Lipids

, Volume 44, Issue 4, pp 297–309

Carbohydrate Restriction has a More Favorable Impact on the Metabolic Syndrome than a Low Fat Diet

  • Jeff S. Volek
  • Stephen D. Phinney
  • Cassandra E. Forsythe
  • Erin E. Quann
  • Richard J. Wood
  • Michael J. Puglisi
  • William J. Kraemer
  • Doug M. Bibus
  • Maria Luz Fernandez
  • Richard D. Feinman
Original Article

DOI: 10.1007/s11745-008-3274-2

Cite this article as:
Volek, J.S., Phinney, S.D., Forsythe, C.E. et al. Lipids (2009) 44: 297. doi:10.1007/s11745-008-3274-2

Abstract

We recently proposed that the biological markers improved by carbohydrate restriction were precisely those that define the metabolic syndrome (MetS), and that the common thread was regulation of insulin as a control element. We specifically tested the idea with a 12-week study comparing two hypocaloric diets (~1,500 kcal): a carbohydrate-restricted diet (CRD) (%carbohydrate:fat:protein = 12:59:28) and a low-fat diet (LFD) (56:24:20) in 40 subjects with atherogenic dyslipidemia. Both interventions led to improvements in several metabolic markers, but subjects following the CRD had consistently reduced glucose (−12%) and insulin (−50%) concentrations, insulin sensitivity (−55%), weight loss (−10%), decreased adiposity (−14%), and more favorable triacylglycerol (TAG) (−51%), HDL-C (13%) and total cholesterol/HDL-C ratio (−14%) responses. In addition to these markers for MetS, the CRD subjects showed more favorable responses to alternative indicators of cardiovascular risk: postprandial lipemia (−47%), the Apo B/Apo A-1 ratio (−16%), and LDL particle distribution. Despite a threefold higher intake of dietary saturated fat during the CRD, saturated fatty acids in TAG and cholesteryl ester were significantly decreased, as was palmitoleic acid (16:1n-7), an endogenous marker of lipogenesis, compared to subjects consuming the LFD. Serum retinol binding protein 4 has been linked to insulin-resistant states, and only the CRD decreased this marker (−20%). The findings provide support for unifying the disparate markers of MetS and for the proposed intimate connection with dietary carbohydrate. The results support the use of dietary carbohydrate restriction as an effective approach to improve features of MetS and cardiovascular risk.

Keywords

Metabolic syndromeHDLLDLLipoprotein metabolismPlasma lipidsTriglyceride metabolismDietary fatHuman

Abbreviations

Apo

Apolipoprotein

CA-IMT

Carotid artery intima-media thickness

CE

Cholesteryl ester

CRD

Carbohydrate-restricted diets

ChREBP

Carbohydrate response element binding protein

DSL

Diagnostics Systems Laboratory

HDL-C

HDL cholesterol

LDL-C

LDL cholesterol

LFD

Low-fat diets

MetS

Metabolic syndrome

NMR

Nuclear magnetic resonance

PAGE

Polyacrylamide gel electrophoresis

RBP4

Retinol binding protein 4

SCD-1

Stearoyl-coenzyme A desaturase 1

SFA

Saturated fatty acid

SREBP1c

Sterol response element binding protein

TAG

Triacylglycerols

Supplementary material

11745_2008_3274_MOESM1_ESM.doc (94 kb)
MOESM1 [INSERT CAPTION HERE] (DOC 94 kb)

Copyright information

© AOCS 2008

Authors and Affiliations

  • Jeff S. Volek
    • 1
    • 2
  • Stephen D. Phinney
    • 3
  • Cassandra E. Forsythe
    • 1
  • Erin E. Quann
    • 1
  • Richard J. Wood
    • 1
  • Michael J. Puglisi
    • 1
  • William J. Kraemer
    • 1
  • Doug M. Bibus
    • 4
    • 5
  • Maria Luz Fernandez
    • 3
  • Richard D. Feinman
    • 6
  1. 1.Department of KinesiologyUniversity of ConnecticutStorrsUSA
  2. 2.Department of Nutritional ScienceUniversity of ConnecticutStorrsUSA
  3. 3.School of MedicineUniversity of California, DavisDavisUSA
  4. 4.Lipid Technologies, LLCAustinUSA
  5. 5.University of MinnesotaMinneapolisUSA
  6. 6.Department of BiochemistrySUNY Downstate Medical CenterBrooklynUSA