This is a somewhat complex topic because a multitude of factors influence atherosclerotic processes, yet it is not known that any substance transparently removes atherosclerotic deposits in the arteries. Orthodox medicine still operates under the belief that diet does not impact the removal of already formed atherosclerotic plaques and simultaneously asserts that the state of atherosclerosis is irreversible. This conviction is based on the postulate that there is insufficient evidence to truly support this, which, in areas governed by the rules of modern science, is essentially acceptable. Until sufficient serious research is conducted that ultimately provides clear evidence, medicine will not change its approach.
From partial research, we know that the course of atherosclerosis is positively influenced not only by lecithin (or phospholipid complexes that are part of it) but also by soluble forms of fiber, antioxidants, omega-3 fatty acids (specifically the ratio of O3:O6), the proportion of protein in the diet including its structure, (negative) energy balance, fasting... The prevailing opinion is that the most important factor in achieving the desired effect is a long-term engagement with all the factors, meaning a holistic approach to nutrition.
Carbohydrates are a quick source of energy. If you consume more than you currently burn, they are stored in fat reserves through the action of insulin, regardless of whether you may be in a negative energy balance. For the same reason, it is beneficial to limit (but not completely eliminate) their quantity (including monitoring their quality - simple vs. complex) in the evening - if you do not plan to engage in significant physical activity after dinner, the body will tend to store the excess in energy reserves. A living organism is a set of complex systems where simple mathematics does not apply - that is, setting a negative balance is not a hundred percent guarantee that the body will shed fat reserves.
A higher fat content in the evening meal is problematic due to the increase in energy intake. If you do not monitor the distribution of macronutrients in your diet, you risk storing excess energy in your body's reserves. Therefore, it is more advantageous (though not essential) if the last meal does not contain an excessively high amount of fat (it should contain fat, meaning the optimal approach is to avoid high-fat foods that can disrupt energy balance). If you control your energy balance, a dinner with a slightly higher fat content may not be an issue, but in such a case (for health reasons), pay attention to the quality of the fat included.
A higher proportion of fats in the diet in itself may not be risky; this is only general information. It always depends on a number of factors, the most important being the individual's health status, the total amount of fats used, their quality, and the ratios between groups of fatty acids (saturated vs. unsaturated, monounsaturated vs. polyunsaturated, etc.). Essentially, it is valid to say that even a properly structured low-carb system is healthy considering the higher proportion of fats.
The glycemic load (GL) is an "artificial" parameter that should always be perceived with some reservation and simultaneously in relation to other nutritional characteristics. For example, if side dishes (as the main source of carbohydrates) are based on whole grain products (ideally in the form of whole unpeeled grains), and the fiber and fat content in the given meal (or daily diet) align with common standards, the metabolism will react to higher GL values with relatively slow sugar release into the bloodstream, so essentially such a situation will be completely fine (in terms of balanced energy balance). Always remember that in our studies, we aim to translate generally defined nutrition rules into practice, so theoretically presented numbers may not be translatable into reality down to the last detail.
For individuals with pre-diabetes, reducing the excess carbohydrates in the diet is always beneficial. In the context of monitoring the energy balance, you should compensate by increasing the proportion of fats, just make sure to be strict in adhering to all the related rules regarding fats.
Questions answered by
Mgr. Martin Jelinek
Lecturer and author of the educational system
Nutrition educator, lecturer, and author of the educational system and the ZOF learning application.
Mgr. Martin Jelínek has been systematically involved in nutrition education since 1999. He is the founder of ATAC, the educational company behind NutriCourses, and the author of an educational system focused on nutrition, healthy lifestyle, and the practical application of nutrition knowledge.
He graduated from the Faculty of Science at Masaryk University in Brno. Throughout his professional career, he has combined nutrition, education, and the practical application of acquired knowledge. His educational system also includes the ZOF (Zone of Optimal Functioning) learning application, where students turn theory into practical work with meal plans.
In 2007, he launched the first intake of a six-month course focused on the education of nutrition advisors. Over time, this course became the foundation for the further development of the educational system and a range of specialised courses.