Long-term effects of weight loss with a very low carbohydrate and low fat diet on vascular function in overweight and obese patients.

"Long-term effects of weight loss with a very low carbohydrate and low fat diet on vascular function in overweight and obese patients. TP Wycherley, GD Brinkworth, JB Keogh et al. Journal of Internal Medicine. 2010 May;267(5):452-61. Epub 2009 Oct 6. "
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"To compare the effects of an E-reduced very low-carbohydrate, high saturated fat diet (LC) and an isocaloric high carbohydrate, low fat diet (LF) on endothelial function after 12 months. "
12 mo
"VLC diet Wks 1-8 Targets E: men ~7000kJ/d (~1673kcal/d); women ~6500kJ/d (~1553kcal/d) Carb: 4%E, <20g/d; 7.6%E Protein: 35%E Fat: 61%E, 20%E saturated fat Wks 9-52 Targets Same as above <40g/d carb allowed Intake: E: 6694kJ/d (~1600kcal/d) Carb: 30.4g/d Protein: 130.4g/d Fat: 102.2g/d; 57.6%E Saturated fat: 37.3g/d"
"LF diet Targets E: men ~7000kJ/d (~1673kcal/d); women ~6500kJ/d (~1553kcal/d) Carb: 46%E Protein: 24%E Fat: 30%E Saturated fat: <8%E, <10g/d Intake: E: 6433kJ/d Carb: 166.9g/d Protein: 87.7g/d Fat: 47.4g/d Saturated fat: 11.4g/d "
"Primary: markers of endothelial function - intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1(VCAM-1), eSelectin - adiponectin - endothelium-derived fibrinolytic factors plasminogen activator inhibitor-1 (PAI-1) and tissue plasminogen activator (tPA) - flow-mediated dilitation (FMD), pulse wave velocity (PWV) Secondary: lipids, FBG, weight, SBP, SBP, BMI"
"Both diets SS improved FBG, HDL-C, TG, SBP, DBP with BG NSS. Total C, LDL-C, and FMD (-2.1%) worsened SS on LC diet. BG SS. PWV and other markers for endothelial function: most SS improved on both diets with BG NSS differences. However, ICAM-1 only SS improved on LC diet. BG SS. Both diets results in SS reductions in weight and BMI."
"Dietary records indicated dietary compliance was consistent with the prescribed dietary patterns."
"FMD WG: N BG: N Worsened (-2.1%) in LC diet but not LF diet PWV WG: Y BG: N improved SS with both diets WG p<0.01 BG NSS Endothelial function PAI-1, tPA, eSelectin, adiponectin WG: Y BG: N improved SS on both diets BG NSS VCAM-1 WG: N (both groups) BG: N BG NSS ICAM-1 WG: Y (improved only on LC diet) BG: Y "
" ... both LC and LF hypoenergetic diets achieved similar reductions in body weight and were associated with improvements in PWV and a number of endothelium- derived factors. However, the LC diet impaired FMD suggesting chronic consumption of a LC diet may have detrimental effects on endothelial function."


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


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