title: Negative effect of a low-carbohydrate, high-protein, high-fat diet on small peripheral artery reactivity in patients with increased cardiovascular risk.
abstract: Low-carbohydrate diets have become increasingly popular for weight loss. Although they may improve some metabolic markers, particularly in type 2 diabetes mellitus (T2D) or the metabolic syndrome (MS), their net effect on arterial wall function remains unclear. The objective was to evaluate the relation between dietary macronutrient composition and the small artery reactive hyperaemia index (saRHI), a marker of small artery endothelial function, in a cohort of patients at increased cardiovascular (CV) risk. The present cross-sectional study included 247 patients. Diet was evaluated by a 3-d food-intake register and reduced to a novel low-carbohydrate diet score (LCDS). Physical examination, demographic, biochemical and anthropometry parameters were recorded, and the saRHI was measured in each patient. Individuals in the lowest LCDS quartile (Q1, 45 % carbohydrate; 20 % protein; 32 % fat) had higher saRHI values than those in the top quartile (Q4, 29 % carbohydrate, 24 % protein, 40 % fat; 1.66 (sd 0.41) v. 1.52 (sd 0.22), P= 0.037). These results were particularly strong in patients with the MS (Q1 = 1.82 (sd 0.32) v. Q4 = 1.61 (sd 027); P= 0.021) and T2D (Q1 = 1.78 (sd 0.31) v. Q4 = 1.62 (sd 0.35); P= 0.011). Multivariate analysis demonstrated that individuals in the highest LCDS quartile had a significantly negative coefficient of saRHI, which was independent of confounders (OR -0.85; 95 % CI 0.19, 0.92; P= 0.031). These findings suggest that a dietary pattern characterised by a low amount of carbohydrate, but high amounts of protein and fat, is associated with a poorer small artery vascular reactivity in patients with increased CV risk.
authors: Vascular Medicine and Metabolism Unit, Lipids and Atherosclerosis Research Unit, Sant Joan University Hospital, Institut d'Investigació Sanitària Pere Virgili (IISPV), Faculty of Medicine, Universitat Rovira i Virgili, Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Barcelona, Spain. jordi.merino@urv.cat
authors: Jordi
authors: J
authors: Merino
authors: Richard
authors: R
authors: Kones
authors: Raimon
authors: R
authors: Ferré
authors: Núria
authors: N
authors: Plana
authors: Josefa
authors: J
authors: Girona
authors: Gemma
authors: G
authors: Aragonés
authors: Daiana
authors: D
authors: Ibarretxe
authors: Mercedes
authors: M
authors: Heras
authors: Luis
authors: L
authors: Masana
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology; D050528:Diet, Carbohydrate-Restricted / Q000009:adverse effects*; D059305:Diet, High-Fat / Q000009:adverse effects*; D004038:Diet, Reducing / Q000009:adverse effects / Q000379:methods*; D004044:Dietary Proteins / Q000009:adverse effects; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000503:physiopathology; D055806:Microvessels / Q000503:physiopathology*; D008875:Middle Aged; D050177:Overweight / Q000150:complications / Q000178:diet therapy; D012307:Risk Factors; D012648:Self Care / Q000009:adverse effects; D013030:Spain
chemical_list: D004044:Dietary Proteins