title: Effects of Diet Composition and Insulin Resistance Status on Plasma Lipid Levels in a Weight Loss Intervention in Women.
abstract: BACKGROUND
  Optimal macronutrient distribution of weight loss diets has not been established. The distribution of energy from carbohydrate and fat has been observed to promote differential plasma lipid responses in previous weight loss studies, and insulin resistance status may interact with diet composition and affect weight loss and lipid responses.
  
  
  RESULTS
  Overweight and obese women (n=245) were enrolled in a 1-year behavioral weight loss intervention and randomly assigned to 1 of 3 study groups: a lower fat (20% energy), higher carbohydrate (65% energy) diet; a lower carbohydrate (45% energy), higher fat (35% energy) diet; or a walnut-rich, higher fat (35% energy), lower carbohydrate (45% energy) diet. Blood samples and data available from 213 women at baseline and at 6 months were the focus of this analysis. Triglycerides, total cholesterol, and high- and low-density lipoprotein cholesterol were quantified and compared between and within groups. Triglycerides decreased in all study arms at 6 months (P<0.05). The walnut-rich diet increased high-density lipoprotein cholesterol more than either the lower fat or lower carbohydrate diet (P<0.05). The walnut-rich diet also reduced low-density lipoprotein cholesterol in insulin-sensitive women, whereas the lower fat diet reduced both total cholesterol and high-density lipoprotein cholesterol in insulin-sensitive women (P<0.05). Insulin sensitivity and C-reactive protein levels also improved.
  
  
  CONCLUSIONS
  Weight loss was similar across the diet groups, although insulin-sensitive women lost more weight with a lower fat, higher carbohydrate diet versus a higher fat, lower carbohydrate diet. The walnut-rich, higher fat diet resulted in the most favorable changes in lipid levels.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT01424007.
authors.affiliation: Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla, CA (T.L., S.W.F., L.N., B.P., E.L.Q., D.D.H., C.L.R.).
authors.forename: Tran
authors.initials: T
authors.lastname: Le
authors.affiliation: Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla, CA (T.L., S.W.F., L.N., B.P., E.L.Q., D.D.H., C.L.R.).
authors.forename: Shirley W
authors.initials: SW
authors.lastname: Flatt
authors.affiliation: Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla, CA (T.L., S.W.F., L.N., B.P., E.L.Q., D.D.H., C.L.R.).
authors.forename: Loki
authors.initials: L
authors.lastname: Natarajan
authors.affiliation: Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla, CA (T.L., S.W.F., L.N., B.P., E.L.Q., D.D.H., C.L.R.).
authors.forename: Bilge
authors.initials: B
authors.lastname: Pakiz
authors.affiliation: Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla, CA (T.L., S.W.F., L.N., B.P., E.L.Q., D.D.H., C.L.R.).
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Quintana
authors.affiliation: Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla, CA (T.L., S.W.F., L.N., B.P., E.L.Q., D.D.H., C.L.R.).
authors.forename: Dennis D
authors.initials: DD
authors.lastname: Heath
authors.affiliation: Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA (B.K.R.).
authors.forename: Brinda K
authors.initials: BK
authors.lastname: Rana
authors.affiliation: Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla, CA (T.L., S.W.F., L.N., B.P., E.L.Q., D.D.H., C.L.R.).
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Rock
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D031204:Caloric Restriction; D050528:Diet, Carbohydrate-Restricted; D018752:Diet, Fat-Restricted; D004041:Dietary Fats / Q000008:administration & dosage*; D002149:Energy Intake; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D031324:Juglans; D008055:Lipids / Q000097:blood*; D008875:Middle Aged; D009754:Nuts; D009765:Obesity / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004041:Dietary Fats; D008055:Lipids
keywords: insulin resistance; lipids; walnuts
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