Sunday, September 21, 2014

Low Carb Diet Trials: Lim, et al (2009)

 
Participants and Diets
 
113 people with a BMI 28-40 and aged 20-65 and with at least one CVD risk factor other than obesity were randomised to one of 4 diet groups:
 
1.      Very low carbohydrate diet (VLC)
2.      Very low fat diet (VLF)
3.      High unsaturated fat diet (HUF)
4.      Control
 
At baseline there were no differences between the three experimental groups (VLC, VLF, HUF), but the control group had lower total cholesterol, ApoB, SBP and DBP (Table 1).  The 3 diet groups received intensive support for the first 3 months then asked to maintain the diet for an additional 12 months
 
Pro:Fat:Carb (SFA)
VLC
VLF
HUF
3 Months
31:54:12 (17.7)
20:13:66 (5.1)
21:28:49 (6.0)
6 Months
24:39:33 (13.9)
21:26:51 (10.2)
21:28:48 (9.4)
9 Months
22:37:39 (14.0)
19:27:53 (11.1)
21:29:50 (10.1)
12 Months
21:39:38 (14.4)
22:27:51 (10.4)
20:29:48 (11.1)
15 Months
24:38:37 (13.2)
20:28:51 (10.7)
24:30:43 (9.9)
Target
35:60:4 (20.0)
20:10:70 (3.0)
20:30:50 (8.0)
 
Calorie Intake
VLC
VLF
HUF
3 Months
1848
1679
1837
6 Months
1767
1672
1547
9 Months
1628
1801
1688
12 Months
1853
1895
1708
15 Months
1641
1903
1581
Target
1560
1560
1560
 
Notably the groups had very good adherence to the diets at 3 months, which declined when the intensive support was gone
 
Results
 
The three diet groups had greater weight loss than the control group but there weren’t significant differences between groups (although at 15 months HUF was close with p = 0.065 vs. VLF)
 
Weight Loss (kg)
VLC
VLF
HUF
3 Months
−8.0 (2.8)
−6.7 (3.5)
−6.3 (2.9)
15 Months
−2.9 (4.9)
−2.1 (4.7)
−3.9 (6.3)
 
 
Below is table 3 (except weight loss).  ‘d’ refers to changes compared to baseline; ‘x’ and ‘y’ refer to significant differences between groups.  I’ve bolded cells containing those letters.  Overall there weren't much of difference between groups or compared to baseline, with most happening at 3 months, except blood pressure, which improved quite a bit at 15 months
 
 
VLC
VLF
HUF
Cholesterol, mmol/L
3 months
0.1 (1.1)
−0.5 (0.8)
−0.5 (0.6)
15 months
−0.4 (0.8)
−0.3 (0.8)
−0.3 (1.2)
HDL-C
mmol/L
3 months
0.1 (0.2)x
−0.1 (0.2)y
−0.1 (0.2)y
15 months
0.1 (0.3)
0.1 (0.3)
−0.1 (0.2)
LDL-C
(mmol/L)
3 months
0.3 (1.0)x
−0.4 (0.6)y
−0.6 (1.1)y
15 months
−0.3 (0.7)
−0.3 (0.7)
−0.1 (1.1)
Triglyceride
mmol/L
3 months
−0.7 (0.6)x
−0.1 (0.6)y
−0.2 (0.5)y
15 months
−0.2 (0.7)
0.1 (0.9)
−0.3 (0.8)
Chol:HDL
3 months
−0.2 (0.2)
−0.2 (0.1)
−0.2 (0.2)
15 months
−0.2 (0.2)
−0.3 (0.1)
−0.02 (0.4)
Trig:HDL
3 months
−0.6 (0.1)x
−0.03 (0.1)y
−0.04 (0.1)y
15 months
−0.09 (0.2)
0.05 (1.8)
−0.1 (0.2)
ApoB
g/L
3 months
−0.1 (0.3)
−0.1 (0.2)
−0.1 (0.1)
15 months
0.1 (0.3)
−0.1 (0.2)
−0.1 (0.3)
CRP
mg/L
3 months
1.2 (12.2)
0.3 (5.0)
−0.5 (3.2)
15 months
−1.7 (6.7)d
−2.1 (2.5)d
−1.8 (3.1)
Folate
nmol/L
3 months
−0.7 (4.2)
3.6 (6.2)
0.9 (8.4)
15 months
−1.3 (8.9)
0.1 (9.2)
−6.0 (8.7)d
Homocysteine
μmol/L
3 months
0.6 (1.4)x
−0.5 (1.5)y
0.1 (1.1)xy
15 months
0.4 (1.2)
−0.6 (1.1)d
0.1 (1.2)
Vitamin B12
pmol/L
3 months
6.8 (61.4)
−4.6 (49.1)
−4.1 (78.7)
15 months
33.5 (76.9)d
18.9 (66.9)
41.9 (73)d
Fasting insulin
mU/L
3 months
−3.9 (3.7)x
3.0 (13.8)y
−1.8 (2.7)x
15 months
−1.5 (4.4)
0.5 (5.5)
−1.7 (4)
Fasting glucose, mmol/L
3 months
−0.1 (0.3)
0.1 (0.6)
−0.2 (0.4)
15 months
0.1 (0.3)
0.3 (0.6)
−0.4 (1)
SBP
mmHg
3 months
−10.5 (12.7)
−7.1 (12.6)
−3.1 (14.5)
15 months
−10.6 (10.6)d
−6.0 (13.3)d
−5.4 (13.3)
DBP
mmHg
3 months
−3.8 (9.5)
−2.1 (11)
−2.0 (9.3)
15 months
−6.6 (12.1)d
−7.5 (8.7)d
−9.0 (9.3)d
 
“The attrition rate was 43%, 40%, 50% and 17% for VLC, VLF, HUF and the control group respectively (P = 0.098).”

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