Objective
To determine whether a diet of high saturated fat and avoidance of starch (HSF-SA)
results in weight loss without adverse effects on serum lipids in obese nondiabetic
patients.
Patients and Methods
Twenty-three patients with atherosclerotic cardiovascular disease participated in
a prospective 6-week trial at the Christiana Care Medical Center in Newark, Del, between
August 2000 and September 2001. All patients were obese (mean ± SD body mass index
[BMI], 39.0±7.3 kg/m2) and had been treated with statins before entry in the trial. Fifteen obese patients
with polycystic ovary syndrome (BMI, 36.1±9.7 kg/m2) and 8 obese patients with reactive hypoglycemia (BMI, 46.8±10 kg/m2) were monitored during an HSF-SA diet for 24 and 52 weeks, respectively, between
1997 and 2000.
Results
In patients with atherosclerotic cardiovascular disease, mean ± SD total body weight
(TBW) decreased 5.2%±2.5% (P<.001) as did body fat percentage (P =.02). Nuclear magnetic resonance spectroscopic analysis of lipids showed decreases
in total triglycerides (P<.001), very low-density lipoprotein (VLDL) triglycerides (P<.001), VLDL size (P<.001), large VLDL concentration (P<.001), and medium VLDL concentration (P<.001). High-density lipoprotein (HDL) and LDL concentrations were unchanged, but
HDL size (P =.01) and LDL size (P =.02) increased. Patients with polycystic ovary syndrome lost 14.3%±20.3% of TBW
(P =.008) and patients with reactive hypoglycemia lost 19.9%±8.7% of TBW (P<.001) at 24 and 52 weeks, respectively, without adverse effects on serum lipids.
Conclusion
An HSF-SA diet results in weight loss after 6 weeks without adverse effects on serum
lipid levels verified by nuclear magnetic resonance, and further weight loss with
a lipid-neutral effect may persist for up to 52 weeks.
Abbreviations:
ASCVD (atherosclerotic cardiovascular disease), BMI (body mass index), BOHB (β-hydroxybutyrate), CRP (C-reactive protein), HDL (high-density lipoprotein), HSF-SA (high saturated fat and avoidance of starch), LDL (low-density lipoprotein), NMR (nuclear magnetic resonance), PCOS (polycystic ovary syndrome), RH (reactive hypoglycemia), TBW (total body weight), TG (triglyceride), VLDL (very low-density lipoprotein)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Mayo Clinic ProceedingsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Prevalence and trends in obesity among US adults, 1999-2000.JAMA. 2002; 288: 1723-1727
- Obesity: impact on cardiovascular disease.Circulation. 1998; 98: 1472-1476
- Hypertriglyceridemia, atherogenic dyslipidemia, and the metabolic syndrome.Am J Cardiol. 1998; 81: 18B-25B
- Measurement of lipoprotein subclass profiles by nuclear magnetic resonance spectroscopy.in: Rifai N Warnick GR Dominiczak MH Handbook of Lipoprotein Testing. 2nd ed. AACC Press, Washington, DC2000: 609-623
- Results of use of metformin and replacement of starch with saturated fat in diets of patients with type 2 diabetes.Endocr Pract. 2002; 8: 177-183
- Metformin therapy in polycystic ovary syndrome reduces hyperinsulinemia, insulin resistance, hyperandrogenemia, and systolic blood pressure, while facilitating normal menses and pregnancy.Metabolism. 1994; 43: 647-654
- The insulin-sensitizing agent troglitazone improves metabolic and reproductive abnormalities in the polycystic ovary syndrome.J Clin Endocrinol Metab. 1996; 81: 3299-3306
- Hypoglycemic disorders in the adult.in: Becker KL Bilezikian JP Bremner WJ Principles and Practice of Endocrinology and Metabolism. 3rd ed. Lippincott Williams & Wilkins, Philadelphia, Pa2001: 1469-1477
- Dr. Atkins' New Diet Revolution. Avon Books, New York, NY1999: 57-64
- Influence of age and endurance training on metabolic rate and hormones in healthy men.Am J Physiol. 1990; 259: E66-E72
- Energy metabolism in sedentary and active 49- to 70-yr-old women.J Appl Physiol. 1998; 84: 1333-1340
- Circumferences.in: Lohman TG Roche AF Martorell R Anthropometric Standardization Reference Manual. Human Kinetics Books, Champaign, Ill1988: 39-54
- Effect of ingestion of meat on plasma cholesterol of vegetarians.JAMA. 1981; 246: 640-644
- Effects of dietary cholesterol and fatty acids on plasma lipoproteins.J Clin Invest. 1982; 69: 1072-1080
- Individual cholesterol variation in response to a margarine- or butter-based diet: a study in families.JAMA. 2000; 284: 2740-2747
- Normal plasma cholesterol in an 88-year-old man who eats 25 eggs a day: mechanisms of adaptation.N Engl J Med. 1991; 324: 896-899
- Effect of dietary stearic acid on plasma cholesterol and lipoprotein levels.N Engl J Med. 1988; 318: 1244-1248
- Effect of 6-month adherence to a very low carbohydrate diet program.Am J Med. 2002; 113: 30-36
- Effect of degree of weight loss on health benefits.Obes Res. 1995; 3: 211s-216s
- Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance.N Engl J Med. 2001; 344: 1343-1350
- Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.N Engl J Med. 2002; 346: 393-403
- Insulin and cardiovascular disease: Paris Prospective Study.Diabetes Care. 1991; 14: 461-469
- Hypertriglycer-idaemia as a risk factor of coronary heart disease mortality in subjects with impaired glucose tolerance or diabetes; results from the 11-year follow-up of the Paris Prospective Study.DiabetologiA. 1989; 32: 300-304
- Relation of lipoprotein subclasses as measured by proton nuclear magnetic resonance spectroscopy to coronary artery disease.Arterioscler Thromb Vasc Biol. 1998; 18: 1046-1053
- Plasma homocysteine levels and mortality in patients with coronary artery disease.N Engl J Med. 1997; 337: 230-236
- Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events.N Engl J Med. 2002; 347: 1557-1565
- Effect of diet composition on metabolic adaptations to hypocaloric nutrition: comparison of high carbohydrate and high fat isocaloric diets.Am J Clin Nutr. 1977; 30: 160-170
Article Info
Footnotes
Research grant funding by the Department of Medicine at Christiana Care Health Services, Inc.
Identification
Copyright
© 2003 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- The Search for the Perfect Heart-Healthy DietMayo Clinic ProceedingsVol. 78Issue 11
- PreviewFor the past 2 decades, obesity has steadily increased in the United States and is now paralleled with an obesity-driven increase in type 2 diabetes in both adults and children.1 At the same time, the National Cholesterol Education Program (NCEP) of the American Heart Association, the American College of Cardiology, the American Medical Association, and other medical groups have developed extensive guidelines to decrease low-density lipoprotein (LDL) cholesterol and modify other risk factors with the hope of decreasing the incidence of heart disease.
- Full-Text
- Preview
