Objective: High fat, low carbohydrate (HFLC) diets have become popular tools for weight management. We sought to determine the effects of a HFLC diet compared to a low fat high carbohydrate (LFHC) diet on the change in weight loss, cardiovascular risk factors and inflammation in subjects with obesity.
Methods: Obese subjects (29.0-44.6 kg/m2) recruited from Boston Medical Center were randomized to a hypocaloric LFHC (n=26) or HFLC (n=29) diet for 12 weeks.
Results: The age range of subjects was 21-62 years. As a percentage of daily calories, the HFLC group consumed 33.5% protein, 56.0% fat and 9.6% carbohydrate and the LFHC group consumed 22.0% protein, 25.0% fat and 55.7% carbohydrate. The change in percent body weight, lean and fat mass, blood pressure, flow mediated dilation, hip:waist ratio, hemoglobin A1C, fasting insulin and glucose, and glucose and insulin response to a 2h oral glucose tolerance test did not differ (P>0.05) between diets after 12 weeks. The HFLC group had greater mean decreases in serum triglyceride (P=0.07), and hs-CRP (P=0.03), and greater mean increases in HDL cholesterol (P=0.004), and total adiponectin (P=0.045) relative to the LFHC. Secreted adipose tissue adiponectin or TNF-α did not differ after weight loss for either diet.
Conclusions: Relative to the LFHC group, the HFLC group had greater improvements in blood lipids and systemic inflammation with similar changes in body weight and composition. This small-scale study suggests that HFLC diets may be more beneficial to cardiovascular health and inflammation in free-living obese adults compared to LFHC diets.
Keywords: AUC; BMI; Cardiovascular; DXA; ELISA; FMD; HDL; HFLC; HMW; HOMA-IR; HbA1C; Inflammation; LDL; LFHC; Macronutrients; OGTT; TNF-α; Weight loss; area under the curve; body mass index; dual energy x-ray absorptiometry; enzyme-linked immunosorbent assay; flow mediated dilation; hemoglobin A1C; high density lipoprotein; high fat low carbohydrate; high molecular weight; high sensitivity-C-reactive protein; homeostatic model assessment-insulin resistance; hs-CRP; low density lipoprotein; low fat high carbohydrate; oral glucose tolerance test; tumor necrosis factor-alpha.