A randomized study comparing the effects of a low-carbohydrate diet and a conventional diet on lipoprotein subfractions and C-reactive protein levels in patients with severe obesity.

Abstract

PURPOSE:

To compare the effects of a low-carbohydrate diet and a conventional (fat- and calorie-restricted) diet on lipoprotein subfractions and inflammation in severely obese subjects.

METHODS:

We compared changes in lipoprotein subfractions and C-reactive protein levels in 78 severely obese subjects, including 86% with either diabetes or metabolic syndrome, who were randomly assigned to either a low-carbohydrate or conventional diet for 6 months.

RESULTS:

Subjects on a low-carbohydrate diet experienced a greater decrease in large very low-density lipoprotein (VLDL) levels (difference = -0.26 mg/dL, P = 0.03) but more frequently developed detectable chylomicrons (44% vs. 22%, P = 0.04). Both diet groups experienced similar decreases in the number of low-density lipoprotein (LDL) particles (difference = -30 nmol/L, P = 0.74) and increases in large high-density lipoprotein (HDL) concentrations (difference = 0.70 mg/dL, P = 0.63). Overall, C-reactive protein levels decreased modestly in both diet groups. However, patients with a high-risk baseline level (>3 mg/dL, n = 48) experienced a greater decrease in C-reactive protein levels on a low-carbohydrate diet (adjusted difference = -2.0 mg/dL, P = 0.005), independent of weight loss.

CONCLUSION:

In this 6-month study involving severely obese subjects, we found an overall favorable effect of a low-carbohydrate diet on lipoprotein subfractions, and on inflammation in high-risk subjects. Both diets had similar effects on LDL and HDL subfractions.

• Authors: Prakash Seshadri, Nayyar Iqbal, Linda Stern, Monica Williams, Kathryn L Chicano, Denise A Daily, Joyce McGrory, Edward J Gracely, Daniel J Rader, Frederick F Samaha
• Journal: The American journal of medicine (Am J Med) Vol. 117 Issue 6 Pg. 398-405 (Sep 15 2004) ISSN: 0002-9343 [Print] United States
• PMID: 15380496 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright 2004 Elsevier Inc.

Chemical References

• Biomarkers
• Chylomicrons
• Dietary Carbohydrates
• Hypolipidemic Agents
• Lipoproteins
• Lipoproteins, HDL
• Lipoproteins, LDL
• Lipoproteins, VLDL
• C-Reactive Protein

Topics

• Adult
• Biomarkers (blood)
• Body Composition
• C-Reactive Protein (drug effects, metabolism)
• Caloric Restriction
• Chylomicrons (drug effects, metabolism)
• Diabetes Mellitus (diet therapy, epidemiology, metabolism)
• Diet, Fat-Restricted
• Dietary Carbohydrates (administration & dosage, metabolism)
• Female
• Humans
• Hypolipidemic Agents (therapeutic use)
• Lipoproteins (drug effects, metabolism)
• Lipoproteins, HDL (drug effects, metabolism)
• Lipoproteins, LDL (drug effects, metabolism)
• Lipoproteins, VLDL (drug effects, metabolism)
• Male
• Middle Aged
• Obesity (diet therapy, epidemiology, metabolism)
• Pennsylvania
• Risk Factors
• Severity of Illness Index
• Treatment Outcome
• Weight Loss