Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity

Abstract Objectives We compared a high-fiber bean-rich diet with a low-carbohydrate diet in a randomized controlled trial to assess their effects on body weight, blood lipids and micronutrient adequacy. Methods One hundred and seventy-three women and men with a mean body mass index of approximately 36 kg · m−2 were randomized to a high-fiber bean-rich diet that achieved mean (SD) fiber intakes of 35.5 (18.6) g · day−1 for women and 42.5 (30.3) g · day−1 for men, or a low-carbohydrate diet (<120 g · day−1). Both diets were induced gradually over 4 weeks and included a 3-day feeding phase. Results After 52 weeks, the low-carbohydrate (n = 24) group tended to retain weight loss better than the high-fiber group (n = 30) (P = 0.06), although total cholesterol remained lower with the bean-rich diet (P = 0.049). The low-carbohydrate group consumed more vitamin K (P = 0.006), thiamin (P = 0.001), and niacin (P = 0.02) whereas those in the high-fiber group consumed more folate (P = 0.006), magnesium (P = 0.046) and copper (P = 0.017). Both groups consumed less than the RDA for vitamin D, vitamin E, calcium, magnesium and copper. Conclusions A high-fiber bean-rich diet was as effective as a low-carbohydrate diet for weight loss. However, both diets were deficient in micronutrients. These results may have implications for long-term disease risk and morbidity management. Funding Sources Lifestyle Center of America (Sulphur, OK).

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Comparison of a Low-Fat Diet to a Low-Carbohydrate Diet on Weight Loss, Body Composition, and Risk Factors for Diabetes and Cardiovascular Disease in Free-Living, Overweight Men and Women

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2003-031606 ◽

2004 ◽

Vol 89 (6) ◽

pp. 2717-2723 ◽

Cited By ~ 130

Author(s):

Kelly A. Meckling ◽

Caitriona O’Sullivan ◽

Dayna Saari

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Weight Loss ◽

Body Composition ◽

Carbohydrate Diet ◽

Free Living ◽

Men And Women ◽

Low Carbohydrate Diet ◽

Low Fat Diet ◽

Low Carbohydrate

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Alternate Day Fasting Combined with a Low Carbohydrate Diet: Effect on Sleep Quality, Duration, Insomnia Severity and Risk of Obstructive Sleep Apnea in Adults with Obesity

Nutrients ◽

10.3390/nu13010211 ◽

2021 ◽

Vol 13 (1) ◽

pp. 211

Author(s):

Faiza Kalam ◽

Kelsey Gabel ◽

Sofia Cienfuegos ◽

Mark Ezpeleta ◽

Eric Wiseman ◽

...

Keyword(s):

Weight Loss ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Quality ◽

Weight Maintenance ◽

Carbohydrate Diet ◽

Low Carbohydrate Diet ◽

Obstructive Sleep ◽

Low Carbohydrate ◽

Insomnia Severity

Background: Alternate day fasting combined with a low carbohydrate diet (ADF-LC) is an effective weight loss regimen. Whether the weight loss induced by ADF-LC can improve sleep, remains unknown. Objective: This study examined the effect an ADF-LC diet on sleep quality, duration, insomnia severity and the risk of obstructive sleep apnea. Methods: Adults with obesity (n = 31) participated in ADF (600 kcal “fast day”; ad libitum intake “feast day”) with a low-carbohydrate diet (30% carbohydrates, 35% protein, and 35% fat). The 6-month trial consisted of a 3-month weight loss period followed by a 3-month weight maintenance period. Results: Reductions in body weight (−5 ± 1 kg, p < 0.001) and fat mass (−4 ± 1 kg, p < 0.01) were noted during the weight loss period, and these reductions were sustained during the weight maintenance period. Lean mass and visceral fat remained unchanged. The Pittsburgh Sleep Quality Index (PSQI) score indicated poor sleep quality at baseline (6.4 ± 0.7) with no change by month 3 or 6, versus baseline. ISI score indicated subthreshold insomnia at baseline (8.5 ± 1.0), with no change by month 3 or 6, versus baseline. The percent of subjects with high risk of obstructive sleep apnea at baseline was 45%, with no change by month 3 or 6. Wake time, bedtime, and sleep duration remained unchanged. Conclusion: The ADF-LC diet does not impact sleep quality, duration, insomnia severity or the risk of obstructive sleep apnea in adults with obesity.

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Abstract P249: A Behavioral Weight Loss Intervention is Effective for Change in CVD Risk Factors in Young Adults: The IDEA Study

Circulation ◽

10.1161/circ.131.suppl_1.p249 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

John M Jakicic ◽

Kelliann K Davis ◽

Bethany Barone Gibbs ◽

Diane Helsel ◽

Wendy C King ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Weight Loss ◽

Young Adults ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Cardiovascular Disease Risk Factors ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

Introduction: Few studies have examined behavioral weight loss interventions with respect to change in cardiovascular disease risk factors in young adults (aged 18 to 35 years). Hypothesis: We tested the hypothesis that a 6 month behavioral weight loss intervention resulted in significant improvements in selective cardiovascular disease risk factors in young adults. Methods: Data are presented as median [25 th , 75 th percentiles]. 470 participants (age: 30.9 [27.8, 33.7] years); BMI: 31.2 [28.4, 34.3] kg/m 2 ) were enrolled in a 6 month behavioral weight loss intervention that included weekly group sessions and prescribed an energy restricted diet and moderate-to-vigorous physical activity. Assessments included weight using a standardized protocol, resting blood pressure, and fasting lipids, glucose, and insulin. Statistical significance of change was according to tests of symmetry or the Wilcoxon matched pairs signed ranks test. Results: The primary outcome (weight) was available for 424 of the 470 participants (90.2%). Weight significantly decreased (-7.8 kg [-12.2, -3.7]) (p<0.0001). Systolic (-4.0 mmHg [-8.5, 0.5] and diastolic blood pressure (-3.0 mmHg [-6.5, 1.0]) decreased (p<0.0001). Total cholesterol (-13 mg/dl [-28.0, 2.0]), LDL cholesterol (-9.5 mg/dl [-21.7, 2.0]), triglycerides (-8.5 mg/dl [-44.0, 9.0]), glucose (-4.0 mg/dl [-8.0, 1.0]), and insulin (-2.6 mIU/L [-5.9, 0.7]) decreased (p<0.0001, n=416). There was not a significant change in HDL cholesterol (p=0.72). Conclusions: In conclusion, after 6 months, weight loss was observed in young adults assigned to this behavioral intervention that focused on physical activity and diet modification. They tended to also have improved cardiovascular disease risk factors. This may demonstrate an approach to reducing cardiovascular disease risk in young adults. Supported by NIH (U01HL096770) and AHA (12BGIA9410032)

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Sleep deprivation and endothelial function: reconciling seminal evidence with recent perspectives

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00607.2020 ◽

2021 ◽

Vol 320 (1) ◽

pp. H29-H35

Author(s):

Joshua M. Cherubini ◽

Jem L. Cheng ◽

Jennifer S. Williams ◽

Maureen J. MacDonald

Keyword(s):

Cardiovascular Disease ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Sleep Deprivation ◽

Vascular Function ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Health Concern ◽

Short Sleep ◽

Inadequate Sleep

Sleep is critical for the maintenance of physiological homeostasis and, as such, inadequate sleep beckons a myriad of pathologies. Sleep deprivation is a growing health concern in contemporary society since short sleep durations are associated with increased cardiovascular disease risk and atherosclerotic plaque development. Vascular endothelial dysfunction is an antecedent to atherosclerosis and cardiovascular disease. Herein, we review seminal literature indicating that short sleep durations attenuate endothelial function and explore more recent evidence indicating that sleep deprivation perturbs autonomic balance and the circadian rhythmicity of peripheral vascular clock components. We further examine literature that indicates a mechanistic link between short sleep duration and endothelial dysfunction and subsequent morbidity. Understanding the mechanisms that regulate endothelial function in the context of sleep deprivation facilitates the development and optimization of interventions, such as exercise, that mitigate the ramifications of inadequate sleep on vascular function and cardiovascular health. Listen to this article’s corresponding podcast at https://ajpheart.podbean.com/e/sleep-deprivation-and-endothelial-function/

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Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial

BMJ ◽

10.1136/bmj.k4583 ◽

2018 ◽

pp. k4583 ◽

Cited By ~ 72

Author(s):

Cara B Ebbeling ◽

Henry A Feldman ◽

Gloria L Klein ◽

Julia M W Wong ◽

Lisa Bielak ◽

...

Keyword(s):

Weight Loss ◽

Energy Expenditure ◽

Total Energy ◽

Total Energy Expenditure ◽

Carbohydrate Diet ◽

Intention To Treat ◽

Low Carbohydrate Diet ◽

High Carbohydrate ◽

Low Carbohydrate ◽

Treat Analysis

AbstractObjectiveTo determine the effects of diets varying in carbohydrate to fat ratio on total energy expenditure.DesignRandomized trial.SettingMulticenter collaboration at US two sites, August 2014 to May 2017.Participants164 adults aged 18-65 years with a body mass index of 25 or more.InterventionsAfter 12% (within 2%) weight loss on a run-in diet, participants were randomly assigned to one of three test diets according to carbohydrate content (high, 60%, n=54; moderate, 40%, n=53; or low, 20%, n=57) for 20 weeks. Test diets were controlled for protein and were energy adjusted to maintain weight loss within 2 kg. To test for effect modification predicted by the carbohydrate-insulin model, the sample was divided into thirds of pre-weight loss insulin secretion (insulin concentration 30 minutes after oral glucose).Main outcome measuresThe primary outcome was total energy expenditure, measured with doubly labeled water, by intention-to-treat analysis. Per protocol analysis included participants who maintained target weight loss, potentially providing a more precise effect estimate. Secondary outcomes were resting energy expenditure, measures of physical activity, and levels of the metabolic hormones leptin and ghrelin.ResultsTotal energy expenditure differed by diet in the intention-to-treat analysis (n=162, P=0.002), with a linear trend of 52 kcal/d (95% confidence interval 23 to 82) for every 10% decrease in the contribution of carbohydrate to total energy intake (1 kcal=4.18 kJ=0.00418 MJ). Change in total energy expenditure was 91 kcal/d (95% confidence interval −29 to 210) greater in participants assigned to the moderate carbohydrate diet and 209 kcal/d (91 to 326) greater in those assigned to the low carbohydrate diet compared with the high carbohydrate diet. In the per protocol analysis (n=120, P<0.001), the respective differences were 131 kcal/d (−6 to 267) and 278 kcal/d (144 to 411). Among participants in the highest third of pre-weight loss insulin secretion, the difference between the low and high carbohydrate diet was 308 kcal/d in the intention-to-treat analysis and 478 kcal/d in the per protocol analysis (P<0.004). Ghrelin was significantly lower in participants assigned to the low carbohydrate diet compared with those assigned to the high carbohydrate diet (both analyses). Leptin was also significantly lower in participants assigned to the low carbohydrate diet (per protocol).ConclusionsConsistent with the carbohydrate-insulin model, lowering dietary carbohydrate increased energy expenditure during weight loss maintenance. This metabolic effect may improve the success of obesity treatment, especially among those with high insulin secretion.Trial registrationClinicalTrials.govNCT02068885.

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