title: The Effects of a Low-Carbohydrate Diet vs. a Low-Fat Diet on Novel Cardiovascular Risk Factors: A Randomized Controlled Trial.
abstract: Increasing evidence supports a low-carbohydrate diet for weight loss and improvement in traditional cardiovascular disease (CVD) markers. Effects on novel CVD markers remain unclear. We examined the effects of a low-carbohydrate diet (<40 g/day; n = 75) versus a low-fat diet (<30% kcal/day from total fat, <7% saturated fat; n = 73) on biomarkers representing inflammation, adipocyte dysfunction, and endothelial dysfunction in a 12 month clinical trial among 148 obese adults free of diabetes and CVD. Participants met with a study dietitian on a periodic basis and each diet group received the same behavioral curriculum which included dietary instruction and supportive counseling. Eighty percent of participants completed the intervention. At 12 months, participants on the low-carbohydrate diet had significantly greater increases in adiponectin (mean difference in change, 1336 ng/mL (95% CI, 342 to 2330 ng/mL); p = 0.009) and greater decreases in intercellular adhesion molecule-1 concentrations (-16.8 ng/mL (-32.0 to -1.6 ng/mL); p = 0.031) than those on the low-fat diet. Changes in other novel CVD markers were not significantly different between groups. In conclusion, despite the differences in weight changes on diets, a low-carbohydrate diet resulted in similar or greater improvement in inflammation, adipocyte dysfunction, and endothelial dysfunction than a standard low-fat diet among obese persons.
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University 1440 Canal Street, Suite 2000, New Orleans, LA 70112, USA. thu1@tulane.edu.
authors.forename: Tian
authors.initials: T
authors.lastname: Hu
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd Street, Suite 300, Minneapolis, MN 55454, USA. yaoxx097@umn.edu.
authors.forename: Lu
authors.initials: L
authors.lastname: Yao
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, 2nd Floor, Pasadena, CA 91101, USA. Kristi.Reynolds@kp.org.
authors.forename: Kristi
authors.initials: K
authors.lastname: Reynolds
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University 1440 Canal Street, Suite 2000, New Orleans, LA 70112, USA. pkwhelton@gmail.com.
authors.forename: Paul K
authors.initials: PK
authors.lastname: Whelton
authors.affiliation: Department of Biostatistics and Bioinformatics, School of Public Health and Tropical Medicine, Tulane University 1440 Canal Street, Suite 2001, New Orleans, LA 70112, USA. tniu@tulane.edu.
authors.forename: Tianhua
authors.initials: T
authors.lastname: Niu
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University 1440 Canal Street, Suite 2000, New Orleans, LA 70112, USA. sli10@tulane.edu.
authors.forename: Shengxu
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University 1440 Canal Street, Suite 2000, New Orleans, LA 70112, USA. jhe@tulane.edu.
authors.forename: Jiang
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University 1440 Canal Street, Suite 2000, New Orleans, LA 70112, USA. lbazzano@tulane.edu.
authors.forename: Lydia A
authors.initials: LA
authors.lastname: Bazzano
mesh_terms: D017667:Adipocytes / Q000378:metabolism; D052242:Adiponectin / Q000097:blood; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D003376:Counseling; D050528:Diet, Carbohydrate-Restricted; D018752:Diet, Fat-Restricted; D042783:Endothelial Cells / Q000378:metabolism; D002149:Energy Intake; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D055820:New Orleans; D009765:Obesity / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy*; D065840:Protective Factors; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; C573420:ICAM1 protein, human; D018836:Inflammation Mediators; D008055:Lipids; D018799:Intercellular Adhesion Molecule-1
keywords: adipocytokines; clinical trial; dietary carbohydrate; endothelial dysfunction; inflammation; nutrition; obesity