The People's Perspective on Medicine

Are High Carb Diets Better Than Low Carb Diets?

In a long-running cohort study, people getting about half their calories from carbohydrates had a better chance of long life than those eating either low carb or high carb diets.

Do you shun fats and focus on carbohydrates for most of your energy? Or do you subscribe to a low-carb lifestyle? Proponents of both high carb diets and low carb diets have been debating their pros and cons for decades. Now, a long-running study suggests that both are less than ideal as a way to achieve longevity (The Lancet Public Health, Aug. 16, 2018).

Basics of the Study:

The Atherosclerosis Risk in Communities (ARIC) study included 15,428 individuals who were middle-aged (45 to 64 years old) at the beginning of the study. All of them filled out questionnaires about their usual diets. During 25 years of follow-up, 6,283 of these people died. That permitted the researchers to evaluate which diets were associated with the greatest risk for mortality during that time. They also analyzed data from seven other multinational studies.

Shun Both Low Carb Diets and High Carb Diets for Longer Life:

The answer would have pleased Goldilocks:

“both low carbohydrate consumption (<40%) and high carbohydrate consumption (>70%) conferred greater mortality risk than did moderate intake.”

People following a low-carb diet were 20 percent more likely to die during the study than those who had more moderate diets, while those on high-carb diets were 23 percent more likely to die.

Vegetarians May Live Longer:

The sweet spot appeared to be around half of calories from carbohydrates. The researchers dug a bit deeper, however. As a result, they determined that when people got more calories from animal-based foods like meat and cheese rather than carbs like bread or cereal, they had higher mortality rates. Those who substituted plant-based fats and proteins from beans, nuts or seeds for carbohydrate calories were less likely to die during the study. Presumably, vegetarians getting roughly 50 percent of their calories from carbs like whole-grain bread or steel-cut oats and their fats and proteins from peanut butter or tofu would do well.

Learn More:

If you’d like some guidance on fixing delicious foods that would fit nicely into an eating pattern with moderate carbohydrate intake, you might want to consider our cookbook, Recipes & Remedies From The People’s Pharmacy. It contains recipes from some of the notable nutrition experts we have interviewed for our radio show.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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This raises a question in my mind. What does this mean for us diabetics who are on a “very low carb diet”?

My old aunt was right all along-only eat the good stuff honey, in moderation! Vegetables have always been a main-stay of our diet, with neither elimination nor excess in any category of food. Food fads certainly change over time & you could go crazy trying to keep up with the good & the bad. Common sense!

I think the study is flawed. They consider less then 40% low carb. We know that low carb means below 10% lower. This was not tested.

This was an informative read, as always, thank you. I have a question regarding the recent finding on Quaker oats containing glyphosate: Do you know of the content of other brands of oats? I have been eating old fashioned oats of a general brand for a couple of years, & am now wondering if they all contain this poison. Thank you.

I would like to know about the exposure to cancer causing chemicals in our food system also. Those used by agri-business appear to be serious.

Seems to always come back around to eating a balanced diet with a variety of foods.Just like our parents and grand parents did.Seems we always over think food too much.Who needs more stress in life.

I am with you and your thinking!

I always wonder if results of these kind of studies represent causation or correlation. That is, was the lower mortality a result of the diets (caused by), or should the conclusion be these diets are found to be correlated with the diets (not necessarily caused by). Also, I did not see study of lifestyle – exercise, non-smoking, etc as input to the conclusions. So, this study provides good information, but that information cannot represent a single cause of lower mortality, instead must be evaluated along with other inputs.

There are serious problems with this paper and a number of nutrition professionals who work with the diet are launching a campaign to have it corrected. Anyone wanting a sophisticated account of exactly why it is so badly flawed – especially where statistical manipulation is concerned – look at at this detailed critique by Dr Zoe Harcombe.

Here are brief summaries of just three of the flaws she picks up, although they are enough to suggest it should be taken with large amounts of saltl

1) It is an obervational study which means it can only tell you that one thing – carb intake – is associated with another – dying earlier. It creates a hypothesis – low carbs mean you are likely to die earlier – which needs to be tested.

2) The data about who was eating more or less carbs was estimated from the results of a Food Questionnaire adminstered on two occasions – between 1987 and 1989 and again between 1993 and 1995. You had to remember how many ‘portion sizes’ (several options) of 66 items you ate on average during the previous year. To get a sense of how impossible this is to do with any degree of accuracy, take a look at the questionnaire itself which can be found here:

Just imagine what is involved. Can you remember what you ate last year? How standard were your portions? Did you have 5-6 ‘pats’ of butter a week or did it tip over to 1 a day? What’s a pat anyway? Then imagine that your diet then stay the same for 20-25 years, becasue there wasn’t an option to factor any chage in.

One curious result from looking at the data in the tables that were published in the paper (the questionnaire wasn’t) was that, apparently, none of the participants consumed more than an average of 1,660 calories a day. Really?? These were Americans tracked over 25 years.

3) One of the big causes of confusion in nutrition and drug studies is the difference between relative and absolute risk. If the chance you will die of heart disease is known to be 2 in a 100 and a new drug reduces that to 1 in a hundred, the relative risk has dropped by 100% – fantastic. But the absolute risk has only changed by 1in a hundred. Not so fantastic.

Essentially the figure of four fewer lives – sounds really bad – was the change in relative risk. And not an actual result just a calculation. The actual figures were 1.16 vs 1.37.

In case you are still thinking – maybe I will avoid low carbs all the same – Dr Harcombe has plenty more areeas of critical concern – the next three of 10 are:
4) Incomplete adjustment of the data
5) The healthy person confounder.
6) Failure to adjust for a serious confounder (alcohol).


I lost 35 pounds in 45 days on a low carb-high fat ketogenic diet and managed to keep off 80% of that weight loss for over 3 years.

The increase in energy and my improved general health proved that for the changes in my metabolism (fast>slow over the years), that the change in diet were right for me.

This article is bogus. Not only do ppl forget what they eat, the ppl chosen already had heart disease or T2D or more! So surprised LANCET allowed this article!

I’ve always contended that a diet in moderation was the best. Eat less to lose weight. But keep your diet balanced. This Keto diet is all the rage now. In the long run, it will destroy your health. My husband lost his health after almost dying on the Adkins diet many years ago. He had always had good health until this diet broke it.

Age: mid 70s .. suffering 40 yrs of depression…took Zoloft (50mg) until AFIB & pacemaker in 2016.

Now not recommended bc of potential bleeding internally..
on Eliquis (5 mg 2x daily)

Am extremely depressed. Attend therapy sessions, exercise, socialize etc. any suggestions?

From what I’ve read & heard about this, it wasn’t the best study in the world. It was done by questionnaire…..!?!?? Not the most scientific way to prove anything.

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