Abstract
ObjectivesThis study compared LDL, HDL, and VLDL subclasses in overweight or obese adults consuming either a reduced carbohydrate (RC) or reduced fat (RF) weight maintenance diet for 9 months following significant weight loss.MethodsThirty-five (21 RC; 14 RF) overweight or obese middle-aged adults completed a 1-year weight management clinic. Participants met weekly for the first six months and bi-weekly thereafter. Meetings included instruction for diet, physical activity, and behavior change related to weight management. Additionally, participants followed a liquid very low-energy diet of ~2092 kJ per day for the first three months of the study. Subsequently, participants followed a dietary plan for nine months that targeted a reduced percentage of carbohydrate (~20%) or fat (~30%) intake and an energy intake level calculated to maintain weight loss. Lipid subclasses using NMR spectroscopy were analyzed prior to weight loss and at multiple intervals during weight maintenance.ResultsBody weight change was not significantly different within or between groups during weight maintenance (p > 0.05). The RC group showed significant increases in mean LDL size, large LDL, total HDL, large and small HDL, mean VLDL size, and large VLDL during weight maintenance while the RF group showed increases in total HDL, large and small HDL, total VLDL, and large, medium, and small VLDL (p < 0.05). Group*time interactions were significant for large and medium VLDL (p > 0.05).ConclusionSome individual lipid subclasses improved in both dietary groups. Large and medium VLDL subclasses increased to a greater extent across weight maintenance in the RF group.
Highlights
Low fat diets have been shown to reduce some risk factors associated with coronary heart disease (CHD) and have traditionally been considered the standard of care for dietary treatment in overweight and obese adults [1]
There has been increased interest in how lipoprotein subclasses for LDL, HDL, and VLDL respond to manipulation of dietary carbohydrate and fat, as it relates to CHD risk
There were no significant differences at baseline between the reduced carbohydrate (RC) group and reduced fat (RF) group for body weight, BMI, or age (Table 1)
Summary
Low fat diets have been shown to reduce some risk factors associated with coronary heart disease (CHD) and have traditionally been considered the standard of care for dietary treatment in overweight and obese adults [1]. Compared to a traditional low fat diet, low carbohydrate diets are associated with greater weight loss over six months, decreased triglycerides, and increased HDL cholesterol while other important risk factors such as, total cholesterol and LDL cholesterol tend to be reduced. There has been increased interest in how lipoprotein subclasses for LDL, HDL, and VLDL respond to manipulation of dietary carbohydrate and fat, as it relates to CHD risk. Existing studies comparing low carbohydrate and low fat diets have primarily reported lipoprotein subclasses during a period of weight loss and not weight stability [7]. The purpose of this study was to compare LDL, HDL, and VLDL subclasses in overweight/obese participants consuming either a reduced carbohydrate or reduced fat weight loss maintenance diet for nine months subsequent to three months of weight loss on a very low-energy diet (VLED). As there is currently no-agreed upon definition for a low carbohydrate diet [7] and the present study is not a very-low carbohydrate or ketogenic diet as reported elsewhere, the low carbohydrate and low fat diet groups will be described hereafter as reduced carbohydrate (RC) and reduced fat (RF) diet groups, respectively
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