption of simple sugars... consumptions of food with high glycaemic index.. all are deterrant to CV health, especially with a background of lifestyle-related (above mentioned) diseases.

Dear  S. Charles Bronson

Thank  you very much  for the comprehensive reply ,

Dear Dr. Adam,

Thank you sir.

It is  advisable for one to consume their daily carbohydrates in the morning so that the body can  break them over the course of the day. 

I am not sure of the evidence for that, Dolo. It is fairly common folklore but I have never seen any evidence that carbohydrates cannot ne digested and/or metabolised after dark. I would like to know if anyone had such evidence?

Discerning the effect of diet on the heart is difficult, because there is no "no food" control group. Two diets have been shown by RCT to reduce the risk of heart disease- DASH, and Mediterranean. The controls were "average Western diet" in the countries where the RCTs were performed, for example Spain, and the United States.

Whether or not a carbohydrate rich diet increases insulin resistance and heart disease depends largely on how fat you are. If you stay thin enough, any adverse effects are likely slim to none. This has obvious implications for the study of carbohydrate rich diets in developing countries. 

High carbohydrate diet cause obesity and cardiovascular disease

That's a very definite statement to make, Moslem. Evidence?

Dear Larry,

Most of the specialists do not recommend carbs in the evening not because it van not be digested, but because it is digested too fast and so the person will be sleeping and may store that nutrient as fat. That absortion can be retarded by fat ingestion, then one may need water some time after and he will either have heartburn or will wake up during the night to urinate. There can be thousands of other motives and the ones given above not be true for some individuais. Or even worse it can be true for you today and not  tomorrow. Bit as a rule of thumb I would say no to carbs in the evening regardless if you feel bad after having it or not.

Few studies that i read proposed that dietary cholesterol give little effect on the level of cholesterol in our body (refer Mcnamara 2000; Rosenman 1993; Volk 2007). If we eat a lot of cholesterol, our body will produce less and vice versa. The Scientific Report 2015 Dietary Guidelines Advisory Committee, also has suggest to remove the limit for cholesterol intake suggesting there is no harm in taking more cholesterol. However, in my opinion, this conclusion is still premature. Cholesterol level is indeed a very important risk factor for CVD, and the influence of dietary cholesterol need to be researched carefully.

Only two types of diet have been tested in randomized controlled trials, DASH, and Mediterranean, which are similar to each other. They lower risk of CVD compared to usual diet. Other studies are observational and inherently unreliable. If carbs make you fat and you get diabetes, it increases CVD risk. Otherwise, we don't know.

I think  all  of you and Regina Wikinski specifically mentioned the main points

Thank  you for you all  for valuable comments 

Im Sid, you a right that, for most people, dietary saturated fat, but not cholesterol, affects levels of total cholesterol and LDL. However, certain individuals are "egg sensitive" and experience significantly higher blood cholesterol levels with increased intake of dietary cholesterol. 

good day i want to differ a bit from the above answers  not because they are not theoretically correct but because in my village this is not observable  our daily staples is rice and   yam  which are high in carbs ,we seldom it proteins food except on festivity but we take a lot of vegetables.obesity is not a common occurrence i believe it is storing more than you can use that leads to cardiovascular problem s most of us are farmers not mechanized but manual which make room for burning of store fats 

thanks

All carbohydrate is not the same.

Using OECD and WHO figures, we found a very high  correlation of around 0.9 between milk consumption and coronary heart disease death, in the four groups we studied, which were three age groups of men and one of women. Cheese had a slight negative correlation. Increases in milk consumption were highly correlated with increases in CHD death. UK death rates from CHD dropped about 10 years after consumption of milk dropped, in all these groups. The obvious difference between milk and cheese is the sugar. 

Lactose is broken down into glucose and galactose. The second highest correlation was with sugar. Sucrose breaks down into glucose and fructose. Galactose is a very avid glycator of protein. Fructose is less avid, and glucose less again. Glycation leads to oxidation. Cholesterol is not a problem, so long as it is not oxidised. Antioxidants help, but you need 1.5 litres of wine to antidote 1 litre of milk. There is no French paradox. The French do have enough wine to antidote most of their milk consumption.

Starches break down to glucose, which is not a great problem. Eat starch not sugar. Consume hard cheese not milk. It should be pressed to remove the sugar. Eat lots of vegetables and little fruit.

Cheese has the additional advantage over milk that it is fermented, and contains vitamin K2, which removes calcium from the arteries, and puts it in the bone. 

Thanks Margaret Moss   for the comprehensive comments 

High carbohydrate diet  is certainly a positve risk factor for CVD. This can be explained by looking into its effect on Interrelationship between metabolism of Carbohydrates, fats and proteins.

Dear  Lalit Mohan Srivastava

I think  both  direct and indirect interactions have to  be considered  

Some people are more adapted than others to consume large quantities of carbs (Perry 2007). More importantly, in my opinion, is how many times a day we consume carbs. Every event raises insulin so if not given time to rest and regenerate the insulinogenic system may become insensitive. In my opinion, over-snacking is one of the major causes of all illnesses that are associated with insulin resistance. Over-snacking is one of the most profound mis-matches between modern day lifestyle and evolutionary lifestyle.

Surely the issue has more to do with overall energy (calorie) excess irrespective of the source of energy. High complex carbohydrate intake, particularly refined carbohydrate will cause weight gain with it's associated problems. We should stop worrying too much on the source of the energy (calories) and rather concentrate on reducing energy intake overall and increasing energy expenditure (exercise). Replacing carbohydrate with an equivalent amount of energy from another source will achieve very little.

Dear  Larry A Distiller is it easy  to  change one`s habit towards the better one

No one said it was easy. If lifestyle change was easy there would be far fewer obese people and far less diabetes in the world.

The glycaemic index demonises starch and glucose, whereas the worst sugars are galactose in milk and fructose in sugar, corn syrup and fruit. These are more avid glycators of proteins, and more associated with coronary heart disease, type 2 diabetes, obesity and cancer.

I think the  rich CHO diets is a risk factor for CVD. a study on women showed that women who consumed diets rich in carbs had an increased CHD risk. 

Certainly, I agree with the views of  Dr. Ishag Adam.

I am really puzzled by all these statements. It seems that generally people are talking of mostly refined carbohydrates as are used commonly in our diets. I have assisted to 2 seminaries in the US and 5 seminaries in Germany which were held on the topics of cardiovascular disease and diabetes. We drew blood tests from all paticipants at the beginning and at the end of the seminaries. After 3, resp. 4 weeks of teaching people to change their diet to about 70% complex carbohydrates, 15% protein and not more than 15% fat and to do regular exercise, we found a respectable drop in blood values and vital parameters. (See: www.chiphealth.com). When you consume foods as grown and sort out all those refined products, then the amount of carbohydrates doesn't count. Also important is not to snack between meals. You should give your stomach a rest of at least 4 hours between meals, drink abaut 2 - 3 L of water, exercise regularly and get enough rest and sleep. It is just that simple!

High carbohydrate intake produces more simple sugar (glucose) after digestion and stimulates glycogenesis. When the sugar level exceeds than the glycogen storage capacity of the cells, is ultimately converted in to fat. Hence High carbohydrate diet is also considered as a risk factor for CVD.

We are now in the era of cheep carbihydrates which is the main cause of the Obesity Epidemy who plagues the modern society and is related to the risk factors for heart disease. Beside cheep carbohydrates , processed food is flooded by natrium chloride and both these detrimentaly act on health ( trough cardiovascular risks ) no less than smoking cigarets. Health education  may help in coping with this and should start  as early as possible as part of  schools education programes.

Yes , I agree with you , high intake of CHO causes cardiovascular disease because excess CHO are converted into fat. This fat storage under skin as result body weight increases . increase in body weight increase risk over weight. this overweight lead to increase risk of cardiovascular disease

Article High carbohydrate intake increases risk of coronary heart di...

Article Associations of fats and carbohydrate intake with cardiovasc...

We found the correlations between various foods consumed and coronary heart disease death after 17 years. The highest positive correlation was with milk, while there was a slight negative correlation with cheese. This suggests that reducing the sugar by fermenting milk is beneficial.

The second highest correlation was with sugar. Galactose in milk and fructose in sugar are more potent glycators than glucose. Glycated cholesterol is prone to oxidation, and oxidation causes atherosclerosis.

Eat cheese rather than milk. Avoid sugar. Eat your carbohydrates as starch, as they break down to glucose.

The membrane round the fat globules in milk also causes clotting.

Fermentation produces vitamin K2, which clears calcium from the arteries, and moves it to the bones.

We found that countries that decreased milk consumption decreased coronary deaths, after a time lag. One country increased milk consumption and increased coronary deaths, after the time lag.

Look at what you eat rather than the calories. All calories are not equal.

Carbohydrates may directly influence human diseases by affecting physiological and metabolic processes .

Many genetic and lifestyle factors are involved in the etiology of coronary heart disease and influence both the atherosclerotic and thrombotic processes underlying the clinical manifestations of this disease. Dietary factors may influence these processes directly or via a range of cardiovascular disease risk factors.

It depends if the carbohydrate is complex as it is found in its natural state or if it is refined as it exists in flour and sugar. It is the overcompensation of refined carbohydrate that is associated with obesity and its associated diseases.

Starch is a chain of glucose molecules. Lactose is glucose and galactose. Sucrose, for instance from cane and beet sugar, is fructose and glucose. Maybe because we evolved eating tubers, we cope with glucose reasonably well. When blood glucose is too high, we make leptin to take away appetite. We did not evolve with much sweet fruit or honey, did not milk animals, did not have high fructose corn syrup, and did not have sugar processed from cane and beet. So we do not have mechanisms for dealing with fructose and galactose. Both damage arteries. The fear of fat, which came from Ancel Keys' cherry picked figures, led to an increase in sugar consumption, and then an increase in obesity, cancer and ulcerative colitis, and probably hyperactivity. Eat starch rather than sugar.

Whether starch should be refined or not is another matter. Unrefined wheat, for example, contains lectins and phytate. Lectins can lead to arthritis and gut disorders, and phytate binds to minerals, causing their excretion.

Sure. Many studies proved that . When glucose increased in blood it will converted to TG.

And increase of LDL- C.

and it will increase the risk of Oxidised LDL. That increase the risk of atherosclerosis

Certainly, high carbohydrate diet would lead to heart problem. However carbohydrates in moderation alongwith moderate amount of fats and proteins in the diet would be the most ideal diet combination for good health that include better functioning of heart and its functional activities.

If you mean refined carbohydrate such as flout and sugar the over consumption leads to persistent hyperglycemia. These extra calories are stored as fat including cholesterol. Fruits and vegetables are also high in carbohydrates however a diet low in flour and sugar and high in fruits and vegetables are beneficial re cholesterol and weight management.

Recent studies have demonstrated negative effect of the high carbohydrate diet than routine diet in the development of CVD.

Yes.

Excess consumption of refined carbohydrate (flour and sugar) is rapidly converted to fat which in turn increases cholesterol with deposition in the endothelial layer of coronary vessels. ie., coronary occlusion, angina and myocardial infarction.

I would like Madelyn Moss to comment on cows' milk and coronary heart disease particularly in the USA where there is too much CVD. A1 protein from a vast majority of black & white Holstein cows differs from A2 milk protein (with β-casein) in Jersey & Guernsey cows. A1 β-casein may also be a risk factor for coronary heart disease. This A2 is very similar to human protein, while grass contains yellow B-carotine that is not digested by brown Guernsey and Masai cows. Curiously, child diabetes is very rare where Maasai cattle are domesticated. Personal note: I was allergic to A1 cows milk as a baby in 1941, but not knowing any better, I kept drinking much A1 milk with breakfast cereal. I grew up very healthy, athletic, never fat, never smoking. I had a coronary blockage issue with Vtac, flying at 30,000 feet over Dallas, Texas, resulting in a quintuple coronary bypass at age 67. This was familial, at same age my grandfather died in agony, and my father also had a bad heart blockage. Then I discovered A2 milk that, with statins, reduced my blood carbs, arterial plaque, and am doing very well 13 years later. Plus- men need Magnesium ++!

Thank you so much for new information Mr Uzakov

Many studies have shown that high carbohydrates diet can be a risk for CVDs through mechanisms well described @Regina and @Mitchell.

Large number of studies performed in animals as well as humans have shown and discussed through interrelationship of the metabolism of carbohydrates, fats and proteins proving the notion that high carbohydrate diet would be converted into the metabolites which are risk factors for cardiovascular diseases.

There are several factors which should be considered in this case. Usually diets are rich in carbohydrates (60-70%) but consuming only carbohydrates is bad for health. Also physical activity play an important role in influencing BMR (basal metabolic rate), highly active individuals may consume high amounts of carbohydrates and may not be obese and if same amount is consumed by people with sedentary lifestyle they may suffer from various lifestyle related disorders life hypertension, diabetes, obesity etc.

My colleague and I wrote the following about the relationship of milk with coronary heart disease:

1. Moss M, Freed DLJ. Survival Trends, Coronary Event Rates, and the MONICA Project (letter). Lancet 1999; 354 (9181): 862.

2. Moss M. Does Milk Cause Coronary Heart Disease? J Nutr Env Med 2002; 12(3): 207-16.

3. Moss M, Freed D. The Cow and the Coronary: Epidemiology, Biochemistry and Immunology. Int J Cardiol 2003; 87: 203-216.

Reasons for the close relationship may be

glycation by galactose,

platelet aggregation caused by the membrane round the globules of fat in milk, Interaction between milk fat globule membrane and NK cells, leading to inflammation,

the high calcium:magnesium ratio, leading to calcification of arteries, and an increased tendency of the blood to clot

lactose increasing calcium absorption,

a high ratio of methionine to relevant B vitamins, promoting high homocysteine,

a low level of cardioprotective vitamin E, and

a low level of taurine, which prevents arrhythmias.

McLachlan CNS, Clarke AJ: Heart Disease, Diabetes, Gut immune Suppression and Epidemiology Studies. J Nutr Env Med 2002; 12(3): 197-216, discusses beta casein A1 and beta casein B, saying they are sources of a tyrosyl radical, which promotes oxidation of LDL. Beta casein A2 does not provide this tyrosyl radical.

I avoid milk, because of the galactose, which is in all milk. However, I do use goat butter, cheese and yogurt. Goat milk is low in beta casein A1. I avoid cow milk products, as I probably have a cow milk protein allergy.

M. Moss states...Beta casein A2 as from Guernsey cows, does not provide this tyrosyl radical that oxidizes LDL. Then, is it a good element or not?

Thank you, it depends on the type of carbohydrates (whole grains), fiber contents, and whether unsaturated fats are consumed, no single diet fits all. However, the Mediterranean diet is recommended. Weight loss and maintenance is of paramount importance, weight cycling may be more hazardous in terms of cardiovascular mortality.

Not a single dietary component would cause cardiovascular disease and so is true for high carbohydrate diet as well. Hence interrelationship.of dietary components in the body through its metabolism would be the causal factor for cardiovascular diseases.

Yes, since the background (acetylcoA) for cholesterol and fatty acids synthesis comes from carbohydrates in the presence of insulin (anabolic hormone) that following carbohydrates food.

High carbohydrate diet would lead to cardiovascular diseases by virtue of its being converted to several metabolic products in the organs of the body which are certainly the major cause.

There is much disagreement over whether high-carbohydrate diets increase weight-gain and disease risk, especially when calories are not significantly higher between compared diets. Many scientific studies demonstrate positive correlations between diets high in added sugars with weight gain and disease risk, but some others do not show a significant relationship. In regard to refined grains, there are no studies that show consumption of refined grains increases weight gain or disease risk. What is clear, however, is that getting more of your carbohydrates from dietary sources containing whole grains instead of refined grains stimulates weight loss and reduces disease risk.

https://med.libretexts.org/Under_Construction/Purgatory/Book%3A_Human_Nutrition_(University_of_Hawaii)_1st_Ed/04%3A_Carbohydrates/4.04%3A_Health_Consequences_and_Benefits_of_High-Carbohydrate_Diets

Galactose in milk and fructose in sugar, honey and fruit juice, are potent glycators of proteins, and to be minimised, to avoid artery disease. Glucose is a less potent glycator. Refined starch breaks down to glucose, which is therefore not such a problem.

Many people do not tolerate whole grains, because the lectins in them cause them to have diarrhoea or arthritis.

Yes... particularly from refined carbohydrates, it can cause inflammation in the body. Some experts have speculated that this may be one of the main causes of a leptin resistance diet and obesity. Refined carbohydrates also increase blood triglyceride levels. This is a risk factor for heart disease and type 2 diabetes, also oxydative stress has a main role for triggering to CVD

Thank you Ms. Ufamy for adding supporting the list of maladies associated with the overconsumption of refined carbohydrate. Triglyceride levels need to be persistently elevated with generalized oxidative stress which offers several other avenues triggering CVD. It all requires the compulsive overconsumption of refined carbohydrate.

Dr. Mitchell Kaminiski's views are commendable and i support and recommend the same. The oxidative stress is phenomenon that goes hand in hand with carohydrate consumption and cardiovascular disease.

The liver converts fructose to triglycerides. It is sugar, honey, corn syrup, maple syrup, agave, fruit juice and other sweet foods that are the issue, rather than glucose from starch. The body uses glucose fairly efficiently to make energy. We did not evolve consuming much fructose, and are not good at using it. When we evolved, we had fruit in autumn, which allowed us to build up a fat store for the hungry winter. There was not a lot of fructose available all year. Even at the Equator, where there is no winter, there was not a concentrated supply of fructose, like what we can buy at the shops nowadays.

Yes it is one of the positive factor for cardiovascular diseases

"Carbohydrate" is not a toxin unless in is refined and eaten in volume due to an obsessive compulsion. Fruits, vegetables and grains etc. are complex carbohydrates and consumption as a meal will not raise glucose and all the other negative metabolic effects such as free radicals and oxidative stress.

Yes, a diet high in carbohydrates raises blood glucose and insulin levels, increases the level of fatty substances called triglycerides in the blood and reduces the levels of good cholesterol. These changes increase the risk of cardiovascular disease.

https://www.nhs.uk/news/food-and-diet/carbohydrates-and-heart-problems/

Eating high amounts of simple carbohydrate is harmful to health. Complex carbohydrates are recommended instead of simple carbohydrates. Because its glycemic index is lower. It does not increase oxidative stress as much as simple sugar.

Article The Associations Between Oral Complex Carbohydrate Sensitivi...

A period from 8/1/2015 to 1/13/2021, my averaged carbs intake per meal is 14 grams, my weight is 172 lbs or 78kg, my BMI is 25.4, my averaged PPG is 116 mg/dL or 6.44 mmol/l, my risk of having CVD or syroke is 55% which is very low in comparing my 2010 data (high carbs, 220 lbs, BMI32, PPG 280, CVD risk 90%).

I agree with @Regina and Arvind Singh for the reasons adduced. High carbohydrate diet is a known risk factor for CVDs.

Carbohydrates are not bad for your heart, as long as you choose a variety of whole, minimally processed carbohydrates in moderation," Keh says. "For example, quinoa is a healthy carbohydrate, but eating three to four cups of quinoa at a time is too much for most people."

Not all carbohydrates are unhealthy to the body but some studies done revealed that some varieties of high carb foods such as white bread when consumed in high quantities regularly can lead to cardiac problems and diabetes.

I agree with the views expressed by Drs. Helen Ojwang and Sanjeev Kumar. These are quite pertinent to the question.