Carbohydrate Restriction has a More Favorable Impact on the Metabolic Syndrome than a Low Fat Diet |
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Authors: | Jeff S Volek Stephen D Phinney Cassandra E Forsythe Erin E Quann Richard J Wood Michael J Puglisi William J Kraemer Doug M Bibus Maria Luz Fernandez Richard D Feinman |
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Affiliation: | (1) Department of Kinesiology, University of Connecticut, 2095 Hillside Road, Unit 1110, Storrs, CT 06269-1110, USA;(2) Department of Nutritional Science, University of Connecticut, Storrs, CT, USA;(3) School of Medicine, University of California, Davis, Davis, CA, USA;(4) Lipid Technologies, LLC, Austin, MN, USA;(5) University of Minnesota, Minneapolis, MN, USA;(6) Department of Biochemistry, SUNY Downstate Medical Center, Brooklyn, NY, USA |
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Abstract: | We recently proposed that the biological markers improved by carbohydrate restriction were precisely those that define the
metabolic syndrome (MetS), and that the common thread was regulation of insulin as a control element. We specifically tested
the idea with a 12-week study comparing two hypocaloric diets (~1,500 kcal): a carbohydrate-restricted diet (CRD) (%carbohydrate:fat:protein = 12:59:28)
and a low-fat diet (LFD) (56:24:20) in 40 subjects with atherogenic dyslipidemia. Both interventions led to improvements in
several metabolic markers, but subjects following the CRD had consistently reduced glucose (−12%) and insulin (−50%) concentrations,
insulin sensitivity (−55%), weight loss (−10%), decreased adiposity (−14%), and more favorable triacylglycerol (TAG) (−51%),
HDL-C (13%) and total cholesterol/HDL-C ratio (−14%) responses. In addition to these markers for MetS, the CRD subjects showed
more favorable responses to alternative indicators of cardiovascular risk: postprandial lipemia (−47%), the Apo B/Apo A-1
ratio (−16%), and LDL particle distribution. Despite a threefold higher intake of dietary saturated fat during the CRD, saturated
fatty acids in TAG and cholesteryl ester were significantly decreased, as was palmitoleic acid (16:1n-7), an endogenous marker
of lipogenesis, compared to subjects consuming the LFD. Serum retinol binding protein 4 has been linked to insulin-resistant
states, and only the CRD decreased this marker (−20%). The findings provide support for unifying the disparate markers of
MetS and for the proposed intimate connection with dietary carbohydrate. The results support the use of dietary carbohydrate
restriction as an effective approach to improve features of MetS and cardiovascular risk.
Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users. |
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Keywords: | Metabolic syndrome HDL LDL Lipoprotein metabolism Plasma lipids Triglyceride metabolism Dietary fat Human |
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