Effects of moderate variations in the macronutrient content of the diet on cardiovascular disease risk factors in obese patients with the metabolic syndrome.
BACKGROUND
The metabolic syndrome is a cluster of abnormalities that is accompanied by a 2-fold increase in the risk of cardiovascular disease. Even if there is full agreement that lifestyle changes to induce weight loss are the first-line approach, the ideal diet for the treatment of the metabolic syndrome remains uncertain.


OBJECTIVE
The objective was to compare the effects of 2 diets on cardiovascular disease risk factors in obese patients with the metabolic syndrome.


METHODS
The study was carried out in 100 patients randomly assigned to either a diet relatively rich in carbohydrate [65% of energy as carbohydrate, 13% as protein, and 22% as fat (17% as unsaturated fat)] or a diet that was low in carbohydrate and high in protein and in monounsaturated fat [48% of energy as carbohydrate, 19% as protein, and 33% as fat (24% as unsaturated fat)].


RESULTS
All 100 patients completed the 5-mo study. At the end of the study, all the components of the metabolic syndrome (except HDL, which did not change) decreased significantly in both groups. With the high-carbohydrate diet, a significant decrease in LDL-cholesterol concentrations was also observed. Although the extent of the resolution of the metabolic syndrome was not different between groups, the low-carbohydrate diet was associated with a greater decrease in the prevalence of hypertension (P < 0.05) and of hypertriacylglycerolemia (P < 0.001).


CONCLUSIONS
Tailoring diet interventions to the specific presentation of the metabolic syndrome may be the best way of reducing the risk factors for cardiovascular disease.
Muzio
Fulvio
F
Clinical Nutrition Unit, G Salvini Hospital, Garbagnate Milanese, Milan, Italy. fmuzio@aogarbagnate.lombardia.it
Mondazzi
Luca
L
Harris
William S
WS
Sommariva
Domenico
D
Branchi
Adriana
A
D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage* / Q000378:metabolism; D004041:Dietary Fats / Q000008:administration & dosage / Q000378:metabolism; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage / Q000378:metabolism; D004044:Dietary Proteins / Q000008:administration & dosage* / Q000378:metabolism; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000178:diet therapy*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000178:diet therapy*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood
D008078:Cholesterol, LDL; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004042:Dietary Fats, Unsaturated; D004044:Dietary Proteins; D014280:Triglycerides