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Comparison of a reduced carbohydrate and reduced fat diet for LDL, HDL, and VLDL subclasses during 9-months of weight maintenance subsequent to weight loss

DOI: 10.1186/1476-511x-9-54

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Thirty-five (21 RC; 14 RF) overweight or obese middle-aged adults completed a 1-year weight management clinic. Participants met weekly for the first six months and bi-weekly thereafter. Meetings included instruction for diet, physical activity, and behavior change related to weight management. Additionally, participants followed a liquid very low-energy diet of ~2092 kJ per day for the first three months of the study. Subsequently, participants followed a dietary plan for nine months that targeted a reduced percentage of carbohydrate (~20%) or fat (~30%) intake and an energy intake level calculated to maintain weight loss. Lipid subclasses using NMR spectroscopy were analyzed prior to weight loss and at multiple intervals during weight maintenance.Body weight change was not significantly different within or between groups during weight maintenance (p > 0.05). The RC group showed significant increases in mean LDL size, large LDL, total HDL, large and small HDL, mean VLDL size, and large VLDL during weight maintenance while the RF group showed increases in total HDL, large and small HDL, total VLDL, and large, medium, and small VLDL (p < 0.05). Group*time interactions were significant for large and medium VLDL (p > 0.05).Some individual lipid subclasses improved in both dietary groups. Large and medium VLDL subclasses increased to a greater extent across weight maintenance in the RF group.Low fat diets have been shown to reduce some risk factors associated with coronary heart disease (CHD) and have traditionally been considered the standard of care for dietary treatment in overweight and obese adults [1]. Recently, a low carbohydrate diet has emerged as a potentially viable alternative diet to reduce some risk factors for CHD. Compared to a traditional low fat diet, low carbohydrate diets are associated with greater weight loss over six months, decreased triglycerides, and increased HDL cholesterol while other important risk factors such as, total cholesterol and LDL


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