Endothelial function and weight loss: Comparison of low-carbohydrate and low-fat diets

Authors

  • Emile R. Mohler III,

    Corresponding author
    1. Department of Medicine, Cardiovascular Division, Section of Vascular Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
    • Department of Medicine, Cardiovascular Division, Section of Vascular Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA

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  • Alexandra A. Sibley,

    1. Department of Medicine, Cardiovascular Division, Section of Vascular Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
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  • Richard Stein,

    1. Department of Medicine and Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
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  • Victor Davila-Roman,

    1. Department of Medicine and Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
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  • Holly Wyatt,

    1. Department of Medicine and Center for Obesity Research and Education, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
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  • Karen Badellino,

    1. School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Daniel J. Rader,

    1. Department of Medicine, Cardiovascular Division, Section of Vascular Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
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  • Samuel Klein,

    1. Department of Medicine and Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
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  • Gary D. Foster

    1. Department of Medicine and Center for Obesity Research and Education, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
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  • Disclosures: Gary D. Foster serves on the Scientific Advisory Boards of Con Agra Foods, Nutrisystem, Tate and Lyle and United Health Group. He has received grants from NIH, CDC, USDA, Robert Wood Johnson Foundation, Nutrisystem, the American Beverage Association and Novo-Nordisk.

  • Funding agencies: Study was funded by National Institutes of Health (NIH) grant AT1103 to Temple University (GDF), NIH grant UL1RR024134 to University of Pennsylvania (DJR), NIH grant DK56341 to University of Washington (SK), NIH grant K12 HL083772-01 (ERM) and American Heart Association Scientist Development Grant (KB).

Abstract

Objective: The effect of weight loss on obesity-associated endothelial dysfunction is not clear because of conflicting data, demonstrating both improvement and no change in endothelial function after weight loss in obese subjects. A 2-year prospective study (n = 121) was conducted to examine: (1) the effect of obesity and weight loss (either a low-carbohydrate or and low-fat diet) on flow mediated vasodilatation (FMD), a measure of endothelial function.

Design and Methods: Participants reduced body weight by 7.1% ± 4.4%, 8.7% ± 6.8%, 7.1% ± 7.8%, and 4.1% ± 7.7% at 3, 6, 12, and 24 months, respectively with no significant differences between the low-fat and low-carbohydrate groups.

Results: Endothelial function was inversely correlated with waist circumference, triglyceride level, and directly correlated with leptin in obese persons prior to weight loss. These weight losses did not confer any improvements in FMD. There were no differences between the low-fat and low-carbohydrate diets in FMD at any time point. At 6 months (r = 0.26, P = 0.04) and 1 year (r =0.28, P = 0.03), there were positive correlations between change in FMD and change in leptin but not at 2 years.

Conclusion: There was no significant improvement in endothelial function after 7.1% ± 7.8% weight loss at 1 year and 4.1% ± 7.7% at 2 years, achieved by either a low carbohydrate or a low fat diet.

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