Effect of Dietary Composition of Weight Loss Diets on High Sensitivity C-Reactive Protein: The Randomized POUNDS LOST Trial

Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Brookline, Massachusetts, USA
Obesity (Impact Factor: 3.73). 04/2013; 21(4):681-689. DOI: 10.1002/oby.20072
Source: PubMed


Overweight and obesity are associated with increased high-sensitivity C-reactive protein (hsCRP) levels. The purpose of this study was to determine if weight loss diets differing in fat, protein, or carbohydrate composition differentially reduce hsCRP.

Design and methods:
POUNDS (preventing overweight using novel dietary strategies) LOST was a 2-year trial of overweight and obese adults randomly allocated to one of four weight loss diets with targeted percentages of energy derived from fat, protein, and carbohydrates (20, 15, 65%; 20, 25, 55%; 40, 15, 45%; 40, 25, 35%, respectively). hsCRP was measured at baseline, 6, and 24 months among 710 participants, and adiposity as measured by dual X-ray absorptiometry (N = 340) or abdominal computed tomography (N = 126) was correlated with hsCRP change.

At 6 months, hsCRP was reduced in all trial participants by -24.7% (Interquartile range (IQR) +7%, -50%), weight by -6.7% (IQR -3%, -11%), and waist circumference by -6.0% (IQR -3%, -10%) (all P < 0.002), with no significant differences according to dietary composition. The percent change in hsCRP at 6 and 24 months correlated modestly with change in weight, waist circumference, fasting insulin, fasting glucose, HOMA, and most lipid levels. Reductions in hsCRP persisted despite ∼ 50% regain of weight by 24 months. The percent change in hsCRP at 24 months significantly correlated with changes in total body fat (r = 0.42), total abdominal adiposity (r = 0.52), subcutaneous abdominal adiposity (r = 0.52), visceral adiposity (r = 0.47), and hepatic tissue density (r = -0.34) (all P < 0.0006).

Weight loss decreased hsCRP by similar magnitude, irrespective of dietary composition. Clinicians concerned about inflammation and cardiovascular risk should recommend weight loss diets most likely to succeed for their patients.

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Available from: Meryl S Leboff, Mar 06, 2014
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