The Study
Biomarker-based risk assessment of dietary intervention in patients with coronary artery disease during cardiac rehabilitation—a quasi-experimental study
This study watched what happened when people with heart disease chose different diets during rehab, but didn't randomly assign them. So we can see that people on low-carb or low-fat diets lost more weight, but we don't know if the diet caused it — maybe they were more motivated to get healthy in the first place.
Analysis score
Maximum 72 for a cohort study.
Where the score came from
After a heart attack, patients in rehab tried three diets: low-carb, low-fat, or regular. All diets helped them lose weight and belly fat, but only the low-fat diet kept the weight off longer. The low-carb diet helped blood sugar drop at first, but it went back up later.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 565 / 100
Quality score
Groups of people are followed over time to see who develops an outcome. Strong for identifying risk factors and associations, but cannot prove causation as firmly as RCTs.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Losing belly fat is good, but it didn't lower predicted heart death risk or prevent heart events in the short term.
- 2Long-term weight control was better with low-fat.
- 3Low-carb and low-fat diets reduced BMI by 1.6–2.3%, body fat by 2.6–2.8%, and visceral fat by 4.8–6.1% in 3–4 weeks.
- 4HbA1c dropped 4% with low-carb during rehab but rose again at 6 months.
- 5MACCE events were similar across groups (8–14%).
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
Frontiers in Nutrition
Year
2025
Authors
M. Kotewitsch, H. Scharnagl, Dennis Köstler, M. Teschler, R. Garbsch, Hendrik Schäfer, M. Waranski, K. Vereckei, Gereon Böll, M. Kleber, Alexander Dressel, Winfried März, B. Schmitz, F. Mooren
Related Content
Claims (5)
Among patients with coronary artery disease in cardiac rehabilitation, those following a low-carbohydrate or low-fat diet lose more body weight, body fat, and visceral fat over 3–4 weeks than those following a standard diet.
Among patients with coronary artery disease in cardiac rehabilitation, the rate of serious heart and brain events over about 15 months is the same whether they eat a low-carbohydrate, low-fat, or standard diet.
Among patients with coronary artery disease in cardiac rehabilitation, those following a low-fat diet maintain more consistent changes in body composition over six months than those following a low-carbohydrate diet.
Patients with coronary artery disease who follow a low-carbohydrate diet during inpatient cardiac rehabilitation experience a temporary improvement in blood sugar control, but their blood sugar levels rise back to higher levels than those of patients on low-fat or standard diets by six months after discharge.
Among patients with coronary artery disease in cardiac rehab, switching to a low-carbohydrate or low-fat diet for 3–4 weeks does not lower the risk of dying from cardiovascular disease over the next 10 years more than a standard diet, even though body composition improves.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.