An isoenergetic very low carbohydrate diet improves serum HDL cholesterol and triacylglycerol concentrations, the total cholesterol to HDL cholesterol ratio and postprandial pipemic responses compared with a low fat diet in normal weight, normolipidemic women

J Nutr. 2003 Sep;133(9):2756-61. doi: 10.1093/jn/133.9.2756.


Very low carbohydrate diets are popular, yet little is known about their effects on blood lipids and other cardiovascular disease risk factors. We reported previously that a very low carbohydrate diet favorably affected fasting and postprandial triacylglycerols, LDL subclasses and HDL cholesterol (HDL-C) in men but the effects in women are unclear. We compared the effects of a very low carbohydrate and a low fat diet on fasting lipids, postprandial lipemia and markers of inflammation in women. We conducted a balanced, randomized, two-period, crossover study in 10 healthy normolipidemic women who consumed both a low fat (<30% fat) and a very low carbohydrate (<10% carbohydrate) diet for 4 wk each. Two blood draws were performed on separate days at 0, 2 and 4 wk and an oral fat tolerance test was performed at baseline and after each diet period. Compared with the low fat diet, the very low carbohydrate diet increased (P <or= 0.05) fasting serum total cholesterol (16%), LDL cholesterol (LDL-C) (15%) and HDL-C (33%) and decreased serum triacylglycerols (-30%), the total cholesterol to HDL ratio (-13%) and the area under the 8-h postprandial triacylglycerol curve (-31%). There were no significant changes in LDL size or markers of inflammation (C-reactive protein, interleukin-6, tumor necrosis factor-alpha) after the very low carbohydrate diet. In normal weight, normolipidemic women, a short-term very low carbohydrate diet modestly increased LDL-C, yet there were favorable effects on cardiovascular disease risk status by virtue of a relatively larger increase in HDL-C and a decrease in fasting and postprandial triaclyglycerols.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Weight
  • C-Reactive Protein / analysis
  • Cholesterol / blood*
  • Cholesterol, HDL / blood*
  • Cross-Over Studies
  • Cytokines / blood
  • Diet, Fat-Restricted
  • Dietary Carbohydrates / adverse effects*
  • Dose-Response Relationship, Drug
  • Energy Metabolism*
  • Female
  • Humans
  • Inflammation Mediators / blood
  • Lipids / blood*
  • Osmolar Concentration
  • Postprandial Period
  • Reference Values
  • Triglycerides / blood*


  • Cholesterol, HDL
  • Cytokines
  • Dietary Carbohydrates
  • Inflammation Mediators
  • Lipids
  • Triglycerides
  • C-Reactive Protein
  • Cholesterol