Friday, July 24, 2009

Low-carb vs high-carb terhadap BB dan profil lipid

Diet rendah karbohidrat tinggi protein hewani (Atkins) dapat menurunkan berat badan (BB) namun terhadap kolesterol LDL (LDL-C) pengaruhnya kurang baik. Dalam penelitian ini protein hewani diganti bahan nabati (diet "Eco-Atkins" atau Atkins nabati) kemudian dibandingkan dengan diet tinggi karbohidrat dalam hal menurunkan BB dan LDL-C.
 
Diet Atkins nabati mengandung 26% karbohidrat, 31% protein nabati dan 43% minyak nabati.
Diet tinggi karbohidrat lakto-ovo vegetarian mengandung 58% karbohidrat, 16% protein dan 25% lemak.
 
Dilakukan studi paralel selama 4 minggu.
 
Hasilnya: dalam hal penurunan BB kedua diet sama (turun 4.0 kg). Dalam hal penurunan LDL, rasio total kolesterol-HDL, rasio apolipoprotein B-apolipoprotein AI lebih besar diet rendah karbohidrat (masing2 –8.1% [P = .002], –8.7% [P = .004], and –9.6% [P = .001] ). Juga terjadi penurunan tekanan sistolik dan diastolik (masing2 –1.9% [P = .052] and –2.4% [P = .02] ).
 
Kesimpulan diet rendah karbohidrat protein nabati (Atkins nabati) lebih unggul dibanding diet tinggi karbohidrat dalam hal memperbaiki faktor risiko kardiovaskuler. Hal mana tidak terjadi pada diet Atkins. 
 
The Effect of a Plant-Based Low-Carbohydrate ("Eco-Atkins") Diet on Body Weight and Blood Lipid Concentrations in Hyperlipidemic Subjects

David J. A. Jenkins, MD; Julia M. W. Wong, RD; Cyril W. C. Kendall, PhD; Amin Esfahani, MSc; Vivian W. Y. Ng, RD; Tracy C. K. Leong, BASc; Dorothea A. Faulkner, PhD; Ed Vidgen, BSc; Kathryn A. Greaves, PhD; Gregory Paul, PhD; William Singer, MD

Arch Intern Med. 2009;169(11):1046-1054.

Background  Low-carbohydrate, high–animal protein diets, which are advocated for weight loss, may not promote the desired reduction in low-density lipoprotein cholesterol (LDL-C) concentration. The effect of exchanging the animal proteins and fats for those of vegetable origin has not been tested. Our objective was to determine the effect on weight loss and LDL-C concentration of a low-carbohydrate diet high in vegetable proteins from gluten, soy, nuts, fruits, vegetables, cereals, and vegetable oils compared with a high-carbohydrate diet based on low-fat dairy and whole grain products.

Methods  A total of 47 overweight hyperlipidemic men and women consumed either (1) a low-carbohydrate (26% of total calories), high–vegetable protein (31% from gluten, soy, nuts, fruit, vegetables, and cereals), and vegetable oil (43%) plant-based diet or (2) a high-carbohydrate lacto-ovo vegetarian diet (58% carbohydrate, 16% protein, and 25% fat) for 4 weeks each in a parallel study design. The study food was provided at 60% of calorie requirements.

Results  Of the 47 subjects, 44 (94%) (test, n = 22 [92%]; control, n = 22 [96%]) completed the study. Weight loss was similar for both diets (approximately 4.0 kg). However, reductions in LDL-C concentration and total cholesterol–HDL-C and apolipoprotein B–apolipoprotein AI ratios were greater for the low-carbohydrate compared with the high-carbohydrate diet (–8.1% [P = .002], –8.7% [P = .004], and –9.6% [P = .001], respectively). Reductions in systolic and diastolic blood pressure were also seen (–1.9% [P = .052] and –2.4% [P = .02], respectively).

Conclusion  A low-carbohydrate plant-based diet has lipid-lowering advantages over a high-carbohydrate, low-fat weight-loss diet in improving heart disease risk factors not seen with conventional low-fat diets with animal products.

 

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