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American Journal of Clinical Nutrition, Vol. 86, No. 4, 946-951, October 2007
© 2007 American Society for Nutrition

ORIGINAL RESEARCH COMMUNICATION

Effects of moderate variations in the macronutrient content of the diet on cardiovascular disease risk factors in obese patients with the metabolic syndrome1,2,3

Fulvio Muzio, Luca Mondazzi, William S Harris, Domenico Sommariva and Adriana Branchi

1 From the Clinical Nutrition Unit (FM and LM) and the Department of Internal Medicine (DS), G Salvini Hospital, Garbagnate Milanese, Milan, Italy; the Nutrition and Metabolic Disease Research Institute, South Dakota Health Research Foundation, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD (WSH); and the Department of Internal Medicine, University of Milan, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico. Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy (AB)

Background: The metabolic syndrome is a cluster of abnormalities that is accompanied by a 2-fold increase in the risk of cardiovascular disease. Even if there is full agreement that lifestyle changes to induce weight loss are the first-line approach, the ideal diet for the treatment of the metabolic syndrome remains uncertain.

Objective: The objective was to compare the effects of 2 diets on cardiovascular disease risk factors in obese patients with the metabolic syndrome.

Design: The study was carried out in 100 patients randomly assigned to either a diet relatively rich in carbohydrate [65% of energy as carbohydrate, 13% as protein, and 22% as fat (17% as unsaturated fat)] or a diet that was low in carbohydrate and high in protein and in monounsaturated fat [48% of energy as carbohydrate, 19% as protein, and 33% as fat (24% as unsaturated fat)].

Results: All 100 patients completed the 5-mo study. At the end of the study, all the components of the metabolic syndrome (except HDL, which did not change) decreased significantly in both groups. With the high-carbohydrate diet, a significant decrease in LDL-cholesterol concentrations was also observed. Although the extent of the resolution of the metabolic syndrome was not different between groups, the low-carbohydrate diet was associated with a greater decrease in the prevalence of hypertension (P < 0.05) and of hypertriacylglycerolemia (P < 0.001).

Conclusion: Tailoring diet interventions to the specific presentation of the metabolic syndrome may be the best way of reducing the risk factors for cardiovascular disease.

Key Words: Metabolic syndrome • diet treatment • cardiovascular disease risk factors • high-protein diets • low-carbohydrate diets • high-lipid diets • insulin resistance • blood pressure






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