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Lack of suppression of circulating free fatty acids and hypercholesterolemia during weight loss on a high-fat, low-carbohydrate diet.

The American journal of clinical nutrition
March 1, 2010
Teri L Hernandez et al. (10 authors)
Journal ArticleRandomized Controlled TrialResearch Support, N.I.H., ExtramuralHuman StudyClinical
Study Details

Study Goal

The researchers aimed to compare the metabolic effects of a low-carbohydrate (high-fat) diet versus a high-carbohydrate (low-fat) diet during active weight loss in obese adults.

Results Summary

Weight loss was similar between diets, but the high-fat diet increased LDL cholesterol and free fatty acids without suppressing fasting insulin, while the high-carbohydrate diet reduced LDL cholesterol. No significant differences were found in triglycerides or remnant lipoprotein cholesterol between diets.

Population

Healthy, obese adults (n = 32; 22 women, 10 men; BMI 35.8 ± 2.9 for high-fat group, 36.7 ± 4.6 for high-carb group).

Effective Dosage

High-fat diet: ≤20 g carbohydrates/day; high-carb diet: 55% of total energy intake from carbohydrates.

Duration

6 weeks

Interactions

None mentioned

Extracted Claims (9)
InterventionDirectionEndpointPopulationDosageImpactClaim #
low-carbohydrate diet (< or =20 g/d)
no change
fasting triglycerides
Healthy, obese adults
no significant change
no diet treatment effect
#1
low-carbohydrate diet (< or =20 g/d)
no change
remnant lipoprotein cholesterol
Healthy, obese adults
no significant change
no diet treatment effect
#2
low-carbohydrate diet (< or =20 g/d)
decrease
fasting insulin
Healthy, obese adults
-
decreased
#3
low-carbohydrate diet (< or =20 g/d)
increase
fasting free fatty acids (FFAs)
Healthy, obese adults
-
increased
#4
low-carbohydrate diet (< or =20 g/d)
increase
24-h free fatty acids (FFAs)
Healthy, obese adults
-
increased
#5
low-carbohydrate diet (< or =20 g/d)
decrease
24-h insulin
Healthy, obese adults
-
decreased
#6
calorie-restricted, low-fat diet
decrease
24-h insulin
Healthy, obese adults
-
decreased
#7
calorie-restricted, low-fat diet
decrease
fasting LDL cholesterol
Healthy, obese adults
-
decreased
#8
low-carbohydrate diet (< or =20 g/d)
increase
LDL-cholesterol concentrations
Healthy, obese adults
-
increased
#9
Abstract

BACKGROUND: Little is known about the comparative effect of weight-loss diets on metabolic profiles during dieting. OBJECTIVE: The purpose of this study was to compare the effect of a low-carbohydrate diet (< or =20 g/d) with a high-carbohydrate diet (55% of total energy intake) on fasting and hourly metabolic variables during active weight loss. DESIGN: Healthy, obese adults (n = 32; 22 women, 10 men) were randomly assigned to receive either a carbohydrate-restricted diet [High Fat; mean +/- SD body mass index (BMI; in kg/m(2)): 35.8 +/- 2.9] or a calorie-restricted, low-fat diet (High Carb; BMI: 36.7 +/- 4.6) for 6 wk. A 24-h in-patient feeding study was performed at baseline and after 6 wk. Glucose, insulin, free fatty acids (FFAs), and triglycerides were measured hourly during meals, at regimented times. Remnant lipoprotein cholesterol was measured every 4 h. RESULTS: Patients lost a similar amount of weight in both groups (P = 0.57). There was an absence of any diet treatment effect between groups on fasting triglycerides or on remnant lipoprotein cholesterol, which was the main outcome. Fasting insulin decreased (P = 0.03), and both fasting (P = 0.040) and 24-h FFAs (P < 0.0001) increased within the High Fat group. Twenty-four-hour insulin decreased (P < 0.05 for both groups). Fasting LDL cholesterol decreased in the High Carb group only (P = 0.003). In both groups, the differences in fasting and 24-h FFAs at 6 wk were significantly correlated with the change in LDL cholesterol (fasting FFA: r = 0.41, P = 0.02; 24-h FFA: r = 0.52, P = 0.002). CONCLUSIONS: Weight loss was similar between diets, but only the high-fat diet increased LDL-cholesterol concentrations. This effect was related to the lack of suppression of both fasting and 24-h FFAs.

Medical Subject Headings (MeSH)
AdultCholesterol, LDLDiet, Carbohydrate-RestrictedDiet, Fat-RestrictedDiet, ReducingDietary CarbohydratesDietary FatsEnergy IntakeFatty Acids, NonesterifiedFemaleHumansHypercholesterolemiaInsulinLipoproteinsMaleMiddle AgedObesityTriglyceridesWeight Loss
Study Links
Quality Scores
Safety70
Efficacy65/10
Quality80/10
Citation Metrics
Total Citations40
Citations/Year2.7
Relative Citation Ratio1.06
NIH Percentile52.5%
Research Impact Scores
APT Score0.75
Weight Score1.31
Normalized Score0.70
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