Very Low-Carbohydrate High-Fat Diet Improves Risk Markers for Cardiometabolic Health More Than Exercise in Men and Women With Overfat Constitution: Secondary Analysis of a Randomized Controlled Clinical Trial
Abstract:PurposeThis randomized controlled parallel-group study examined the effects of a very low-carbohydrate high-fat (VLCHF) diet and high-intensity interval training (HIIT) program over 12-weeks on cardiometabolic risk factors in individuals with overfat constitution.MethodsNinety-one participants out of 109 completed the study. The participants were randomly allocated to the HIIT (N = 22), VLCHF (N = 25), VLCHF+HIIT (N = 25), or control (N = 19) groups for 12 weeks. Fasting plasma samples were collected before th… Show more
“…In addition, 1 study was included after updating the search [ 53 ]. Finally, 47 randomized trials (parallel-arm trials) were included in the meta-analysis, of which 6 included Ex and DI [ [54] , [55] , [56] , [57] , [58] , [59] ], 22 included Ex + DI and DI [ [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] ], 2 included Ex + DI and Ex [ 82 , 83 ], and 17 included Ex + DI, Ex, and DI [ 53 , [84] , [85] , [86] , [87] , [88] , [89] , [90] , [91] , [92] , [93] , [94] , [95] , [96] , [97] , [98] , [99] ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Five studies included only male participants [ 54 , 56 , 57 , 89 , 94 ], whereas 16 studies included only female participants [ 59 , 60 , [66] , [67] , [68] , 71 , 73 , 77 , 78 , 80 , 83 , 84 , 86 , [90] , [91] , [92] ]. The remaining 26 studies included both male and female participants [ 53 , 55 , 58 , [61] , [62] , [63] , [64] , [65] , 69 , 70 , 72 , [74] , [75] , [76] , 79 , 81 , 82 , 85 , 87 , 88 , 93 , [95] , [96] , [97] , [98] , [99] ]. All the participants were overweight or had obesity, with a wide range of health and chronic diseases, including metabolic syndrome, type 2 diabetes, nonalcoholic fatty liver disease, chronic kidney disease, and asthma ( Table 1 ).…”
Section: Resultsmentioning
confidence: 99%
“…(2014) [ 81 ] 89 (EX + DI: 44; DI: 45) F (76%)/M (24%) Leptin EX + DI: 61.00 ± 7.75 DI: 52.00 ± 8.49 EX + DI: 27.30 ± 4.26 DI: 28.40 ± 4.24 Overweight Healthy Cipryan et al. (2022) [ 53 ] 88 (EX + DI: 30; DI: 30; EX: 28) F (71%)/M (29%) Leptin, adiponectin EX + DI: 42.00 ± 14.94 DI: 43.17 ± 12.97 EX: 46.03 ± 11.49 EX + DI: 31.10 ± 6.21 DI: 30.67 ± 4.17 EX: 28.83 ± 3.17 Obese Healthy DI, diet intervention; EX, exercise training. 1 n = 47 studies.…”
Section: Resultsmentioning
confidence: 99%
“…(2014) [ 81 ] Aerobic 60-min running, walking, and cycling at lactate threshold, 5 d/wk Supervised and nonsupervised Total energy intake of 25 kcal/kg of ideal body weight Mild 12 wk Cipryan et al. (2022) [ 53 ] HIT 4–8 sets of 3 min at a rating of 18–19 BRPE by 3-min recovery at a rating of 9–11 BRPE, 3 d/wk Nonsupervised Very-low-carbohydrate high-fat, maximum 50 g of carbohydrates per day Mild 12 wk DI, diet intervention; EX, exercise; HIT, high-intensity interval training; HR max/peak , maximal or peak heart rate; HRR, heart rate reverse; 1RM, one-repetition maximum; BRPE, Borg rating of perceived exertion; ND, not described. 1 n = 47 studies.…”
“…In addition, 1 study was included after updating the search [ 53 ]. Finally, 47 randomized trials (parallel-arm trials) were included in the meta-analysis, of which 6 included Ex and DI [ [54] , [55] , [56] , [57] , [58] , [59] ], 22 included Ex + DI and DI [ [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] ], 2 included Ex + DI and Ex [ 82 , 83 ], and 17 included Ex + DI, Ex, and DI [ 53 , [84] , [85] , [86] , [87] , [88] , [89] , [90] , [91] , [92] , [93] , [94] , [95] , [96] , [97] , [98] , [99] ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Five studies included only male participants [ 54 , 56 , 57 , 89 , 94 ], whereas 16 studies included only female participants [ 59 , 60 , [66] , [67] , [68] , 71 , 73 , 77 , 78 , 80 , 83 , 84 , 86 , [90] , [91] , [92] ]. The remaining 26 studies included both male and female participants [ 53 , 55 , 58 , [61] , [62] , [63] , [64] , [65] , 69 , 70 , 72 , [74] , [75] , [76] , 79 , 81 , 82 , 85 , 87 , 88 , 93 , [95] , [96] , [97] , [98] , [99] ]. All the participants were overweight or had obesity, with a wide range of health and chronic diseases, including metabolic syndrome, type 2 diabetes, nonalcoholic fatty liver disease, chronic kidney disease, and asthma ( Table 1 ).…”
Section: Resultsmentioning
confidence: 99%
“…(2014) [ 81 ] 89 (EX + DI: 44; DI: 45) F (76%)/M (24%) Leptin EX + DI: 61.00 ± 7.75 DI: 52.00 ± 8.49 EX + DI: 27.30 ± 4.26 DI: 28.40 ± 4.24 Overweight Healthy Cipryan et al. (2022) [ 53 ] 88 (EX + DI: 30; DI: 30; EX: 28) F (71%)/M (29%) Leptin, adiponectin EX + DI: 42.00 ± 14.94 DI: 43.17 ± 12.97 EX: 46.03 ± 11.49 EX + DI: 31.10 ± 6.21 DI: 30.67 ± 4.17 EX: 28.83 ± 3.17 Obese Healthy DI, diet intervention; EX, exercise training. 1 n = 47 studies.…”
Section: Resultsmentioning
confidence: 99%
“…(2014) [ 81 ] Aerobic 60-min running, walking, and cycling at lactate threshold, 5 d/wk Supervised and nonsupervised Total energy intake of 25 kcal/kg of ideal body weight Mild 12 wk Cipryan et al. (2022) [ 53 ] HIT 4–8 sets of 3 min at a rating of 18–19 BRPE by 3-min recovery at a rating of 9–11 BRPE, 3 d/wk Nonsupervised Very-low-carbohydrate high-fat, maximum 50 g of carbohydrates per day Mild 12 wk DI, diet intervention; EX, exercise; HIT, high-intensity interval training; HR max/peak , maximal or peak heart rate; HRR, heart rate reverse; 1RM, one-repetition maximum; BRPE, Borg rating of perceived exertion; ND, not described. 1 n = 47 studies.…”
“…Modest dietary changes can be more effective in the treatment of metabolic syndrome than commonly used antidiabetic drugs in improving CVD risk [163]. Specifically, improvement in the cluster of components of metabolic syndrome is intimately connected with carbohydrate restriction in adults [164–167,168 ▪ ,169 ▪ ,170 ▪ ,171,172 ▪▪ ,173–177,178 ▪▪ ,179–180,181 ▪ ] and in adolescents [182]. LCDs have been shown to improve other CVD risk factors, as well, such as visceral fat, blood pressure, Lp(a) and inflammation [183–189].…”
Section: Effects Of Low Carbohydrate Diets On Cardiovascular Disease ...mentioning
Purpose of reviewAlthough there is an extensive literature on the efficacy of the low carbohydrate diet (LCD) for weight loss and in the management of type 2 diabetes, concerns have been raised that the LCD may increase cardiovascular disease (CVD) risk by increasing the level of low-density lipoprotein cholesterol (LDL-C). We have assessed the value of LDL-C as a CVD risk factor, as well as effects of the LCD on other CVD risk factors. We have also reviewed findings that provide guidance as to whether statin therapy would be beneficial for individuals with high LDL-C on an LCD.
Recent findingsMultiple longitudinal trials have demonstrated the safety and effectiveness of the LCD, while also providing evidence of improvements in the most reliable CVD risk factors. Recent findings have also confirmed how ineffective LDL-C is in predicting CVD risk.
SummaryExtensive research has demonstrated the efficacy of the LCD to improve the most robust CVD risk factors, such as hyperglycemia, hypertension, and atherogenic dyslipidemia. Our review of the literature indicates that statin therapy for both primary and secondary prevention of CVD is not warranted for individuals on an LCD with elevated LDL-C who have achieved a low triglyceride/HDL ratio. Keywords atherogenic dyslipidemia, carbohydrate restriction, cardiovascular disease, insulin-resistant phenotype, ketogenic diet, metabolic syndrome, obesity '.. there are things we know we know. We also know there are known unknowns; that is to say, we know there are some things we do not know.'
Given their importance in predicting clinical outcomes, cardiorespiratory fitness (CRF) and muscle status can be considered new vital signs. However, they are not routinely evaluated in healthcare settings. Here, we present a comprehensive review of the epidemiological, mechanistic, and practical bases of the evaluation of CRF and muscle status in adults in primary healthcare settings. We highlight the importance of CRF and muscle status as predictors of morbidity and mortality, focusing on their association with cardiovascular and metabolic outcomes. Notably, adults in the best quartile of CRF and muscle status have as low as one-fourth the risk of developing some of the most common chronic metabolic and cardiovascular diseases than those in the poorest quartile. The physiological mechanisms that underlie these epidemiological associations are addressed. These mechanisms include the fact that both CRF and muscle status reflect an integrative response to the body function. Indeed, muscle plays an active role in the development of many diseases by regulating the body’s metabolic rate and releasing myokines, which modulate metabolic and cardiovascular functions. We also go over the most relevant techniques for assessing peak oxygen uptake as a surrogate of CRF and muscle strength, mass, and quality as surrogates of muscle status in adults. Finally, a clinical case of a middle-aged adult is discussed to integrate and summarize the practical aspects of the information presented throughout. Their clinical importance, the ease with which we can assess CRF and muscle status using affordable techniques, and the availability of reference values, justify their routine evaluation in adults across primary healthcare settings.
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