Re: Effects of Low-Carbohydrate vs Low-Fat Diets on Weight Loss & Cardio Risk

[Guest guest]

When I tested the low-carb approach for myself a couple of years ago

out of curiosity, my total cholesterol went from the 140s to the

170s in just one month. Alarmed, I stopped immediately. My TC

corrected itself to back to the 140s. (I'm 47 years old and my BMI

is 23.)

>

> Dueling Diets: Low-Carb Equals Low-Fat for Weight Loss but Boosts

> Cholesterol

>

>

> By Judith Groch , MedPage Today Staff Writer

> Reviewed by Jasmer, MD; Assistant Professor of Medicine,

> University of California, San Francisco

>

>

>

> MedPage Today Action Points

>

> * Explain to patients that his study showed that. low-

carbohydrate

> diets, with their high protein and fat content, are likely to

increase

> cholesterol levels.

>

> * Note that low-fat diets and low-carb diets were equally

> effective for weight loss.

>

>

> Review

> BASEL, Switzerland - Low-carbohydrate and low-fat diets are equally

> effective for weight loss, but the low-carb route raises total and

> low-density lipoprotein cholesterol levels, according to

researchers here.

>

> In a Cochrane-style meta-analysis of five controlled clinical

trials,

> the investigators found that an increase in total cholesterol and

> low-density lipoprotein cholesterol for low-carb dieters offset an

> increase in HDL cholesterol and a decrease in triglyceride levels.

>

> The analysis involved trials with 222 individuals on low-carb diets

> and 225 on low-fat diets, all with BMIs of 25 or higher, Alain J.

> Nordmann, M.D., M.Sc., of University Hospital and colleagues

reported

> in the Feb. 13 issue of the Archives of Internal Medicine.

>

> The low-carb diets held some advantages at six months, but at 12

> months the differences evened out, with a mean difference of -1.0

kg

> (95% CI -3.5 to 1.5 kg). There was also no difference in blood

> pressure levels between the two groups, Dr. Nordmann said.

>

> Low-carb dieters were restricted to a maximum of 60 grams of

> carbohydrates a day without energy restriction. In contrast, low-

fat

> diets allowed a maximum of 30% of daily energy intake from fat.

>

> At six months, the researchers reported that the low-carb dieters

were

> more likely to stick with the diet, and they lost more weight than

the

> low-fat dieters. The weighted mean difference favored the low-carb

> group at -3.3 kg (95% CI -5.3 to -1.4 kg).

>

> Beyond six months, there was some good news for the low-carb

dieters:

> Compared with the low-fat group, their triglycerides were lower

with a

> weighted mean difference of -22.1 mg/dL (95% CI 38.1 to 5.3 mg/dL).

> Desirable HDLs were up at a mean difference of 4.6 mg/dL (95% CI

> 1,2-10.1 mg/dL).

>

> But on the down side for the low-carb diets, which tend to be high

in

> protein and fat, LDL levels and total cholesterol were higher

compared

> with the low-fat diets.

>

> For low-fat dieters, the mean downward change for LDL cholesterol

was

> 5.4 mg/dL (95% CI, 1.2 to 10.1 mg/dL). Total cholesterol was also

> better for the low-fat dieters with a mean decrease of 10.1 mg/dL

(CI,

> 3.5-16.2 mg/dL),

>

> the researchers reported.

>

> " Because no trials have yet examined the risk of heart attack or

death

> in people on low-carbohydrate diets, it's unclear whether the

> beneficial effects that low-carbohydrate diets appear to have on

HDL

> and triglyceride levels cancel out their apparent negative effects

on

> overall and LDL cholesterol levels, " Dr. Nordmann said.

>

> At 12 months, the differences in weight loss between the two diets

> were " minor and not clinically relevant, " the researchers wrote.

This

> aside, they said, " We believe there is still insufficient evidence

to

> make recommendations for or against the use of low-carbohydrate

diets

> to induce weight loss, especially for durations longer than six

months. "

>

> " Such diets currently cannot be recommended for prevention of

> cardiovascular disease, " they added.

>

> The study was supported in part by Swissmilk of Berne, Switzerland.

> Primary source: Archives of Internal Medicine, Feb 13, 2006:166:

285-293

> Source reference:

> Nordmann, Alain J., M.D., MSc, et al " Effects of Low-Carbohydrate

vs.

> Low-Fat Diets on Weight Loss and Cardiovascular Risk Factors: A

> Meta-analysis of Randomized Controlled Trials. "

> http://www.medpagetoday.com/tbprint.cfm?tbid=2664

>

>

>

>

>

>

> Effects of Low-Carbohydrate vs Low-Fat Diets on Weight Loss and

> Cardiovascular Risk Factors

>

> A Meta-analysis of Randomized Controlled Trials

>

> Alain J. Nordmann, MD, MSc; Abigail Nordmann, BS; Matthias Briel,

MD;

> Ulrich Keller, MD; S. Yancy, Jr, MD, MSH; Bonnie J. Brehm,

> PhD; Heiner C. Bucher, MD, MPH

>

> Arch Intern Med. 2006;166:285-293.

>

> Background Low-carbohydrate diets have become increasingly popular

> for weight loss. However, evidence from individual trials about

> benefits and risks of these diets to achieve weight loss and modify

> cardiovascular risk factors is preliminary.

>

> Methods We used the Cochrane Collaboration search strategy to

> identify trials comparing the effects of low-carbohydrate diets

> without restriction of energy intake vs low-fat diets in

individuals

> with a body mass index (calculated as weight in kilograms divided

by

> the square of height in meters) of at least 25. Included trials

had to

> report changes in body weight in intention-to-treat analysis and to

> have a follow-up of at least 6 months. Two reviewers independently

> assessed trial eligibility and quality of randomized controlled

trials.

>

> Results Five trials including a total of 447 individuals fulfilled

> our inclusion criteria. After 6 months, individuals assigned to

> low-carbohydrate diets had lost more weight than individuals

> randomized to low-fat diets (weighted mean difference, –3.3 kg; 95%

> confidence interval [CI], –5.3 to –1.4 kg). This difference was no

> longer obvious after 12 months (weighted mean difference, –1.0 kg;

95%

> CI, –3.5 to 1.5 kg). There were no differences in blood pressure.

> Triglyceride and high-density lipoprotein cholesterol values

changed

> more favorably in individuals assigned to low-carbohydrate diets

> (after 6 months, for triglycerides, weighted mean difference, –22.1

> mg/dL [–0.25 mmol/L]; 95% CI, –38.1 to –5.3 mg/dL [–0.43 to –0.06

> mmol/L]; and for high-density lipoprotein cholesterol, weighted

mean

> difference, 4.6 mg/dL [0.12 mmol/L]; 95% CI, 1.5-8.1 mg/dL [0.04-

0.21

> mmol/L]), but total cholesterol and low-density lipoprotein

> cholesterol values changed more favorably in individuals assigned

to

> low-fat diets (weighted mean difference in low-density lipoprotein

> cholesterol after 6 months, 5.4 mg/dL [0.14 mmol/L]; 95% CI, 1.2-

10.1

> mg/dL [0.03-0.26 mmol/L]).

>

> Conclusions Low-carbohydrate, non–energy-restricted diets appear

to

> be at least as effective as low-fat, energy-restricted diets in

> inducing weight loss for up to 1 year. However, potential favorable

> changes in triglyceride and high-density lipoprotein cholesterol

> values should be weighed against potential unfavorable changes in

> low-density lipoprotein cholesterol values when low-carbohydrate

diets

> to induce weight loss are considered.

>

[Guest guest]

When I tested the low-carb approach for myself a couple of years ago

out of curiosity, my total cholesterol went from the 140s to the

170s in just one month. Alarmed, I stopped immediately. My TC

corrected itself to back to the 140s. (I'm 47 years old and my BMI

is 23.)

>

> Dueling Diets: Low-Carb Equals Low-Fat for Weight Loss but Boosts

> Cholesterol

>

>

> By Judith Groch , MedPage Today Staff Writer

> Reviewed by Jasmer, MD; Assistant Professor of Medicine,

> University of California, San Francisco

>

>

>

> MedPage Today Action Points

>

> * Explain to patients that his study showed that. low-

carbohydrate

> diets, with their high protein and fat content, are likely to

increase

> cholesterol levels.

>

> * Note that low-fat diets and low-carb diets were equally

> effective for weight loss.

>

>

> Review

> BASEL, Switzerland - Low-carbohydrate and low-fat diets are equally

> effective for weight loss, but the low-carb route raises total and

> low-density lipoprotein cholesterol levels, according to

researchers here.

>

> In a Cochrane-style meta-analysis of five controlled clinical

trials,

> the investigators found that an increase in total cholesterol and

> low-density lipoprotein cholesterol for low-carb dieters offset an

> increase in HDL cholesterol and a decrease in triglyceride levels.

>

> The analysis involved trials with 222 individuals on low-carb diets

> and 225 on low-fat diets, all with BMIs of 25 or higher, Alain J.

> Nordmann, M.D., M.Sc., of University Hospital and colleagues

reported

> in the Feb. 13 issue of the Archives of Internal Medicine.

>

> The low-carb diets held some advantages at six months, but at 12

> months the differences evened out, with a mean difference of -1.0

kg

> (95% CI -3.5 to 1.5 kg). There was also no difference in blood

> pressure levels between the two groups, Dr. Nordmann said.

>

> Low-carb dieters were restricted to a maximum of 60 grams of

> carbohydrates a day without energy restriction. In contrast, low-

fat

> diets allowed a maximum of 30% of daily energy intake from fat.

>

> At six months, the researchers reported that the low-carb dieters

were

> more likely to stick with the diet, and they lost more weight than

the

> low-fat dieters. The weighted mean difference favored the low-carb

> group at -3.3 kg (95% CI -5.3 to -1.4 kg).

>

> Beyond six months, there was some good news for the low-carb

dieters:

> Compared with the low-fat group, their triglycerides were lower

with a

> weighted mean difference of -22.1 mg/dL (95% CI 38.1 to 5.3 mg/dL).

> Desirable HDLs were up at a mean difference of 4.6 mg/dL (95% CI

> 1,2-10.1 mg/dL).

>

> But on the down side for the low-carb diets, which tend to be high

in

> protein and fat, LDL levels and total cholesterol were higher

compared

> with the low-fat diets.

>

> For low-fat dieters, the mean downward change for LDL cholesterol

was

> 5.4 mg/dL (95% CI, 1.2 to 10.1 mg/dL). Total cholesterol was also

> better for the low-fat dieters with a mean decrease of 10.1 mg/dL

(CI,

> 3.5-16.2 mg/dL),

>

> the researchers reported.

>

> " Because no trials have yet examined the risk of heart attack or

death

> in people on low-carbohydrate diets, it's unclear whether the

> beneficial effects that low-carbohydrate diets appear to have on

HDL

> and triglyceride levels cancel out their apparent negative effects

on

> overall and LDL cholesterol levels, " Dr. Nordmann said.

>

> At 12 months, the differences in weight loss between the two diets

> were " minor and not clinically relevant, " the researchers wrote.

This

> aside, they said, " We believe there is still insufficient evidence

to

> make recommendations for or against the use of low-carbohydrate

diets

> to induce weight loss, especially for durations longer than six

months. "

>

> " Such diets currently cannot be recommended for prevention of

> cardiovascular disease, " they added.

>

> The study was supported in part by Swissmilk of Berne, Switzerland.

> Primary source: Archives of Internal Medicine, Feb 13, 2006:166:

285-293

> Source reference:

> Nordmann, Alain J., M.D., MSc, et al " Effects of Low-Carbohydrate

vs.

> Low-Fat Diets on Weight Loss and Cardiovascular Risk Factors: A

> Meta-analysis of Randomized Controlled Trials. "

> http://www.medpagetoday.com/tbprint.cfm?tbid=2664

>

>

>

>

>

>

> Effects of Low-Carbohydrate vs Low-Fat Diets on Weight Loss and

> Cardiovascular Risk Factors

>

> A Meta-analysis of Randomized Controlled Trials

>

> Alain J. Nordmann, MD, MSc; Abigail Nordmann, BS; Matthias Briel,

MD;

> Ulrich Keller, MD; S. Yancy, Jr, MD, MSH; Bonnie J. Brehm,

> PhD; Heiner C. Bucher, MD, MPH

>

> Arch Intern Med. 2006;166:285-293.

>

> Background Low-carbohydrate diets have become increasingly popular

> for weight loss. However, evidence from individual trials about

> benefits and risks of these diets to achieve weight loss and modify

> cardiovascular risk factors is preliminary.

>

> Methods We used the Cochrane Collaboration search strategy to

> identify trials comparing the effects of low-carbohydrate diets

> without restriction of energy intake vs low-fat diets in

individuals

> with a body mass index (calculated as weight in kilograms divided

by

> the square of height in meters) of at least 25. Included trials

had to

> report changes in body weight in intention-to-treat analysis and to

> have a follow-up of at least 6 months. Two reviewers independently

> assessed trial eligibility and quality of randomized controlled

trials.

>

> Results Five trials including a total of 447 individuals fulfilled

> our inclusion criteria. After 6 months, individuals assigned to

> low-carbohydrate diets had lost more weight than individuals

> randomized to low-fat diets (weighted mean difference, –3.3 kg; 95%

> confidence interval [CI], –5.3 to –1.4 kg). This difference was no

> longer obvious after 12 months (weighted mean difference, –1.0 kg;

95%

> CI, –3.5 to 1.5 kg). There were no differences in blood pressure.

> Triglyceride and high-density lipoprotein cholesterol values

changed

> more favorably in individuals assigned to low-carbohydrate diets

> (after 6 months, for triglycerides, weighted mean difference, –22.1

> mg/dL [–0.25 mmol/L]; 95% CI, –38.1 to –5.3 mg/dL [–0.43 to –0.06

> mmol/L]; and for high-density lipoprotein cholesterol, weighted

mean

> difference, 4.6 mg/dL [0.12 mmol/L]; 95% CI, 1.5-8.1 mg/dL [0.04-

0.21

> mmol/L]), but total cholesterol and low-density lipoprotein

> cholesterol values changed more favorably in individuals assigned

to

> low-fat diets (weighted mean difference in low-density lipoprotein

> cholesterol after 6 months, 5.4 mg/dL [0.14 mmol/L]; 95% CI, 1.2-

10.1

> mg/dL [0.03-0.26 mmol/L]).

>

> Conclusions Low-carbohydrate, non–energy-restricted diets appear

to

> be at least as effective as low-fat, energy-restricted diets in

> inducing weight loss for up to 1 year. However, potential favorable

> changes in triglyceride and high-density lipoprotein cholesterol

> values should be weighed against potential unfavorable changes in

> low-density lipoprotein cholesterol values when low-carbohydrate

diets

> to induce weight loss are considered.

>