Low carbohydrate-high protein diet and mortality in a cohort of Swedish women

J Intern Med. 2007 Apr;261(4):366-74. doi: 10.1111/j.1365-2796.2007.01774.x.


Objective: The long-term health consequences of diets used for weight control are not established. We have evaluated the association of the frequently recommended low carbohydrate diets - usually characterized by concomitant increase in protein intake - with long-term mortality.

Design: The Women's Lifestyle and Health cohort study initiated in Sweden during 1991-1992, with a 12-year almost complete follow up.

Setting: The Uppsala Health Care Region.

Subjects: 42,237 women, 30-49 years old at baseline, volunteers from a random sample, who completed an extensive questionnaire and were traced through linkages to national registries until 2003.

Main outcome measures: We evaluated the association of mortality with: decreasing carbohydrate intake (in deciles); increasing protein intake (in deciles) and an additive combination of these variables (low carbohydrate-high protein score from 2 to 20), in Cox models controlling for energy intake, saturated fat intake and several nondietary covariates.

Results: Decreasing carbohydrate or increasing protein intake by one decile were associated with increase in total mortality by 6% (95% CI: 0-12%) and 2% (95% CI: -1 to 5%), respectively. For cardiovascular mortality, amongst women 40-49 years old at enrolment, the corresponding increases were, respectively, 13% (95% CI: -4 to 32%) and 16% (95% CI: 5-29%), with the additive score being even more predictive.

Conclusions: A diet characterized by low carbohydrate and high protein intake was associated with increased total and particularly cardiovascular mortality amongst women. Vigilance with respect to long-term adherence to such weight control regimes is advisable.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / mortality*
  • Diet, Carbohydrate-Restricted / adverse effects
  • Diet, Carbohydrate-Restricted / mortality*
  • Dietary Proteins / administration & dosage
  • Dietary Proteins / adverse effects*
  • Epidemiologic Methods
  • Female
  • Humans
  • Middle Aged
  • Sweden / epidemiology


  • Dietary Proteins