Low-carbohydrate diets containing plant-derived fat but not animal-derived fat ameliorate heart failure

Cardiovascular disease (CVD) is a global health burden in the world. Although low-carbohydrate diets (LCDs) have beneficial effects on CVD risk, their preventive effects remain elusive. We investigated whether LCDs ameliorate heart failure (HF) using a murine model of pressure overload. LCD with plant-derived fat (LCD-P) ameliorated HF progression, whereas LCD with animal-derived fat (LCD-A) aggravated inflammation and cardiac dysfunction. In the hearts of LCD-P-fed mice but not LCD-A, fatty acid oxidation-related genes were highly expressed, and peroxisome proliferator-activated receptor alpha (PPAR alpha), which regulates lipid metabolism and inflammation, was activated. Loss- and gain-of-function experiments indicated the critical roles of PPAR alpha in preventing HF progression. Stearic acid, which was more abundant in the serum and heart of LCD-P-fed mice, activated PPAR alpha in cultured cardiomyocytes. We highlight the importance of fat sources substituted for reduced carbohydrates in LCDs and suggest that the LCD-P-stearic acid-PPAR alpha pathway as a therapeutic target for HF.

Automated summary

Cardiovascular disease is a global health burden. Low-carbohydrate diets have beneficial effects on CVD risk, but their preventive effects on heart failure remain unclear. This study shows that a low-carbohydrate diet with plant-derived fat improves heart failure progression, while a low-carbohydrate diet with animal-derived fat aggravates inflammation and cardiac dysfunction. The activation of the PPAR alpha pathway is highlighted as a potential therapeutic target for heart failure.