Purpose
To compare the effects of a low-carbohydrate diet and a conventional (fat- and calorie-restricted)
diet on lipoprotein subfractions and inflammation in severely obese subjects.
Methods
We compared changes in lipoprotein subfractions and C-reactive protein levels in 78
severely obese subjects, including 86% with either diabetes or metabolic syndrome,
who were randomly assigned to either a low-carbohydrate or conventional diet for 6
months.
Results
Subjects on a low-carbohydrate diet experienced a greater decrease in large very low-density
lipoprotein (VLDL) levels (difference = −0.26 mg/dL, P = 0.03) but more frequently developed detectable chylomicrons (44% vs. 22%, P = 0.04). Both diet groups experienced similar decreases in the number of low-density
lipoprotein (LDL) particles (difference = −30 nmol/L, P = 0.74) and increases in large high-density lipoprotein (HDL) concentrations (difference
= 0.70 mg/dL, P = 0.63). Overall, C-reactive protein levels decreased modestly in both diet groups.
However, patients with a high-risk baseline level (>3 mg/dL, n = 48) experienced a
greater decrease in C-reactive protein levels on a low-carbohydrate diet (adjusted
difference = −2.0 mg/dL, P = 0.005), independent of weight loss.
Conclusion
In this 6-month study involving severely obese subjects, we found an overall favorable
effect of a low-carbohydrate diet on lipoprotein subfractions, and on inflammation
in high-risk subjects. Both diets had similar effects on LDL and HDL subfractions.
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Article Info
Publication History
Accepted:
April 27,
2004
Received in revised form:
April 27,
2004
Received:
November 26,
2003
Footnotes
Supported by funding from the Veterans Affairs Healthcare Network Competitive Pilot Project Grant.
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
