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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