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Item #5
High-Saturated-Fat,
Low-Starch Diet Safe, Effective for Weight Loss in Patients on Statins
After
six weeks of diet treatment showed patients lost 5.14 percent of their
total body weight.
A
diet high in saturated fats and low in starch produced dramatic weight
loss without adverse effects on lipid profiles in obese,
atherosclerotic patients treated to goal with statins.
The
findings were presented here Friday by Michael Stillabower, MD, and
colleagues at Mill Creek Medical Center, Wilmington, Delaware, United
States, at the annual meeting of the American Association of Clinical
Endocrinologists (AACE).
The
study enrolled 23 nondiabetic patients, all with atherosclerotic
cardiovascular disease but without acute events in the previous six
months. All patients had a body mass index of greater than 27 (mean
37.3±5.9), and all had low-density lipoprotein (LDL) levels treated
to goal with statins (3-hydroxy-3-methylglutaryl-CoA reductase
inhibitors). Statins were continued at the same dose throughout the
study.
After
baseline morphometric and laboratory measurements, patients were
prescribed a diet with 50 percent of calories from saturated fat, 20
percent from protein, and 30 percent from carbohydrate. Minimum
calorie intake was 1,800 kcal/day. Patients were encouraged to consume
plentiful amounts of fruits and vegetables.
Repeat
measurements after six weeks of diet treatment showed patients lost
5.14±2.42 percent of their total body weight. There were
corresponding decreases in neck, waist, and hip circumference. Lipid
profiles were unchanged except for a decrease in serum triglycerides
from 140.3±84.8 to 85.6±42.1 mg/dL. Fasting plasma glucose and
fasting plasma insulin both decreased, presumably reflecting the
increased insulin sensitivity typically associated with weight loss.
Mean
systolic blood pressure decreased by 8.0±4.1 mm Hg (p=0.07), and mean
diastolic pressure decreased by 4.8±2.6 mm Hg (p=0.09). This decrease
in blood pressure was not significant..
Although
the diet was nonketotic by design, five patients had detectable urine
and serum ketones at the end of the study. Four of these five were
ketotic at baseline, and there was no significant difference in weight
loss between patients who did and did not excrete ketones.
Plasma
levels of homocysteine and C-reactive protein demonstrated a
statistically significant increase, although levels of these
inflammatory markers remained below those typically associated with
cardiovascular risk. Flow-mediated brachial artery dilation decreased,
an effect that has been previously associated with high-fat meals.
However, the post-diet levels were outside the range typically
associated with cardiovascular risk.
"This
is more of a feasibility or pilot study," said study author James
Hays, MD, in an interview with Doctor's Guide. "What you'd really
want to do is another group in which you induced comparable weight
loss and see if these lipid levels hold up. Ideally we'd like to do
that in people not taking lipid-lowering medication," since the
statins may have blocked the expected adverse changes in lipid
profiles in this study.
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