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This is randomized study from R Krauss et co, Mangravite Lara as first author. The study shows that in weight stable situation, high saturated fat -low carbohydrate diet (HSFLC) does not improve any cardiovascular risk factor than TG vs high carbohydrate baseline diet. HSFLC performs worse than low saturated fat -low carbohydrate diet in head to head comparison. The comparisons are made in the presence of high consumption of beef, and highlight the aterogenic nature of high saturated fat -high red meat diets, even in the context of carbohydrate restriction
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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/pronutritionist Mangravite et al. J Nutr. 2011 Dec;141(12):2180-5
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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/pronutritionist Mangravite et al. J Nutr. 2011 Dec;141(12):2180-5
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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/pronutritionist Mangravite et al. J Nutr. 2011 Dec;141(12):2180-5
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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/pronutritionist Mangravite et al. J Nutr. 2011 Dec;141(12):2180-5
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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/pronutritionist Mangravite et al. J Nutr. 2011 Dec;141(12):2180-5
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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 dietshttp://twitter.com/pronutritionist Mangravite et al. J Nutr. 2011
Dec;141(12):2180-5Page 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/pronutritionist Mangravite et al. J Nutr. 2011 Dec;141(12):2180-5
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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/pronutritionist Mangravite et al. J Nutr. 2011 Dec;141(12):2180-5
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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
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Reijo Laatikainen, Authorized Nutritionist, MBA
http://twitter.com/pronutritionist Mangravite et al. J Nutr. 2011
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