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| |  Weight-Loss Diets May Reverse Atherosclerosis in Obese, Overweight People DALLAS -- March 3, 2010 -- A low-carbohydrate diet, a low-fat diet, and the Mediterranean diet were equally effective in helping obese people to reverse carotid atherosclerosis after losing moderate amounts of weight and improving their blood pressure, according to a study published in Circulation: Journal of the American Heart Association. Researchers investigated whether 3 diets could reverse atherosclerosis among overweight participants, mostly men, who were at high risk for atherosclerosis. After 2 years, researchers noted a significant 5% regression in average carotid vessel-wall volume and 1.1% decrease in carotid artery thickness. Compared with participants who had increased carotid wall volume, those with decreases had other improvements: greater weight loss (5.3 kg vs 3.5 kg); decreased systolic blood pressure levels (6.8 mmHg vs 1.1 mmHg); improved homocysteine levels; and an increase in apolipoprotein A1 (Apo A1). The researchers said, beyond drug treatment, the data is some of the earliest showing the potential of diet as a lifestyle modification strategy to prevent atherosclerosis. The findings indicate that sustained, moderate weight loss -- not the macronutrient content of the different diets -- leads to improved cardiovascular health. “Long-term adherence to weight-loss diets is effective for reversing carotid atherosclerosis as long as we stick to 1 of the current options of healthy diet strategy,” said lead author Iris Shai, PhD, Ben-Gurion University of the Negev, Beer-Sheva, Israel. “This effect is more pronounced among mildly obese persons who lose more than 5.5 kg of body weight and whose systolic blood pressure decreases by more than 7 mmHg. An increase in ApoA1 and a decrease in total homocysteine blood levels are further associated with subsequent success in reversing carotid atherosclerosis.” Researchers studied 140 people (88%, mean age 51 years, mean BMI 30.4 kg/m2) from the Nuclear Research Center Negev who were randomly assigned to a low-carbohydrate, low-fat or Mediterranean diet as part of the Dietary Intervention Randomised Controlled Trial-Carotid (DIRECT-Carotid) study. Twenty-six percent of participants used lipid-lowering therapies, including 20% on statins, and nearly one-third of the group took blood pressure medication. They continued with their prescribed treatments throughout the study. Blood pressure was measured every 3 months, and blood samples to measure biomarkers such as homocysteine levels were collected after a 12-hour fast, at baseline, at 6 months, and again at 24 months. Researchers used ultrasound to capture 3-dimensional images of the carotid artery wall and to measure changes in arterial thickness at baseline and at the 2-year follow-up. Participants maintained food diaries and responded to diet questionnaires periodically throughout the study. While caloric deficits were similar among the 3 groups, intake of carbohydrates, fiber, dietary cholesterol, and monounsaturated and saturated fats varied, depending on the type of diet. However, these variations in nutrient intake did not produce significant differences in the outcomes. The study’s findings are promising and could be applicable to other populations. But since few women were in the study, gender-specific effects remain unknown, researchers said.
SOURCE: American Heart Association
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