The pattern of Endothelial Microparticles following intervention with Paleolithic-based low-carbohydrate vs. moderate carbohydrate diets in adults with metabolic syndrome
The pattern of Endothelial Microparticles following intervention with Paleolithic-based low-carbohydrate vs. moderate carbohydrate diets in adults with metabolic syndrome
Introduction: Several recent studies have been undertaken into carbohydrate-restricted diets. it has not been clearly demonstrated whether diets with different proportions of energy from carbohydrate exert distinct effects on endothelial damage or not. The current randomized clinical trial (RCT) has been conducted to further elucidate the effects of severe and mild carbohydrate restriction on endothelial integrity in adults with metabolic syndrome (MetS).
Methods: Eighty adults with metabolic syndrome were randomized to one of the four carbohydrate restricted diets: Paleolithic-based low-carbohydrate diet with calorie-counting method (PLCD-CC) (n=20), Paleolithic-based low-carbohydrate diet with fixed-diet planning method (PLCD-Fixed) (n=20), moderate-carbohydrate diet with calorie-counting method (MCD-CC) (n=20) and moderate-carbohydrate diet with fixed-diet planning method (MCD-Fixed) (n=20) for 10 weeks. PLCD is defined as a diet consisting of 25-30% of energy from carbohydrate, 30% of energy from protein and 40-45% of energy from fat and encourages consumption of fruits, vegetables and lean meat. MCD is characterized as 40-45% carbohydrate, 30% protein and 30-35% fat. Appetite-regulatory hormones and plasma level of endothelial microparticles were assessed at baseline and at the end of 10 weeks.
Results: A total of 69 participants aged 42.95 (9.27) with metabolic syndrome completed the trial. At the end of current 10-week dietary intervention trial, we found significant reduction in CD 144+/42b-/31- EMPs in PLCD-Fixed intervention group (p<0.05). Mean changes of CD 144+/42b-/31- EMPs was also marginally statistically significant between 4 intervention groups (p=0.073). The within-group changes in ghrelin was significant in all 4 groups (p<0.05). However, despite clinical significance, the within- and between-group change in PYY was not statistically significant at the end of trial.
Conclusion: The current RCT in adults with metabolic syndrome revealed that both moderate and Paleolithic-based low carbohydrate diets with both delivery approaches have comparable beneficial effects in terms of appetite regulation and endothelial integrity.