CVD / Heart Health

A Randomized Pilot Trial of a Moderate Carbohydrate Diet Compared to a Very Low Carbohydrate Diet in Overweight or Obese Individuals with Type 2 Diabetes Mellitus or Prediabetes

Laura R. Saslow, Sarah Kim, Jennifer J. Daubenmier, Judith T. Moskowitz, Stephen D. Phinney, Veronica Goldman, Elizabeth J. Murphy, Rachel M. Cox, Patricia Moran, Fredrick M. Hecht

RCT with 34 participants.  Results suggest that a very low carbohydrate diet coupled with skills to promote behavior change may improve glycemic control in type 2 diabetes while allowing decreases in diabetes medications.

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Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial

Lydia A. Bazzano, MD, PhD, MPH; Tian Hu, MD, MS; Kristi Reynolds, PhD; Lu Yao, MD, MS; Calynn Bunol, MS, RD, LDN; Yanxi Liu, MS; Chung-Shiuan Chen, MS; Michael J. Klag, MD, MPH; Paul K. Whelton, MD, MSc, MB; Jiang He, MD, PhD

RCT with 148 participants.  The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors.

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Diets with high-fat cheese, high-fat meat, or carbohydrate on cardiovascular risk markers in overweight postmenopausal women: a randomized crossover trial.

Tanja K Thorning, Farinaz Raziani, Nathalie T Bendsen, Arne Astrup, Tine Tholstrup, Anne Raben

Randomized crossover with 14 participants.  Diets with cheese and meat as primary sources of SFAs cause higher HDL cholesterol and apo A-I and, therefore, appear to be less atherogenic than is a low-fat, high-carbohydrate diet.  Also, our findings confirm that cheese increases fecal fat excretion.

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Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis

Jonathan Sackner-Bernstein, David Kanter, Sanjay Kaul

This trial-level meta-analysis of randomized controlled trials comparing LoCHO diets with LoFAT diets in strictly adherent populations demonstrates that each diet was associated with significant weight loss and reduction in predicted risk of ASCVD events. However, LoCHO diet was associated with modest but significantly greater improvements in weight loss and predicted ASCVD risk in studies from 8 weeks to 24 months in duration. These results suggest that future evaluations of dietary guidelines should consider low carbohydrate diets as effective and safe intervention for weight management in the overweight and obese, although long-term effects require further investigation.

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Effects of Low-Carbohydrate vs Low-Fat Diets on Weight Loss and Cardiovascular Risk Factors: a meta-analysis of randomised controlled trials

Alain J. Nordmann, MD, MSc; Abigail Nordmann, BS; Matthias Briel, MD; Ulrich Keller, MD; William S. Yancy Jr, MD, MSH; Bonnie J. Brehm, PhD; Heiner C. Bucher, MD, MPH

Five trials including a total of 447 individuals.  This meta-analysis demonstrates that low-carbohydrate, non–energy-restricted diets appear to be at least as effective as low-fat, energy-restricted diets in inducing weight loss for up to 1 year. However, potential favorable changes in triglyceride and high-density lipoprotein cholesterol values should be weighed against potential unfavorable changes in low-density lipoprotein cholesterol values when low-carbohydrate diets to induce weight loss are considered.

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Dynamics of intra-pericardial and extra-pericardial fat tissues during long-term, dietary induced, moderate weight loss

Gal Tsaban, Arik Wolak, Hila Avni-Hassid, Yftach Gepner, Ilan Shelef, Yaakov Henkin, Dan Schwarzfuchs, Noa Cohen, Nitzan Bril, Michal Rein Dana Serfaty, Shira Kenigsbuch, Lilac Tene, Hila Zelicha, Anat Yaskolka-Meir, Oded Komy, Avital Bilitzky, Yoash Chassidim, Uta Ceglarek, Michael Stumvoll, Matthias Blüher , Joachim Thiery, Dror Dicker, Assaf Rudich , Meir J Stampfer, Iris Shai

RCT with 80 participants.  Moderate but persistent dietary-induced weight loss substantially decreased both IPF and EPF volumes.  Reduction of pericardial adipose tissues is independently associated with an improved lipid profile.  The Mediterranean diet, rich in unsaturated fats and restricted carbohydrates, is superior to an LF diet in terms of the IPF burden reduction.

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Statin wars: have we been misled about the evidence? A narrative review

Dr Maryanne Demasi PhD

Statins are the most widely prescribed, cholesterol lowering drugs in the world.  Despite the expiration of their patents, revenue for statins is expected to rise, with total sales on track to reach an estimated US$1 trillion by 2020.  A bitter dispute has erupted among doctors over suggestions that statins should be prescribed to millions of healthy people at low risk of heart disease.  There are concerns that the benefits have been exaggerated and the risks have been underplayed.  Also, the raw data on the efficacy and safety of statins are being kept secret and have not been subjected to scrutiny by other scientists. This lack of transparency has led to an erosion of public confidence. Doctors and patients are being misled about the true benefits and harms of statins, and it is now a matter of urgency that the raw data from the clinical trials are released.

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