900,000 Studied: The Truth About Low-Carb and Early Death

Physionic

Oct 20, 2025

Episode description

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0:00 - Introduction
0:50 - Low Carb Diets and Premature Death
5:31 - A Game-changing Criticism
8:38 - Main Points

Video linked at the End: https://youtu.be/tla-JrqhhHI

References
[Study 527] Akter S, Mizoue T, Nanri A, et al; Japan Public Health Center-based Prospective Study Group. Low carbohydrate diet and all cause and cause-specific mortality. Clin Nutr. 2021;40:2016-2024. doi:10.1016/j.clnu.2020.09.022.

Funding/Conflicts: Public Funding: National Cancer Center Research and Development Fund; Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (1989–2010); no other funding (Non-profit or Industry) // No direct Conflicts of Interest

[Study 528] Mazidi M, Katsiki N, Mikhailidis DP, Sattar N, Banach M. Lower carbohydrate diets and all-cause and cause-specific mortality: a population-based cohort study and pooling of prospective studies. Eur Heart J. 2019;40(34):2870-2879. doi:10.1093/eurheartj/ehz174

Funding/Conflicts: Public Funding: No public study funding reported; one author (M.M.) received support from the Chinese Academy of Sciences; funders had no role in study design, conduct, analysis, interpretation, writing, or the decision to submit. ; Non-Profit Funding: No non-profit study funding reported; one author (M.M.) received support from The World Academy of Sciences; no additional non-profit funding disclosed and no role of supporters in the work. Industry Funding: No industry funding for this study; conflicts of interest (author-level): N.K.—talks/conferences/trials sponsored by Amgen, Angelini, AstraZeneca, Boehringer Ingelheim, MSD, Novartis, Novo Nordisk, Sanofi, WinMedica; D.P.M.—talks/conferences sponsored by MSD, AstraZeneca, Libytec; M.B.—speakers’ bureau (Abbott/Mylan, Abbott Vascular, Actavis, Akcea, Amgen, Biofarm, KRKA, MSD, Sanofi-Aventis, Servier, Valeant), consultancy (Abbott Vascular, Akcea, Amgen, Daiichi Sankyo, Esperion, Lilly, MSD, Resverlogix, Sanofi-Aventis), grants (Sanofi, Valeant); N.S.—consulting/speakers’ bureau (Amgen, AstraZeneca, Boehringer Ingelheim, Eli-Lilly, Novo Nordisk, Napp, Sanofi), grant support (Boehringer Ingelheim); M.M.—No other Conflicts of Interest

[Study 529] Noto H, Goto A, Tsujimoto T, Noda M. Low-carbohydrate diets and all-cause mortality: a systematic review and meta-analysis of observational studies. PLoS One. 2013;8(1):e55030. doi:10.1371/journal.pone.0055030.

Funding/Conflicts: Public Funding: Health Sciences Research Grant from the Ministry of Health, Labour and Welfare of Japan; funders had no role in study design, data collection/analysis, decision to publish, or manuscript preparation; No Non-Profit or Industry Funding; No direct Conflicts of Interest

[Study 530] Shan Z, Guo Y, Hu FB, Liu L, Qi Q. Association of low-carbohydrate and low-fat diets with mortality among US adults. JAMA Intern Med. 2020;180(4):513-523. doi:10.1001/jamainternmed.2019.6980

Funding/Conflicts: Public Funding: National Natural Science Foundation of China; US National Institutes of Health—NHLBI grant; role of funder/sponsor: no role in study design, conduct, data collection/management/analysis/interpretation, manuscript preparation/review/approval, or the decision to submit; Industry Funding: Industry relationships outside the submitted work—Hu received grants from the California Walnut Commission and personal fees from Standard Process, Metagenics, and Diet Quality Photo Navigation

[Study 531] Qu X, Huang L, Rong J. The ketogenic diet has the potential to decrease all-cause mortality without a concomitant increase in cardiovascular-related mortality. Sci Rep. 2024;14:22805. doi:10.1038/s41598-024-73384-x.

Funding/Conflicts: Public: No public-sector funding was reported; the authors acknowledge NHANES/NCHS for contributions to study design and data sharing; the authors declare no competing interests; Non-Profit: No non-profit funding was reported; the authors declare no competing interests; Industry: No industry funding was reported // No direct Conflicts of Interest

[Study 532] Fung TT, van Dam RM, Hankinson SE, Stampfer MJ, Willett WC, Hu FB. Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies. Ann Intern Med. 2010;153(5):289-298. doi:10.1059/0003-4819-153-5-201009070-00003.

Funding/Conflicts: Public: Funding—U.S. National Institutes of Health (NIH) grants, ; role of funder—NIH had no role in the study design, conduct, analysis, interpretation, or manuscript preparation; No direct Conflicts of Interest

Mindsip insights from this episode:

Redefine low-carb diets for accurate analysis

Many studies analyzing "low-carbohydrate" diets define them with carbohydrate intakes as high as 46% of total calories, which doesn't reflect a true low-carb or ketogenic diet.

#carbohydrate

#nutrition

Moderate animal protein on low-carb diet reduces mortality risk

Contrary to a simple good/bad narrative, a moderate amount of animal protein on a lower-carbohydrate diet is associated with reduced mortality risk, a benefit that disappears with higher consumption.

#mortality

#protein

Aim for 12% of calories from animal protein on low-carb diet

Based on trends in the data, an educated guess for optimal animal protein intake on a low-carb diet is around 12% of total calories, or 60 grams on a 2000-calorie diet.

#nutrition

#protein

Choose high-quality, fiber-rich carbs on a low-carb diet

With the limited carbohydrate allotment on a lower-carb diet, it's crucial to choose high-quality, fiber-rich sources whenever possible.

#carbohydrate

#fiber

Conduct dedicated research for true ketogenic diet applicability

The conclusions from these studies may not be applicable to individuals on a true ketogenic diet, as they are in a different physiological state that requires its own dedicated research.

#keto

#research

Emphasize plants in low-carb diets for optimal health

The most protective low-carbohydrate diets involve consuming a small to moderate amount of animal protein and fats while heavily emphasizing vegetables and other plant-based sources.

#nutrition

#plant-based

Choose healthy, plant-focused low-carb diets to reduce mortality risk

A low-carbohydrate diet can either increase or decrease mortality risk depending on its composition, with healthy, plant-focused versions reducing risk and unhealthy, animal-heavy versions increasing it.