Effects of Weight Loss and Long-Term Weight Maintenance With Diets Varying in Protein and Glycemic Index on Cardiovascular Risk Factors

The aim of this study was to determine after 52 weeks whether advice to follow a lower carbohydrate diet, either high in monounsaturated fat or low fat, high in protein had differential effects in a free-living community setting. Following weight loss on either a high monounsaturated fat, standard protein (HMF; 50 % fat, 20 % protein (67 g/d), 30 % carbohydrate) or a high protein, moderate fat (HP) (40 % protein (136 g/d), 30 % fat, 30 % carbohydrate) energy-restricted diet (6000 kJ/d) subjects were asked to maintain the same dietary pattern without intensive dietary counselling for the following 36 weeks. Overall weight loss was 6·2 (sd 7·3) kg (P < 0·01 for time with no diet effect, 7·6 (sd 8·1) kg, HMF v. 4·8 (sd 6·6) kg, HP). In a multivariate regression model predictors of weight loss at the end of the study were sex, age and reported percentage energy from protein (R2 0·22, P < 0·05 for the whole model). Fasting plasma insulin decreased (P < 0·01, with no difference between diets), 13·9 (sd 4·6) to 10·2 (sd 5·2) mIU/l, but fasting plasma glucose was not reduced. Neither total cholesterol nor LDL-cholesterol were different but HDL was higher, 1·19 (sd 0·26) v. 1·04 (sd 0·29) (P < 0·001 for time, no diet effect), while TAG was lower, 1·87 (sd 1·23) v. 2·22 (sd 1·15) mmol/l (P < 0·05 for time, no diet effect). C-reactive protein decreased (3·97 (sd 2·84) to 2·43 (sd 2·29) mg/l, P < 0·01). Food records showed that compliance to the prescribed dietary patterns was poor. After 1 year there remained a clinically significant weight loss and improvement in cardiovascular risk factors with no adverse effects of a high monounsaturated fat diet.

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Long-term weight loss decreases the nontraditional cardiovascular risk factors interleukin-18 and matrix metalloproteinase–9 in obese subjects

Metabolism ◽

10.1016/j.metabol.2009.02.031 ◽

2009 ◽

Vol 58 (7) ◽

pp. 946-953 ◽

Cited By ~ 29

Author(s):

Erik L. Madsen ◽

Jens M. Bruun ◽

Kristin Skogstrand ◽

David M. Hougaard ◽

Tore Christiansen ◽

...

Keyword(s):

Risk Factors ◽

Weight Loss ◽

Cardiovascular Risk ◽

Matrix Metalloproteinase ◽

Cardiovascular Risk Factors ◽

Matrix Metalloproteinase 9 ◽

Interleukin 18 ◽

Obese Subjects ◽

Metalloproteinase 9

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Long-Term Effects of 4 Popular Diets on Weight Loss and Cardiovascular Risk Factors: A Systematic Review of Randomized Controlled Trials

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.113.000723 ◽

2014 ◽

Vol 7 (6) ◽

pp. 815-827 ◽

Cited By ~ 37

Author(s):

R. Atallah ◽

K. B. Filion ◽

S. M. Wakil ◽

J. Genest ◽

L. Joseph ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Weight Loss ◽

Cardiovascular Risk ◽

Randomized Controlled Trials ◽

Cardiovascular Risk Factors ◽

Controlled Trials ◽

Long Term Effects ◽

Randomized Controlled

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Better dietary adherence and weight maintenance achieved by a long-term moderate-fat diet

British Journal Of Nutrition ◽

10.1017/s0007114507328602 ◽

2007 ◽

Vol 97 (2) ◽

pp. 399-404 ◽

Cited By ~ 23

Author(s):

Leila Azadbakht ◽

Parvin Mirmiran ◽

Ahmad Esmaillzadeh ◽

Fereidoun Azizi

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Risk ◽

Waist Circumference ◽

Total Cholesterol ◽

Cardiovascular Risk Factors ◽

Weight Maintenance ◽

Low Fat ◽

Low Fat Diet

The objective of the present study was to determine the effects of a long-term moderate-fat diet (30 % energy from fat)v.a low-fat one (20 % energy from fat) on metabolic risks. The study was a randomised, prospective 14-month trial on overweight and obese patients (eighty-nine overweight and obese men and women). The intervention was a moderate-fat diet (30 % energy) or a low-fat diet (20 % energy). The main outcome measurements were change in body weight, waist circumference, LDL-cholesterol, HDL-cholesterol, total cholesterol, TAG, and systolic and diastolic blood pressure. Forty-five subjects on the moderate-fat diet and forty-four subjects on the low-fat one were studied. Characteristics of all randomised participants were similar in both groups. After 7 months, the moderate- and low-fat diets had similar effects on cardiovascular risks. The moderate-fat diet was more successful after 14 months in reducing weight ( − 5·0 (sd2·5) kg in the moderate-fat groupv.− 1·2 (sd1·1) kg in the low-fat one;P < 0·0001), waist circumference ( − 5·5 (sd2·4) cm in the moderate-fat groupv.− 2·3 (sd1·3) cm in the low-fat one;P < 0·0001), and other cardiovascular risk factors as well (LDL, TAG, total cholesterol and systolic blood pressure). In conclusion, a moderate-fat energy-restricted diet in the long term might have more beneficial effects on weight maintenance and cardiovascular risk factors compared with a low-fat diet. Better dietary adherence with the moderate-fat diet may be the reason for its successful effects.

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Faculty Opinions recommendation of Association between degenerative aortic valve disease and long-term exposure to cardiovascular risk factors: results of the longitudinal population-based KORA/MONICA survey.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1208971.674076 ◽

2009 ◽

Author(s):

Melvin Cheitlin

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Aortic Valve ◽

Cardiovascular Risk Factors ◽

Aortic Valve Disease ◽

Population Based ◽

Valve Disease

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Long-term effects (>24 months) of multiple lifestyle intervention on major cardiovascular risk factors among high risk subjects: a meta-analysis

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.253 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

H Bergum ◽

I Sandven ◽

TO Klemsdal

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Risk ◽

Systolic Blood Pressure ◽

Total Cholesterol ◽

Cardiovascular Risk Factors ◽

Lifestyle Intervention ◽

Small Study ◽

Long Term Effects

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Norwegian health department Background The evidence of the long-term effects of multiple lifestyle intervention on cardiovascular risk is uncertain. We aimed to summarize the evidence from randomized clinical trials examining the efficacy of lifestyle intervention on major cardiovascular risk factors in subjects at high cardiovascular risk. Methods Eligible trials investigated the impact of lifestyle intervention versus usual care with minimum 24 months follow-up, reporting more than one major cardiovascular risk factor. A literature search updated April 15, 2020 identified 12 eligible studies. The results from individual trials were combined using fixed and random effect models, using the standardized mean difference (SMD) to estimate effect sizes. Small-study effect was evaluated, and heterogeneity between studies examined by subgroup and meta-regression analyses considering patient- and study-level variables. Results Small-study effect was not identified. Lifestyle intervention reduced systolic blood pressure modestly with an estimated SMD of -0.13, 95% confidence interval (CI): -0.21 to -0.04, with moderate heterogeneity (I² = 59%), corresponding to a mean difference of approximately 2 mmHg (MD = -1.86, 95% CI: -3.14 to -0.57, p = 0.0046). This effect disappeared in the subgroup of trials judged at low risk of bias (SMD = 0.02, 95% CI: -0.08 to 0.11). For the outcome total cholesterol SMD was -0.06, 95% CI: -0.13 to 0.00, with no heterogeneity (I² = 0%), indicating no effect of the intervention. Conclusion Lifestyle intervention resulted in only a modest effect on systolic blood pressure and no effect on total cholesterol after 24 months. Further lifestyle trials should consider the challenge of maintaining larger long-term benefits to ensure impact on cardiovascular outcomes.

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