Differential effects of low-carbohydrate and low-fat diets on inflammation and endothelial function in diabetes

J Diabetes Complications. Nov-Dec 2011;25(6):371-6. doi: 10.1016/j.jdiacomp.2011.08.001. Epub 2011 Oct 27.

Abstract

Objective: To characterize acute (postprandial) and chronic (after a 6-month period of weight loss) effects of a low-carbohydrate vs. a low-fat diet on subclinical markers of cardiovascular disease (CVD) in adults with type 2 diabetes.

Design: At baseline and 6 months, measures of C-reactive protein (CRP), interleukin-6 (IL-6), soluble intercellular adhesion molecule (sICAM) and soluble E-selectin were obtained from archived samples (n = 51) of participants randomized in a clinical trial comparing a low-carbohydrate and a low-fat diet. In a subset of participants (n = 27), postprandial measures of these markers were obtained 3 h after a low-carbohydrate or low-fat liquid meal. Endothelial function was also measured by reactive hyperemic peripheral arterial tonometry during the meal test. Paired t tests and unpaired t tests compared within- and between-group changes.

Results: There were no significant differences observed in postprandial measures of inflammation or endothelial function. After 6 months, CRP (mean ± S.E.) decreased in the low-fat arm from 4.0 ± 0.77 to 3.0 ± 0.77 (P = .01). In the low-carbohydrate arm, sICAM decreased from 234 ± 22 to 199 ± 23 (P = .001), and soluble E-selectin decreased from 93 ± 10 to 82 ± 10 (P = .05.) A significant correlation between change in high-density lipoprotein and change in soluble E-selectin (r = -0.33, P = .04) and with the change in ICAM (r = -0.43, P = .01) was observed.

Conclusions: Low-carbohydrate and low-fat diets both have beneficial effects on CVD markers. There may be different mechanisms through which weight loss with these diets potentially reduces CVD risk.

Trial registration: ClinicalTrials.gov NCT00795691.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / prevention & control*
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Diabetes Mellitus, Type 2 / immunology
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diet, Carbohydrate-Restricted* / adverse effects
  • Diet, Fat-Restricted* / adverse effects
  • E-Selectin / blood
  • E-Selectin / chemistry
  • Endothelium, Vascular / immunology
  • Endothelium, Vascular / physiopathology*
  • Female
  • Humans
  • Intercellular Adhesion Molecule-1 / blood
  • Intercellular Adhesion Molecule-1 / chemistry
  • Lipoproteins, HDL / blood
  • Male
  • Microcirculation
  • Middle Aged
  • Overweight / complications
  • Postprandial Period
  • Solubility
  • Vascular Resistance
  • Weight Loss

Substances

  • Biomarkers
  • E-Selectin
  • Lipoproteins, HDL
  • SELE protein, human
  • Intercellular Adhesion Molecule-1
  • C-Reactive Protein

Associated data

  • ClinicalTrials.gov/NCT00795691