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Negative effect of a low-carbohydrate, high-protein, high-fat diet on small peripheral artery reactivity in patients with increased cardiovascular risk

  • Jordi Merino (a1), Richard Kones (a2), Raimon Ferré (a1), Núria Plana (a1), Josefa Girona (a1), Gemma Aragonés (a1), Daiana Ibarretxe (a1), Mercedes Heras (a1) and Luis Masana (a1)...
Abstract

Low-carbohydrate diets have become increasingly popular for weight loss. Although they may improve some metabolic markers, particularly in type 2 diabetes mellitus (T2D) or the metabolic syndrome (MS), their net effect on arterial wall function remains unclear. The objective was to evaluate the relation between dietary macronutrient composition and the small artery reactive hyperaemia index (saRHI), a marker of small artery endothelial function, in a cohort of patients at increased cardiovascular (CV) risk. The present cross-sectional study included 247 patients. Diet was evaluated by a 3-d food-intake register and reduced to a novel low-carbohydrate diet score (LCDS). Physical examination, demographic, biochemical and anthropometry parameters were recorded, and the saRHI was measured in each patient. Individuals in the lowest LCDS quartile (Q1, 45 % carbohydrate; 20 % protein; 32 % fat) had higher saRHI values than those in the top quartile (Q4, 29 % carbohydrate, 24 % protein, 40 % fat; 1·66 (sd 0·41) v. 1·52 (sd 0·22), P= 0·037). These results were particularly strong in patients with the MS (Q1 = 1·82 (sd 0·32) v. Q4 = 1·61 (sd 027); P= 0·021) and T2D (Q1 = 1·78 (sd 0·31) v. Q4 = 1·62 (sd 0·35); P= 0·011). Multivariate analysis demonstrated that individuals in the highest LCDS quartile had a significantly negative coefficient of saRHI, which was independent of confounders (OR − 0·85; 95 % CI 0·19, 0·92; P= 0·031). These findings suggest that a dietary pattern characterised by a low amount of carbohydrate, but high amounts of protein and fat, is associated with a poorer small artery vascular reactivity in patients with increased CV risk.

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*Corresponding author: J. Merino, fax +34 977319984, E-mail: jordi.merino@urv.cat
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1 RM Krauss , RH Eckel , B Howard , et al. (2000) AHA Dietary Guidelines: revision 2000: a statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Stroke 31, 27512766.

2 S Cummings , ES Parham & GW Strain (2002) Position of the American Dietetic Association: weight management. J Am Diet Assoc 102, 11451155.

3 MR Flock & PM Kris-Etherton (2011) Dietary Guidelines for Americans 2010: implications for cardiovascular disease. Curr Atheroscler Rep 13, 499507.

4 TL Halton , WC Willett , S Liu , et al. (2006) Low-carbohydrate-diet score and the risk of coronary heart disease in women. N Engl J Med 355, 19912002.

5 L de Koning , TT Fung , X Liao , et al. (2011) Low-carbohydrate diet scores and risk of type 2 diabetes in men. Am J Clin Nutr 93, 844850.

6 JT Kuvin , AR Patel , KA Sliney , et al. (2003) Assessment of peripheral vascular endothelial function with finger arterial pulse wave amplitude. Am Heart J 146, 168174.

7 A Nohria , M Gerhard-Herman , MA Creager , et al. (2006) Role of nitric oxide in the regulation of digital pulse volume amplitude in humans. J Appl Physiol 101, 545548.

8 DS Celermajer (2008) Reliable endothelial function testing at our fingertips? Circulation 117, 24282430.

9 M Dhindsa , SM Sommerlad , AE DeVan , et al. (2008) Interrelationships among noninvasive measures of postischemic macro- and microvascular reactivity. J Appl Physiol 105, 427432.

10 R Ferre , N Plana , J Merino , et al. (2012) Effects of therapeutic lifestyle changes on peripheral artery tonometry in patients with abdominal obesity. Nutr Metab Cardiovasc Dis 22, 95102.

12 R Elosua , M Garcia , A Aguilar , et al. (2000) Validation of the Minnesota leisure time physical activity questionnaire in Spanish women. Investigators of the MARATDON Group. Med Sci Sports Exerc 32, 14311437.

13 CC DiClemente , JO Prochaska , SK Fairhurst , et al. (1991) The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol 59, 295304.

14 PO Bonetti , GM Pumper , ST Higano , et al. (2004) Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia. J Am Coll Cardiol 44, 21372141.

15 NM Hamburg , MJ Keyes , MG Larson , et al. (2008) Cross-sectional relations of digital vascular function to cardiovascular risk factors in the Framingham Heart Study. Circulation 117, 24672474.

16 HS Dod , R Bhardwaj , V Sajja , et al. (2010) Effect of intensive lifestyle changes on endothelial function and on inflammatory markers of atherosclerosis. Am J Cardiol 105, 362367.

17 M Miller , V Beach , JD Sorkin , et al. (2009) Comparative effects of three popular diets on lipids, endothelial function, and C-reactive protein during weight maintenance. J Am Diet Assoc 109, 713717.

18 TP Wycherley , GD Brinkworth , JB Keogh , et al. (2010) Long-term effects of weight loss with a very low carbohydrate and low fat diet on vascular function in overweight and obese patients. J Intern Med 267, 452461.

19 SA Phillips , JW Jurva , AQ Syed , et al. (2008) Benefit of low-fat over low-carbohydrate diet on endothelial health in obesity. Hypertension 51, 376382.

20 GD Foster , HR Wyatt , JO Hill , et al. (2003) A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med 348, 20822090.

21 CD Gardner , A Kiazand , S Alhassan , et al. (2007) Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A to Z Weight Loss Study: a randomized trial. JAMA 297, 969977.

23 PM Clifton , JB Keogh , PR Foster , et al. (2005) Effect of weight loss on inflammatory and endothelial markers and FMD using two low-fat diets. Int J Obes (Lond) 29, 14451451.

25 LA Ferrara , P Innelli , V Palmieri , et al. (2006) Effects of different dietary protein intakes on body composition and vascular reactivity. Eur J Clin Nutr 60, 643649.

26 GL Pierce , SD Beske , BR Lawson , et al. (2008) Weight loss alone improves conduit and resistance artery endothelial function in young and older overweight/obese adults. Hypertension 52, 7279.

27 RD Brook (2006) Obesity, weight loss, and vascular function. Endocrine 29, 2125.

28 SY Foo , ER Heller , J Wykrzykowska , et al. (2009) Vascular effects of a low-carbohydrate high-protein diet. Proc Natl Acad Sci U S A 106, 1541815423.

29 SA Phillips (2007) Effects of low-carbohydrate diet on vascular health: more than just weight loss. Am J Physiol Heart Circ Physiol 292, H2037H2039.

30 JS Volek , KD Ballard , R Silvestre , et al. (2009) Effects of dietary carbohydrate restriction versus low-fat diet on flow-mediated dilation. Metabolism 58, 17691777.

31 NM Hamburg , J Palmisano , MG Larson , et al. (2011) Relation of brachial and digital measures of vascular function in the community: The Framingham Heart Study. Hypertension 57, 390396.

32 SL Bacon , KL Lavoie , A Arsenault , et al. (2011) The research on endothelial function in women and men at risk for cardiovascular disease (REWARD) study: methodology. BMC Cardiovasc Disord 11, 50.

33 J Lekakis , P Abraham , A Balbarini , et al. (2011) Methods for evaluating endothelial function: a position statement from the European Society of Cardiology Working Group on Peripheral Circulation. Eur J Cardiovasc Prev Rehabil 18, 775789.

34 RB Schnabel , A Schulz , PS Wild , et al. (2011) Noninvasive vascular function measurement in the community: cross-sectional relations and comparison of methods. Circ Cardiovasc Imaging 4, 371380.

35 P Chouraqui , RP Schnall , I Dvir , et al. (2002) Assessment of peripheral artery tonometry in the detection of treadmill exercise-induced myocardial ischemia. J Am Coll Cardiol 40, 21952200.

36 R Rubinshtein , JT Kuvin , M Soffler , et al. (2010) Assessment of endothelial function by non-invasive peripheral arterial tonometry predicts late cardiovascular adverse events. Eur Heart J 31, 11421148.

37 N Plana , R Ferre , J Merino , et al. (2011) Heterozygous familial hypercholesterolaemic patients have increased arterial stiffness, as determined using the augmentation index. J Atheroscler Thromb 18, 11101116.

38 D Versari , E Daghini , A Virdis , et al. (2009) Endothelial dysfunction as a target for prevention of cardiovascular disease. Diabetes Care 32, Suppl. 2, S314S321.

39 G Aragones , R Ferre , J Girona , et al. (2012) Small artery dilation and endothelial markers in cardiovascular risk patients. Eur J Clin Invest 42, 3441.

40 R Ferre , G Aragones , N Plana , et al. (2011) High-density lipoprotein cholesterol and apolipoprotein A1 levels strongly influence the reactivity of small peripheral arteries. Atherosclerosis 216, 115119.

41 J Yeboah , JR Crouse , FC Hsu , et al. (2007) Brachial flow-mediated dilation predicts incident cardiovascular events in older adults: the Cardiovascular Health Study. Circulation 115, 23902397.

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British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
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