Cardiovascular disease

Cardiovascular disease risk is strongly linked to insulin resistance and metabolic dysfunction.

Evidence from randomised trials and meta-analyses suggests that therapeutic carbohydrate reduction improves multiple cardiovascular risk factors, including:

• insulin resistance
• triglycerides
• blood pressure
• inflammatory markers
• HDL cholesterol.

While LDL cholesterol may increase in some individuals, particularly lean-mass hyperresponders, current evidence does not demonstrate increased atherosclerotic plaque burden when cardiovascular risk is assessed using metabolically informed frameworks.

AMHS draft position statement on metabolic health and heart disease

The Scientific Committee of the Australasian Metabolic Health Society is currently developing a position statement on the management of cardiovascular risk in people using therapeutic carbohydrate reduction.

The final position statement, developed by a multidisciplinary Scientific Committee, will be submitted for publication in a respected peer-reviewed journal in 2026.

There are widespread concerns — and in some cases misinformation — regarding cardiovascular risk and therapeutic carbohydrate reduction. Our aim with this position statement is to provide a clear, evidence-based framework for assessing and managing cardiovascular risk that is grounded in contemporary science rather than speculation.

Contact The AMHS for further information or to take part in the consultation process: ausmetabolichealthsoc@gmail.com

Key messages from the draft position statement

• Insulin resistance is a primary causal driver of atherosclerotic cardiovascular disease, underpinning conditions such as metabolic syndrome, hypertension, obesity, and type 2 diabetes.
• The strongest risk factors and biomarkers for CVD are more closely linked to insulin resistance than to LDL cholesterol alone.
• Symptoms of cardiovascular disease should always be investigated, regardless of calculated risk scores or a coronary artery calcium score of zero.
• Therapeutic carbohydrate reduction improves multiple cardiometabolic risk markers, including insulin resistance, triglycerides, blood pressure, inflammation, and glycaemic control.
• While LDL cholesterol may increase in some individuals — particularly lean-mass hyperresponders — current evidence does not demonstrate increased plaque burden or progression in this group.
• While LDL cholesterol may increase in some individuals — particularly lean-mass hyperresponders — current evidence does not demonstrate increased plaque burden or progression in this group.
• Cardiovascular risk assessment should be individualised, using validated tools and, where appropriate, coronary artery calcium scoring.
• Reversal of insulin resistance should form the foundation of cardiovascular risk management for all patients, not only those using therapeutic carbohydrate reduction.

Together, these points support the position that therapeutic carbohydrate reduction reduces overall cardiovascular risk when assessed using an appropriate, metabolically informed framework.

Managing cardiovascular risk with Therapeutic Carbohydrate Reduction

This presentation is from Low Carb Down Under 2025.

Dr Laureen Lawlor-Smith has been a doctor since 1982. She has owned and managed her own General Practices in Adelaide’s southern suburbs for much of her career. She is passionate about helping people change their lives and improve their health through lifestyle medicine.

Despite following and dispensing conventional medical advice around diet and exercise for 35 years as a general practitioner, Laureen found herself obese, with pre-diabetes, sleep apnoea, and filled with shame. After discovering the transformational benefits of a low-carb lifestyle, she was able to reverse her health issues, lose weight and improve her overall health.

Discovering the low-carb lifestyle has completely changed her life. Her experience led Laureen to leave general practice and co-found the Low Carb Keto Health Clinic, where she helps patients lose weight and improve their health. She has reconnected with the reason she became a doctor in the first place, and now absolutely loves her job again.

Key evidence