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Effect of a High Saturated Fat and No-Starch Diet on Serum Lipid Subfractions in Patients With Documented Atherosclerotic Cardiovascular Disease


      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.


      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.


      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.


      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)
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      • The Search for the Perfect Heart-Healthy Diet
        Mayo Clinic ProceedingsVol. 78Issue 11
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          For 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.
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