title: Effect of a low-fat or low-carbohydrate weight-loss diet on markers of cardiovascular risk among premenopausal women: a randomized trial.
abstract: BACKGROUND
  Low-fat and low-carbohydrate weight-loss diets can have a beneficial effect on longitudinal measures of blood pressure and blood lipids. We aimed to assess longitudinal changes in blood pressure and blood lipids in a population of premenopausal women. We hypothesized that results may differ by level of adherence to the respective diet protocol and baseline presence of hypertension or hyperlipidemia.
  
  
  METHODS
  Overweight or obese premenopausal women were randomized to a low-fat (n=41) or low-carbohydrate (n=38) diet. As part of the 52-week Lifestyle Eating and Fitness (LEAF) intervention trial, we fit linear mixed models to determine whether a change in outcome differed by treatment arm.
  
  
  RESULTS
  Within-group trends in blood pressure and blood lipids did not differ (p>0.30). Across study arms, there was a significant decrease in systolic blood pressure (SBP, 3 mm Hg, p=0.01) over time, but diastolic blood pressure (DBP) did not change significantly over the course of the study. Blood lipids (total cholesterol [TC], low-density lipoproteins [LDL], and high-density lipoproteins [HDL]) all exhibited nonlinear trends over time (p<0.01); each decreased initially but returned to levels comparable to baseline by study conclusion (p>0.20). We observed a decline in SBP among women who were hypertensive at baseline (p<0.01), but hypercholesterolemia at baseline did not affect trends in blood lipids (p>0.40).
  
  
  CONCLUSIONS
  Our results support that dietary interventions may be efficacious for lowering blood pressure and blood lipids among overweight or obese premenopausal women. However, a decrease in SBP was the only favorable change that was sustained in this study population. These changes can be maintained over the course of a 1-year intervention, yet changes in blood lipids may be less sustainable.
authors.affiliation: 1 Comprehensive Cancer Center, The Ohio State University , Columbus, Ohio.
authors.forename: Randi E
authors.initials: RE
authors.lastname: Foraker
authors.forename: Michael
authors.initials: M
authors.lastname: Pennell
authors.forename: Peter
authors.initials: P
authors.lastname: Sprangers
authors.forename: Mara Z
authors.initials: MZ
authors.lastname: Vitolins
authors.forename: Cecilia
authors.initials: C
authors.lastname: DeGraffinreid
authors.forename: Electra D
authors.initials: ED
authors.lastname: Paskett
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D004038:Diet, Reducing; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004041:Dietary Fats / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy; D009820:Ohio; D050177:Overweight / Q000178:diet therapy / Q000378:metabolism; D017697:Premenopause; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D008055:Lipids