Published on January 20, 2012
Mangravite et al. Changes in atherogenic dyslipidemia induced by carbohydrate restriction in men are dependent on dietary protein source. J Nutr. 2011 Dec;141(12):2180-5 http://twitter.com/pronutritionistMangravite et al. J Nutr. 2011 Dec;141(12):2180-5 Page 1
Page 2 Pronutritionist’s background • In recent meta-analyses only marginal worsening of LDL cholesterol is found, if anything during low carbohydrate high fat diet. On the other hand, HDL cholesterolol, triglyserides and some measures of carbohydrate metabolism may be improved (Kirk et al. 2008) • In some previous short term studies, it’s been shown that low carbohydrate high saturated fat diets will increase LDL levels but improve holistic metabolic profiles in weight stable situation when diets include mixed protein sources and saturated fat mainly comes from dairy (Krauss et al. 2006) • Red and especially processed meat has been linked to higher cardiovascular risk in recent meta-analysis of prospective studies ( Micha&Mozaffarian 2009) • The effect of low carbohydrate diet when carbohydrates are replaced almost solely by red meat (beef) and high saturated fat intake is not known. • In Finland, red meat consumption is heavily promoted by many low carb diet advocates http://twitter.com/pronutritionistMangravite et al. J Nutr. 2011 Dec;141(12):2180-5 Page 2
Methods (patients) • Randomized trial, cross over • Primary outcomes: Changes in cardiovascular risk profile, such as LDL-, HDL-cholesterol, triglyserides, size of lipoprotein particles • Secondary outcomes: postprandial TG, glucose and insulin after fat challenge • N=40, healthy males (BMI 20-34) • Length: 3 weeks per arm, 2 week wash out • Run in (“baseline diet”): 2 weeks – Carbohydrates 50 E %, Protein 13 E %, Fat 38 E % – SFA 15 E %, PUFA 6 E %, MUFA 15 E % – Beef protein 0 E % • Experimental diets: Beef+ low SFA vs beef+ high SFA during restricted intake of carbohydrates (no intend to lose weight) • Entrees, lunch and dinner meals provided http://twitter.com/pronutritionistMangravite et al. J Nutr. 2011 Dec;141(12):2180-5 Page 3
Methods (schematic) Randomization Beef + high SFA version of low carb diet Beef + low SFA version of low carb diet Beef + high SFA version of low carb diet Beef + low SFA version of low carb diet Wash out 2 weeks3 weeks 3 weeks No beef, mixed other protein sources, high carbohydrate diet (50 % E), SFA intake 15 % E Run in diet (2 weeks) http://twitter.com/pronutritionistMangravite et al. J Nutr. 2011 Dec;141(12):2180-5 Page 4
Results (diet) Low SFA + Beef (low carb diet) High SFA +Beef (low carb diet) Total fat 38 E % 38 E % Carbohydrates 31 E % 31 E % Protein 32 E % 31 E % SFA 8 E % 15 E% PUFA 6 E % 5 E % MUFA 21 E % 15 E % Dietary intakes (as provided) http://twitter.com/pronutritionistMangravite et al. J Nutr. 2011 Dec;141(12):2180-5 Page 5
Results (lipids) Run in (SFA 15 E %, High Carb) Low SFA + Beef (low carb diet) High SFA +Beef (low carb diet) TG, mmol/l 1,22 1,0 1,1 LDL, mmol/l 2,87 2,5* 2,86 HDL, mmol/l 1,08 1,04* 1,07 Small LDL, nmol/l 207 187* 222 Medium LDL, “ 284 214* 304 Large LDL, “ 698 655 712 ApoB, g/l 0,74 0,68* 0,73 Fasting values (only statistical differences between low and high beef diet given in this table, see the full paper for details) *) p<0,05 low vs high SFA beef diets http://twitter.com/pronutritionistMangravite et al. J Nutr. 2011 Dec;141(12):2180-5 Page 6
Results (postprandial 49 g fat challenge as milkshake) • Plasma TG and apoB48 increased after fat load during all diets, and continued to increase throigh 6 hour period • At 6 h time point, baseline diet (run-in) provided higher TG values than either of two diets • TG iAUC was reduced following intake of low SFA vs high SFA period • Glucose iAUC was reduced following both LC diets vs baseline http://twitter.com/pronutritionistMangravite et al. J Nutr. 2011 Dec;141(12):2180-5 Page 7
Pronutritionist’s discussion • This was a weight stable study design, thus providing valuable information on weight independent situation • Authors state: “… reductions in the other lipoprotein-related risk factors, including apoB and small LDL, were greatest following consumption of a LCLSF diet” (Low Carbohydrate Low Saturated Fat) • High SFA-high beef-low carbohydrate diet did not deliver any significant benefit in cardiovascular risk markers when compared to high carbohydrate diet (run-in), apart from reduced triglycerides • In matter of fact, beef based high SFA low carbohydrate diet may have have deleterious health effects both in terms of LDL concentration and LDL particle size • Taken together the present and previous randomized observations, red and processed meat based high-saturated-fat LC diets seem to be a bad idea, as many prospective cohort studies have suggested • High saturated fat low carbohydrate diet does not improve LDL particle profile when main protein source is beef • This is a study by Ronald Krauss et co http://twitter.com/pronutritionistMangravite et al. J Nutr. 2011 Dec;141(12):2180-5 Page 8
Please read the whole paper at J Nutr. 2011 Dec;141(12):2180-5 http://twitter.com/pronutritionist Mangravite et al. J Nutr. 2011 Dec;141(12):2180-5Page 9
Follow me 24/09/13 http://twitter.com/pronutritionist http://www.facebook.com/pronutritionist http://www.pronutritionist.net Reijo Laatikainen, Authorized Nutritionist, MBA http://twitter.com/pronutritionist Mangravite et al. J Nutr. 2011 Dec;141(12):2180-5Page 10
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