Effect of low carbohydrate high fat diet on LDL cholesterol and gene expression in normal-weight, young adults: A randomized controlled study K Retterstølac, M Svendsen, I Narverud et al.
4
2018
"Effect of low carbohydrate high fat diet on LDL cholesterol and gene expression in normal-weight, young adults: A randomized controlled study K Retterstølac, M Svendsen, I Narverud et al. Atherosclerosis 2018;279:52-61."
Norway
1
"The effects of a low-carbohydrate/ high-fat (LCHF) diet (including effects of saturated fats) on health are debated. Aims: 1) To explore the effects of a diet with <20 g carb/d on LDL in young and healthy adults; 2) To access lipid profile and peripheral blood mononuclear cell (PBMC) gene expression. "
39
30
5%
0
3 weeks
N
30
"Targets E: no restriction Carb: 20g/d or ≤5%E Protein: no restriction Fat: no restriction Intake E: 2062kcal/d Carb: 3%E Protein: 25.6%E Fat: 70.8%E Saturated fat: 29%E "
"Diet as usual Intake E: 2007kcal/d Carb: 45.8%E Protein: 17.2%E Fat: 30.6%E Saturated fat: 11%E"
"Primary: peripheral blood mononuclear cells (PBMCs) Secondary: SBP, DBP, weight, fat mass, lipid profile, ApoA1, ApoB, FBG, C-peptide, HbA1c, CRP, alanin aminotransferase (ALAT), aspartate aminotransferase (ASAT), proprotein convertase subtilisin/kexin 9 (PCSK9)"
"WG SS and BG SS for LDL increase in LCHF diet group; LDL was unchanged in LF diet group. In the LCHF group, the individual increases from baseline in LDL ranged from 5% to 107%. Also there were SS BG increases in the LCHF diet group for ApoB, total C, HDL-C,free fatty acids, uric acid and urea. BG SS for PBMC gene expression of sterol regulator element binding protein 1 (SREBP-1), which was increased in the LCHF group. BG NSS for TRG, lipoprotein (a), FBG, C-peptide or CRP, SBP, DBP, weight, body composition. "
NR
*
*
"CRP WG: N BG: N"
0
0
NR
Seven of 39 participants dropped out due "the non-serious adverse events headache and/or fatigue but there were also two serious adverse events. The cause of the two serious adverse events, myocardiopathy and autoimmune thyroiditis after few days on LCHF diet, remains undetermined despite extensive investigation."
"Drop-out rates for the 2 arms were not explicitly stated. Diet records indicated good compliance with LCHF diet protocol."
"ApoA1 WG: Y BG: Y ApoB WG: N BG: N SS worsening in LC diet Creatinine WG: N BG: N BG NSS ApoA1 Baseline→end of study LCHF diet: 1.6g/L→1.9 WG SS Usual diet: 1.6→1.7 WG NSS BG NSS ApoB Baseline→end of study LCHF diet: 0.7g/L→0.9 WG SS Usual diet: 0.8→0.8 WG NSS BG SS PBMC gene expression of sterol regulator element binding protein 1 (SREBP-1) was increased in the LCHF group vs controls p≤0.01 "
"""An LCHF diet for three weeks increased LDL-C [by] 44% vs controls.The individual response on LCHF varied profoundly ... In clinical practice, the unpredictable response to the LCHF diet suggests that LDL-C should be measured in people using a LCHF diet."" The researchers recognized the short study length as a limitation. "
Abbreviations:
AHA - American Heart Association;
ALT - alanine aminotransferase;
AMDR - acceptable macronutrient distribution range;
AST - aspartate aminotransferase;
BG - between study groups;
BHOB - beta-hydroxybutyrate;
DBP - diastolic blood pressure;
E- energy, caloric intake;
eGFR - estimated glomerular filtration rate;
FBG - fasting blood glucose;
GGT - gamma-glutamyl transferase;
HDL-C - high-density lipoprotein cholesterol;
iGFR - isotope glomerurar filtration rate;
LDL-C - low-density lipoprotein cholesterol;
NAFLD - non-alcoholic fatty liver disease;
NR - not reported (or data needed for calculation not available);
N - no;
NA - not applicable;
NS - not specified;
NSS - not statistically significant;
SBP - systolic blood pressure;
SS - statistically significant;
TG - triglyceride;
total C - total cholesterol;
V - varied, mixed;
WG - within a study group;
WMD - weighted mean difference;
Y - yes
Number of People in Studies:
3,296 Enrolled in randomized controlled trials on 25% or less carbohydrates
2,626 Completed randomized controlled trials on 25% or less carbohydrates
79.67% 82% completion of studies
Duration of Trial
<6 Months
6-9 Months
1 -2 years
>2 years
# of Trials
36
6
9s
1