Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss

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URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6629108/pdf/jciinsight-4-128308.pdf

Journal: JCI Insight

Publication Date: 06/2019

Summary: Metabolic syndrome (MetS) is highly correlated with obesity and cardiovascular risk, but the importance of dietary carbohydrate independent of weight loss in MetS treatment remains controversial. Here, we test the theory that dietary carbohydrate intolerance (i.e., the inability to process carbohydrate in a healthy manner) rather than obesity per se is a fundamental feature of MetS. Individuals who were obese with a diagnosis of MetS were fed three 4-week weight- maintenance diets that were low, moderate, and high in carbohydrate. Protein was constant and fat was exchanged isocalorically for carbohydrate across all diets. Despite maintaining body mass, low-carbohydrate (LC) intake enhanced fat oxidation and was more effective in reversing MetS, especially high triglycerides, low HDL-C, and the small LDL subclass phenotype. Carbohydrate restriction also improved abnormal fatty acid composition, an emerging MetS feature. Despite containing 2.5 times more saturated fat than the high- carbohydrate diet, an LC diet decreased plasma total saturated fat and palmitoleate and increased arachidonate. Consistent with the perspective that MetS is a pathologic state that manifests as dietary carbohydrate intolerance, these results show that compared with eucaloric high- carbohydrate intake, LC/high-fat diets benefit MetS independent of whole-body or fat mass.

Key Takeaways

When the amount of protein remains constant, and carbohydrates are exchanged for fats in equal calorie amounts, diets low in carbohydrate perform better in reversing metabolic syndrome and increase fat burning. Additionally, higher saturated fat consumption was associated with decreased plasma levels of plasma saturated fats.

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