The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat: A randomized trial

Y. Wady Aude, Arthur S. Agatston, Francisco Lopez-Jimenez, Eric H. Lieberman, Marie Almon, Melinda Hansen, Gerardo Rojas, Gervasio A. Lamas, Charles H. Hennekens

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Background: In the United States, obesity is a major clinical and public health problem causing diabetes, dyslipidemia, and hypertension, as well as increasing cardiovascular and total mortality. Dietary restrictions of calories and saturated fat are beneficial. However, it remains unclear whether replacement of saturated fat with carbohydrates (as in the US National Cholesterol Education Program [NCEP] diet) or protein and monounsaturated fat (as in our isocaloric modified low-carbohydrate [MLC] diet, which is lower in total carbohydrates but higher in protein, monounsaturated fat, and complex carbohydrates) is optimal. Methods: We randomized 60 participants (29 women and 31 men) to the NCEP or the MLC diet and evaluated them every 2 weeks for 12 weeks. They were aged 28 to 71 years (mean age, 44 years in the NCEP and 46 years in the MLC group). A total of 36% of participants from the NCEP group and 35% from the MLC group had a body mass index (calculated as weight in kilograms divided by the square of height in meters) greater than 27. The primary end point was weight loss, and secondary end points were blood lipid levels and waist-to-hip ratio. Results: Weight loss was significantly greater in the MLC (13.6 lb) than in the NCEP group (7.5 lb), a difference of 6.1 lb (P = .02). There were no significant differences between the groups for total, low density, and high-density lipoprotein cholesterol, triglycerides, or the proportion of small, dense low-density lipoprotein particles. There were significantly favorable changes in all lipid levels within the MLC but not within the NCEP group. Waist-to-hip ratio was not significantly reduced between the groups (P = .27), but it significantly decreased within the MLC group (P = .009). Conclusions: Compared with the NCEP diet, the MLC diet, which is lower in total carbohydrates but higher in complex carbohydrates, protein, and monounsaturated fat, caused significantly greater weight loss over 12 weeks. There were no significant differences between the groups in blood lipid levels, but favorable changes were observed within the MLC diet group.

Original languageEnglish
Pages (from-to)2141-2146
Number of pages6
JournalArchives of Internal Medicine
Volume164
Issue number19
DOIs
StatePublished - Oct 25 2004
Externally publishedYes

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Fats
Cholesterol
Carbohydrates
Diet
Education
Carbohydrate-Restricted Diet
Proteins
Weight Loss
Waist-Hip Ratio
Lipids
Blood Group Antigens
Dyslipidemias
LDL Lipoproteins
HDL Cholesterol
Triglycerides
Body Mass Index
Public Health
Obesity
Hypertension
Weights and Measures

ASJC Scopus subject areas

  • Internal Medicine

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The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat : A randomized trial. / Aude, Y. Wady; Agatston, Arthur S.; Lopez-Jimenez, Francisco; Lieberman, Eric H.; Almon, Marie; Hansen, Melinda; Rojas, Gerardo; Lamas, Gervasio A.; Hennekens, Charles H.

In: Archives of Internal Medicine, Vol. 164, No. 19, 25.10.2004, p. 2141-2146.

Research output: Contribution to journalArticle

Aude, YW, Agatston, AS, Lopez-Jimenez, F, Lieberman, EH, Almon, M, Hansen, M, Rojas, G, Lamas, GA & Hennekens, CH 2004, 'The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat: A randomized trial', Archives of Internal Medicine, vol. 164, no. 19, pp. 2141-2146. https://doi.org/10.1001/archinte.164.19.2141
Aude, Y. Wady ; Agatston, Arthur S. ; Lopez-Jimenez, Francisco ; Lieberman, Eric H. ; Almon, Marie ; Hansen, Melinda ; Rojas, Gerardo ; Lamas, Gervasio A. ; Hennekens, Charles H. / The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat : A randomized trial. In: Archives of Internal Medicine. 2004 ; Vol. 164, No. 19. pp. 2141-2146.
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abstract = "Background: In the United States, obesity is a major clinical and public health problem causing diabetes, dyslipidemia, and hypertension, as well as increasing cardiovascular and total mortality. Dietary restrictions of calories and saturated fat are beneficial. However, it remains unclear whether replacement of saturated fat with carbohydrates (as in the US National Cholesterol Education Program [NCEP] diet) or protein and monounsaturated fat (as in our isocaloric modified low-carbohydrate [MLC] diet, which is lower in total carbohydrates but higher in protein, monounsaturated fat, and complex carbohydrates) is optimal. Methods: We randomized 60 participants (29 women and 31 men) to the NCEP or the MLC diet and evaluated them every 2 weeks for 12 weeks. They were aged 28 to 71 years (mean age, 44 years in the NCEP and 46 years in the MLC group). A total of 36{\%} of participants from the NCEP group and 35{\%} from the MLC group had a body mass index (calculated as weight in kilograms divided by the square of height in meters) greater than 27. The primary end point was weight loss, and secondary end points were blood lipid levels and waist-to-hip ratio. Results: Weight loss was significantly greater in the MLC (13.6 lb) than in the NCEP group (7.5 lb), a difference of 6.1 lb (P = .02). There were no significant differences between the groups for total, low density, and high-density lipoprotein cholesterol, triglycerides, or the proportion of small, dense low-density lipoprotein particles. There were significantly favorable changes in all lipid levels within the MLC but not within the NCEP group. Waist-to-hip ratio was not significantly reduced between the groups (P = .27), but it significantly decreased within the MLC group (P = .009). Conclusions: Compared with the NCEP diet, the MLC diet, which is lower in total carbohydrates but higher in complex carbohydrates, protein, and monounsaturated fat, caused significantly greater weight loss over 12 weeks. There were no significant differences between the groups in blood lipid levels, but favorable changes were observed within the MLC diet group.",
author = "Aude, {Y. Wady} and Agatston, {Arthur S.} and Francisco Lopez-Jimenez and Lieberman, {Eric H.} and Marie Almon and Melinda Hansen and Gerardo Rojas and Lamas, {Gervasio A.} and Hennekens, {Charles H.}",
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T1 - The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat

T2 - A randomized trial

AU - Aude, Y. Wady

AU - Agatston, Arthur S.

AU - Lopez-Jimenez, Francisco

AU - Lieberman, Eric H.

AU - Almon, Marie

AU - Hansen, Melinda

AU - Rojas, Gerardo

AU - Lamas, Gervasio A.

AU - Hennekens, Charles H.

PY - 2004/10/25

Y1 - 2004/10/25

N2 - Background: In the United States, obesity is a major clinical and public health problem causing diabetes, dyslipidemia, and hypertension, as well as increasing cardiovascular and total mortality. Dietary restrictions of calories and saturated fat are beneficial. However, it remains unclear whether replacement of saturated fat with carbohydrates (as in the US National Cholesterol Education Program [NCEP] diet) or protein and monounsaturated fat (as in our isocaloric modified low-carbohydrate [MLC] diet, which is lower in total carbohydrates but higher in protein, monounsaturated fat, and complex carbohydrates) is optimal. Methods: We randomized 60 participants (29 women and 31 men) to the NCEP or the MLC diet and evaluated them every 2 weeks for 12 weeks. They were aged 28 to 71 years (mean age, 44 years in the NCEP and 46 years in the MLC group). A total of 36% of participants from the NCEP group and 35% from the MLC group had a body mass index (calculated as weight in kilograms divided by the square of height in meters) greater than 27. The primary end point was weight loss, and secondary end points were blood lipid levels and waist-to-hip ratio. Results: Weight loss was significantly greater in the MLC (13.6 lb) than in the NCEP group (7.5 lb), a difference of 6.1 lb (P = .02). There were no significant differences between the groups for total, low density, and high-density lipoprotein cholesterol, triglycerides, or the proportion of small, dense low-density lipoprotein particles. There were significantly favorable changes in all lipid levels within the MLC but not within the NCEP group. Waist-to-hip ratio was not significantly reduced between the groups (P = .27), but it significantly decreased within the MLC group (P = .009). Conclusions: Compared with the NCEP diet, the MLC diet, which is lower in total carbohydrates but higher in complex carbohydrates, protein, and monounsaturated fat, caused significantly greater weight loss over 12 weeks. There were no significant differences between the groups in blood lipid levels, but favorable changes were observed within the MLC diet group.

AB - Background: In the United States, obesity is a major clinical and public health problem causing diabetes, dyslipidemia, and hypertension, as well as increasing cardiovascular and total mortality. Dietary restrictions of calories and saturated fat are beneficial. However, it remains unclear whether replacement of saturated fat with carbohydrates (as in the US National Cholesterol Education Program [NCEP] diet) or protein and monounsaturated fat (as in our isocaloric modified low-carbohydrate [MLC] diet, which is lower in total carbohydrates but higher in protein, monounsaturated fat, and complex carbohydrates) is optimal. Methods: We randomized 60 participants (29 women and 31 men) to the NCEP or the MLC diet and evaluated them every 2 weeks for 12 weeks. They were aged 28 to 71 years (mean age, 44 years in the NCEP and 46 years in the MLC group). A total of 36% of participants from the NCEP group and 35% from the MLC group had a body mass index (calculated as weight in kilograms divided by the square of height in meters) greater than 27. The primary end point was weight loss, and secondary end points were blood lipid levels and waist-to-hip ratio. Results: Weight loss was significantly greater in the MLC (13.6 lb) than in the NCEP group (7.5 lb), a difference of 6.1 lb (P = .02). There were no significant differences between the groups for total, low density, and high-density lipoprotein cholesterol, triglycerides, or the proportion of small, dense low-density lipoprotein particles. There were significantly favorable changes in all lipid levels within the MLC but not within the NCEP group. Waist-to-hip ratio was not significantly reduced between the groups (P = .27), but it significantly decreased within the MLC group (P = .009). Conclusions: Compared with the NCEP diet, the MLC diet, which is lower in total carbohydrates but higher in complex carbohydrates, protein, and monounsaturated fat, caused significantly greater weight loss over 12 weeks. There were no significant differences between the groups in blood lipid levels, but favorable changes were observed within the MLC diet group.

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