Low carbohydrate diets improve atherogenic dyslipidemia even in the absence of weight loss

Department of Biochemistry, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.
Nutrition & Metabolism (Impact Factor: 3.26). 02/2006; 3(1):24. DOI: 10.1186/1743-7075-3-24
Source: PubMed


Because of its effect on insulin, carbohydrate restriction is one of the obvious dietary choices for weight reduction and diabetes. Such interventions generally lead to higher levels of dietary fat than official recommendations and have long been criticized because of potential effects on cardiovascular risk although many literature reports have shown that they are actually protective even in the absence of weight loss. A recent report of Krauss et al. (AJCN, 2006) separates the effects of weight loss and carbohydrate restriction. They clearly confirm that carbohydrate restriction leads to an improvement in atherogenic lipid states in the absence of weight loss or in the presence of higher saturated fat. In distinction, low fat diets seem to require weight loss for effective improvement in atherogenic dyslipidemia.

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Available from: Richard D Feinman
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    • "This is an important aspect in the discussion, because long-term weight loss, as desirable as it may be, will remain an illusion for many individuals with weight problems. Therefore the more important is the fact that favourable changes in blood lipids are achievable without weight loss, if insulin resistant individuals follow an LCHF diet [32]. Thus, isocaloric exchanges of mono/polyunsaturated fatty acids (more) for carbohydrates (less) and/or protein (more) for carbohydrates (less) both improve TC : HDL ratio and LDL : HDL ratio and lower TG levels [20] [31]. "
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    ABSTRACT: THE CHARACTERISTICS OF PATIENTS WITH CVD HAVE CHANGED: whereas smoking prevalence declines, obesity and metabolic syndrome are on the rise. Unfortunately, the traditional low-fat diet for the prevention of cardiovascular disease (CVD) still seems to be the "mainstream knowledge" despite contradicting evidence. But lowering LDL-cholesterol by the wrong diet even may be counterproductive, if sd-LDL is raised and HDL is lowered. New insights into the pathophysiology of insulin resistance and its influence on the effects of dietary changes have led to a better approach: (1) the higher a patient's insulin resistance, the more important is the glycemic load of the diet. (2) Fat quality is much more important than fat quantity. (3) The best principle for a reduced calorie intake is not fat counting, but a high volume diet with low energy density, which means fibre rich vegetables and fruits. (4) And finally, satiation and palatability of a diet is very important: there is no success without the patient's compliance. Thus, the best approach to the dietary prevention of CVD is a Mediterranean style low-carb diet represented in the LOGI pyramid. Dietary guidelines for the prevention of CVD should to be revised accordingly.
    Full-text · Article · Feb 2012 · Cholesterol
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    • "Krieger et al. [4], for example, concluded that, independent of energy intake, low-carbohydrate/high-protein diets elicit a metabolic advantage; significantly reducing body mass (BM), fat mass, percent body fat and retaining significantly more fat-free mass than diets consisting of greater than 42% of energy from CHO and ≤ 1.05 g/kg/d PRO, respectively. Similarly, Krauss et al. [7], which was further explored by Feinman and Volek [8], showed that in the absence of energy restriction, a reduction in CHO and concomitant increase in PRO and dietary fat (FAT) resulted in significant improvements in BM, total cholesterol, triglycerides, and total cholesterol-to-high-density lipoprotein ratio compared to a diet consisting of 54% CHO, 16% PRO and 30% FAT. Increased satiety and thermogenesis are also commonly reported in response to a high-protein versus normative-protein (~15% of total energy from PRO) diet [9]. "
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    ABSTRACT: Exercise and high-protein/reduced-carbohydrate and -fat diets have each been shown separately, or in combination with an energy-restricted diet to improve body composition and health in sedentary, overweight (BMI > 25) adults. The current study, instead, examined the physiological response to 10 weeks of combined aerobic and resistance exercise (EX) versus exercise + minimal nutrition intervention designed to alter the macronutrient profile, in the absence of energy restriction, using a commercially available high-protein/low-carbohydrate and low-fat, nutrient-dense food supplement (EXFS); versus control (CON). Thirty-eight previously sedentary, overweight subjects (female = 19; male = 19) were randomly assigned to either CON (n = 10), EX (n = 14) or EXFS (n = 14). EX and EXFS participated in supervised resistance and endurance training (2x and 3x/wk, respectively); EXFS consumed 1 shake/d (weeks 1 and 2) and 2 shakes/d (weeks 3-10). EXFS significantly decreased total energy, carbohydrate and fat intake (-14.4%, -27.2% and -26.7%, respectively; p < 0.017), and increased protein and fiber intake (+52.1% and +21.2%, respectively; p < 0.017). EX and EXFS significantly decreased fat mass (-4.6% and -9.3%, respectively; p < 0.017), with a greater (p < 0.05) decrease in EXFS than EX and CON. Muscle mass increase only reached significance in EXFS (+2.3%; p < 0.017), which was greater (p < 0.05) than CON but not EX (+1.1%). Relative VO2max improved in both exercise groups (EX = +5.0% and EXFS = +7.9%; p < 0.017); however, only EXFS significantly improved absolute VO2max (+6.2%; p = 0.001). Time-to-exhaustion during treadmill testing increased in EX (+9.8%) but was significantly less (p < 0.05) than in EXFS (+21.2%). Total cholesterol and LDL decreased only in the EXFS (-12.0% and -13.3%, respectively; p < 0.017). Total cholesterol-to-HDL ratio, however, decreased significantly (p < 0.017) in both exercise groups. Absent energy restriction or other dietary controls, provision of a high-protein/low-carbohydrate and -fat, nutrient-dense food supplement significantly, 1) modified ad libitum macronutrient and energy intake (behavior effect), 2) improved physiological adaptations to exercise (metabolic advantage), and 3) reduced the variability of individual responses for fat mass, muscle mass and time-to-exhaustion - all three variables improving in 100% of EXFS subjects.
    Full-text · Article · Apr 2008 · Nutrition & Metabolism
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    • "2) Experiments in which change in macronutrients and weight loss are separated in time show that eucaloric carbohydrate reduction leads to greater improvement in atherogenic lipid markers (TG, HDL, apoB/apoA1 and mean LDL particle size) even in the presence of higher saturated fat[57,58]. A low fat diet, however, required weight loss to achieve effective improvement in the lipid profile (Figure 3). "
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    ABSTRACT: Current nutritional approaches to metabolic syndrome and type 2 diabetes generally rely on reductions in dietary fat. The success of such approaches has been limited and therapy more generally relies on pharmacology. The argument is made that a re-evaluation of the role of carbohydrate restriction, the historical and intuitive approach to the problem, may provide an alternative and possibly superior dietary strategy. The rationale is that carbohydrate restriction improves glycemic control and reduces insulin fluctuations which are primary targets. Experiments are summarized showing that carbohydrate-restricted diets are at least as effective for weight loss as low-fat diets and that substitution of fat for carbohydrate is generally beneficial for risk of cardiovascular disease. These beneficial effects of carbohydrate restriction do not require weight loss. Finally, the point is reiterated that carbohydrate restriction improves all of the features of metabolic syndrome.
    Full-text · Article · Feb 2008 · Nutrition & Metabolism
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