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Low carbohydrate diets should NOT be recommended for patients with familiar hypercholesterolaemia
  1. Roman Pawlak
  1. Nutrition Science, East Carolina University, Greenville, North Carolina, USA
  1. Correspondence to Dr Roman Pawlak, Nutrition Science, East Carolina University, Greenville, NC 27858, USA; pawlakr{at}

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Diamond et al 1 have questioned the efficacy of low-saturated fat, low-cholesterol diet to reduce LDL cholesterol in individuals with familiar hypercholesterolaemia (FH) and suggested that these patients be introduced to low carbohydrate diets (LCD). There are several problems with their suggestions, the main one is addressed in this letter.

Evidence from animal and human studies showed that LCD, which usually are also high in protein (LCHP) and/or fat, exacerbate atherosclerosis independently of ‘significant alterations in traditional atherogenic serum lipids, serum inflammatory markers and histological indicators of inflammatory infiltration’2 and …

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  • Contributors RP has written the entire document with no help of others.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.