Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity

BACKGROUND: The effects of a very-low-carbohydrate, high-saturated-fat weight-loss diet (LC) on brachial artery flow-mediated dilatation (FMD) and markers of endothelial function are unknown. OBJECTIVE: The effect of an LC on markers of endothelial function and cardiovascular disease (CVD) risk was compared with that of an isocaloric high-carbohydrate, low-saturated-fat diet (HC). DESIGN: FMD and markers of endothelial function (n = 70) and CVD risk were measured before and after 8 wk of weight loss. Ninety-nine subjects aged 50.0 ± 8.3 y with a body mass index (in kg/m²) of 33.7 ± 4.1 completed the study. RESULTS: Mean (±SD) FMD did not change significantly (P = 0.55) with either diet. Pulse wave velocity improved with both diets (P < 0.01). Endothelial markers, E- and P selectin, intracellular and cellular-adhesion molecule-1, tissue-type plasminogen activator, and plasminogen activator inhibitor-1 decreased (P < 0.001), with no diet effect. Adiponectin did not change significantly. More weight (P = 0.05 for diet x time interaction) and more abdominal fat mass (P = 0.05 for diet x time interaction) were lost with the LC than with the HC. LDL cholesterol decreased more with the HC than with the LC (P < 0.05, time x diet), and C-reactive protein decreased more with the HC than with the LC (P < 0.05 for diet x time interaction). Homocysteine increased more with the LC (P < 0.01 for diet x time interaction). Folate decreased with the LC and increased with the HC (P < 0.05, time; P < 0.001 for diet x time interaction). CONCLUSION: An LC does not impair FMD. We observed beneficial effects of both diets on most of the CVD risk factors measured. This trial was registered with the Australian Clinical Trials Registry as ACTR N0 12606000203550.