A randomized study comparing the effects of a low-carbohydrate diet and a conventional diet on lipoprotein subfractions and C-reactive protein levels in patients with severe obesity
Section snippets
Methods
The enrollment criteria, randomization process, and study design of the primary study have been previously described (3). This study was approved by the Institutional Review Committee at the Philadelphia Veterans Affairs Medical Center, and all participating subjects gave informed consent. We enrolled 132 subjects from the outpatient practices of the Philadelphia Veterans Affairs Medical Center who had a body mass index ≥35 kg/m2 and randomly assigned them to either a low-carbohydrate (n = 64)
Results
Many subjects had diabetes (40% [31/78]), and among those without diabetes, an additional 36 subjects had metabolic syndrome (Table 1). There were no significant differences in baseline characteristics between diet groups for the 78 subjects included in the study. When compared with those who had dropped out, the 78 subjects who remained in the study were slightly older and more likely to use lipid-lowering medications. Women who had been assigned to the low-carbohydrate diet were more likely
Discussion
In this randomized 6-month trial, we compared the effects of a low-carbohydrate diet with those of a conventional diet on lipoprotein subfractions and C-reactive protein levels in severely obese subjects. It is important that these factors be evaluated, especially given the concerns that improvements in conventional lipid parameters with a low-carbohydrate diet might obscure the deleterious effects on lipid subfractions and inflammation resulting from liberalized fat intake (22).
We found that
Acknowledgment
The authors gratefully acknowledge Dr. James Otvos and LipoScience Inc for technical contributions, Dr. David Freedman for his helpful comments on the analyses, and Megan L. Wolfe for assistance with the C-reactive protein assays.
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Supported by funding from the Veterans Affairs Healthcare Network Competitive Pilot Project Grant.