The use of dietary carbohydrate restriction as an effective approach to improve features of the metabolic syndrome
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Since the authors proposed that the biological markers improved by carbohydrate restriction are those that define the metabolic syndrome, this 12-week study including 40 subjects with atherogenic dyslipidaemia compared the effects on biological markers of the metabolic syndrome and/or cardiovascular risk of two hypocaloric diets, a carbohydrate-restricted diet (CRD) and a low-fat diet (LFD). Although both interventions resulted in improvements of several metabolic markers, the CRD group showed consistently reduced glucose and insulin concentrations, improved insulin sensitivity, weight loss, decreased adiposity, and more favourable triacylglycerol, HDL cholesterol and total cholesterol/HDL cholesterol ratio responses. Moreover, the CRD group displayed more favourable responses to alternative indicators of cardiovascular risks: postprandial triglycerides, Apo B/Apo A-1 ratio, and LDL particle distribution. Compared to the LFD group, saturated fatty acids in triglycerides and cholesteryl ester as well as palmitoleic acid (a marker of lipogenesis) were significantly decreased despite a threefold higher intake of dietary saturated fat. Only in the CRD group was serum retinol binding protein 4, which has been linked to insulin-resistant states, decreased. These findings support the carbohydrate unifying hypothesis underlying the metabolic syndrome, as well as the use of dietary carbohydrate restriction as an effective approach to improve features of the metabolic syndrome and cardiovascular risk.
Abstract
