Effect of dietary composition of weight loss diets on high-sensitivity c-reactive protein: The Randomized POUNDS LOST trial§

Authors


  • Clinical Trial Registration: NCT00072995.

  • Disclosure: Dr. P.M. Ridker is listed as a co-inventor on patents held by the Brigham and Women's Hospital that relate to the use of inflammatory biomarkers in cardiovascular disease. Dr. P.M. Ridker has received research funding support from Astra-Zeneca, Novartis, and Sanofi-Aventis unrelated to this project. No other relationships disclosed.

  • §

    Relevant conflicts of interest/financial disclosures: Nothing to report. Full financial disclosures and author notes may be found in the online version of this article

  • Funding agencies: The POUNDS LOST study was supported by grants from the National Heart, Lung, and Blood Institute (HL073286) and the General Clinical Research Center, National Institutes of Health (RR-02635). Dr. J.M. Nicklas was supported by an Institutional National Research Service Award #T32AT000051 from the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health.

Abstract

Objective:

Overweight and obesity are associated with increased high-sensitivity C-reactive protein (hsCRP) levels. The purpose of this study was to determine if weight loss diets differing in fat, protein, or carbohydrate composition differentially reduce hsCRP.

Design and Methods:

POUNDS (preventing overweight using novel dietary strategies) LOST was a 2-year trial of overweight and obese adults randomly allocated to one of four weight loss diets with targeted percentages of energy derived from fat, protein, and carbohydrates (20, 15, 65%; 20, 25, 55%; 40, 15, 45%; 40, 25, 35%, respectively). hsCRP was measured at baseline, 6, and 24 months among 710 participants, and adiposity as measured by dual X-ray absorptiometry (N = 340) or abdominal computed tomography (N = 126) was correlated with hsCRP change.

Results:

At 6 months, hsCRP was reduced in all trial participants by −24.7% (Interquartile range (IQR) +7%, −50%), weight by −6.7% (IQR −3%, −11%), and waist circumference by −6.0% (IQR −3%, −10%) (all P < 0.002), with no significant differences according to dietary composition. The percent change in hsCRP at 6 and 24 months correlated modestly with change in weight, waist circumference, fasting insulin, fasting glucose, HOMA, and most lipid levels. Reductions in hsCRP persisted despite ∼ 50% regain of weight by 24 months. The percent change in hsCRP at 24 months significantly correlated with changes in total body fat (r = 0.42), total abdominal adiposity (r = 0.52), subcutaneous abdominal adiposity (r = 0.52), visceral adiposity (r = 0.47), and hepatic tissue density (r = −0.34) (all P < 0.0006).

Conclusion:

Weight loss decreased hsCRP by similar magnitude, irrespective of dietary composition. Clinicians concerned about inflammation and cardiovascular risk should recommend weight loss diets most likely to succeed for their patients.

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