Effect of 6-month Adherence to a Very Low Carbohydrate Diet Program

In these subjects, the mean body weight decreased 10.3% +/- 5.9% from baseline to 6 months. The mean percentage of body weight that was fat decreased 2.9% +/- 3.2% from baseline to 6 months. Serum total cholesterol level decreased 11 +/- 26 mg/dL, low-density lipoprotein cholesterol level decreased 10 +/- 25 mg/dL, triglyceride level decreased 56 +/- 45 mg/dL, high-density lipoprotein (HDL) cholesterol level increased 10 +/- 8 mg/dL, and the cholesterol/HDL cholesterol ratio decreased 0.9 +/- 0.6 units. A very low carbohydrate diet program led to sustained weight loss during a 6-month period.

Carbohydrate Restriction has a More Favorable Impact on the Metabolic Syndrome than a Low Fat Diet

Both interventions led to improvements in several metabolic markers, but subjects following the CRD had consistently reduced glucose (-12%) and insulin (-50%) concentrations, insulin sensitivity (-55%), weight loss (-10%), decreased adiposity (-14%), and more favorable triacylglycerol (TAG) (-51%), HDL-C (13%) and total cholesterol/HDL-C ratio (-14%) responses. In addition to these markers for MetS, the CRD subjects showed more favorable responses to alternative indicators of cardiovascular risk: postprandial lipemia (-47%), the Apo B/Apo A-1 ratio (-16%), and LDL particle distribution. The results support the use of dietary carbohydrate restriction as an effective approach to improve features of MetS and cardiovascular risk.

Saturated Fat, Carbohydrate, and Cardiovascular Disease

The substitution of dietary polyunsaturated fat for saturated fat has been shown to lower CVD risk, there are few epidemiologic or clinical trial data to support a benefit of replacing saturated fat with carbohydrate. Furthermore, particularly given the differential effects of dietary saturated fats and carbohydrates on concentrations of larger and smaller LDL particles, respectively, dietary efforts to improve the increasing burden of CVD risk associated with atherogenic dyslipidemia should primarily emphasize the limitation of refined carbohydrate intakes and a reduction in excess adiposity.