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Twelve obese young women (aged 22-36) were studied to determine the·effects of the combination of an exercise program with either a high carbohydrate (HC) hypocaloric diet or low carbohydrate (LC) hypocaloric diet on total cholesterol, high density lipoprotein (HDL) cholesterol and triglycerides. Subjects were randomly placed in one of the diet groups (530 kcal/day) and participated in submaximal (60% VO₂ max) exercise sessions three times per week for a period of 28 days. After the treatment period, the subjects consumed a 1000 kcal/day mixed diet for one week while continuing the exercise program. Blood samples were drawn weekly for the analysis of total cholesterol, HDL cholesterol and triglycerides. Weight significantly decreased in both groups (mean decrease = 9.8% for LC; 8.8% for HC). After week one of the diet, total cholesterol and HDL cholesterol decreased significantly throughout the rest of the study. Due to the changes in total cholesterol, the total cholesterol/HDL cholesterol ratio decreased throughout the study, reaching significance by the post-treatment period when the ratio was 20.6% below baseline levels for both groups. There were no significant changes in triglycerides for either group. However, triglycerides increased throughout the dietary treatment (mean increase 9.5% for LC; 18.7% for HC). Triglyceride concentrations also changed during the post-treatment week as the LC group had a mean decrease of 38.3% and HC group, 8.2% from baseline values. These data suggest that both diets are equally effective in reducing body weight in young women. Also, in spite of the decreases noted in HDL cholesterol in both groups, total cholesterol decreased even further, thus producing a lower, more favorable total cholesterol/HDL cholesterol ratio. / Master of Science

TITLE: Calories vs. Composition: The effect on dietary alterations on anthropometric measures and biochemical parameters in overweight women.LEARNING OUTCOME: To determine if a high-protein, low-carbohydrate, ad-libitum diet is more effective than an energy-restricted diet in promoting weight loss and improving blood lipid and insulin levels.ABSTRACT TEXT: Thirty overweight/obese (BMI: 25-35kg/m2), premenopausal women were matched for Body Mass Index (BMI) and randomly assigned to one of the two diets: (1) High Protein (HP) (30-40% protein, 40-55% fat, 10-20% CHO); (2) Energy Restricted (ER) (1200kcal/d, 20-25% fat, 15-20% protein, 55-60% CHO). Subjects were given weekly menus matching their assigned macronutrient and/or energy requirements to aid in meal planning and dietary compliance. Baseline and post-diet measures included height, weight, body composition, blood lipids (total cholesterol (TC), HDL, LDL< and triglycerides (TG)], and plasma insulin levels. There were no significant differences found among the two groups in any of the above-listed variables prior to the study. Twenty-three women completed the 6-week study (HP=11, ER= 12). Compliance to the diets was adequate as indicated by weekly 24-hour recalls and daily urinary ketone levels. Both groups lost a significant amount of weight and body fat (P<0.05), andweight and body fat losses were not significantly different between the groups. In addition, both groups experienced similar decreases in TG, TC, LDL, HDL, and insulin levels. These results indicate that a HP diet is no more effective than an ER diet in promoting favorable changes in body weight, body composition, blood lipids, and insulin levels. / Department of Family and Consumer Sciences

The objective of this study was to examine the effects of a medium chain triglyceride oil mixture (MCTo), designed to increase energy expenditure and improve lipid profiles containing medium chain triglycerides, phytosterols and n-3 fatty acids in the form of flaxseed oil, versus the antioxidant alpha-lipoic acid (ALA). Forty-eight hamsters were fed (i) hypercholesterol emic (HC) control, (ii) HC MCTo, (iii) HC ALA, (iv) HC MCTo/ALA diets for 4 weeks. No effects on food intake, body weight, total body water, lean body mass, fat mass, and tissue thiobarbituric acid-reactive substances (TBARS) were observed. ALA alone had no effect on total cholesterol (TC); however, MCTo feeding increased TC with (p < 0.03) and without (p < 0.003) ALA when compared to control. ALA increased HDL levels compared to control (p 0.04) and MCTo/ALA (p < 0.007) groups. MCTo, with (p < 0.0001) or without (p < 0.006) ALA, increased non-HDL cholesterol levels versus control. The non-HDL:HDL ratio was decreased by ALA compared to MCTo (45%) and MCTo/ALA (68%) (p < 0.0001), a similar trend was seen when compared to the HC control (22%) group (p < 0.14). Triglyceride levels were not altered by any of the dietary treatments. Liver and heart tissue reduced glutathione (GSH) was increased (p < 0.05) by all three treatments when compared to control. Both tissues showed an increase (p < 0.05) in oxidized glutathione (GSSG) when fed ALA compared to all other treatments. Hamsters fed ALA had a lower (p < 0.05) GSH/GSSG ratio compared to all treatment groups. In conclusion, MCTo feeding does not elicit beneficial effects on circulating plasma lipids and measures of body composition. In addition, our results do not clearly support an improvement in oxidative status through supplementation of ALA. However, our results do support the existence of beneficial effects of ALA on circulating lipoprotein content in the hamster.

We examined the effect of a functional oil (FctO), with potential weight-controlling and blood lipid-lowering attributes, vs beef tallow as control (C), on the cardiovascular risk profile of overweight women. The FctO comprised energy expenditure-enhancing medium chain triacylglycerols, cholesterol-lowering phytosterols and triacylglycerol-suppressing n-3 fatty acids. In a randomized, single-blind, crossover design, inpatient trial, 17 women consumed each oil as part of a controlled, supervised, energy-adjusted diet for 27 days. Body weight decreased similarly during both dietary periods. Plasma total and LDL cholesterol levels decreased by 4.8% and 10.4% following FctO, and were lower by 9.0% and 16.4% respectively, after FctO vs C. HDL cholesterol and circulating triacylglycerol levels were unaffected by treatment, though HDL:LDL and HDL:total cholesterol ratios increased by 19.5% and 9.4% on FctO. Plasma total homocysteine levels were higher on FctO vs C. Plasma glutathione increased with FctO supplementation. / We conclude that consumption of FctO improves the overall cardiovascular risk profile of overweight women.

Background Type 2 diabetes is a common disease and the prevalence has increased in large parts of the world. In treatment of diabetes the type of diet is of great importance considering metabolic factors such as glucose level and blood lipids. Which diet that is most beneficial to avoid diabetic complications has been heavily debated in recent decades. This thesis is based on two clinical studies designed to compare the effects of different macronutrients. Methods A clinical trial was designed to compare a low-carbohydrate diet (LCD) to a low-fat diet (LFD) in treatment of patients with type 2 diabetes. Sixty-one patients at two health care centres were included and randomized to get advice to eat a LCD or a LFD. The LCD had an energy content where 50 energy percent (E%) where from fat, 20 E% from carbohydrates and 30 E% from protein. For the LFD the nutrient composition was similar to what is traditionally recommended for treatment of type 2 diabetes in Sweden. Metabolic factors, anthropometrics and questionnaires were analysed. To study postprandial effects a trial was designed to compare three different diets. Twentyone patients with type 2 diabetes were included to in randomized order test the three types of diets on separate test days. On each test day the patients were served breakfast and lunch and blood samples were taken at six times these days. Glucose, lipids and hormones were analysed. Results There were equal weight reduction in the two groups in the first trial during the two-year study period. At six month when compliance was good according to diet-records, the glucose level (HbA1c) was lowered and the HDL-cholesterol was increased in the LCD group. The inflammatory markers IL-6 and IL-1Ra were significantly lower in the LCD group than in the LFD group. At 12 months the physical function, bodily pain and general health  scores improved within the LCD group only. In the second trial the postprandial glucose and insulin levels were lower on the LCD compared to the LFD. However, the LCD resulted in a tendency to higher postprandial triglyceride levels. The Mediterranean type of diet with all energy intake at lunch resulted in a more pronounced insulin response and a glucose level at lunch similar to that of the low-fat diet. The increase-ratio of insulin correlated to the elevation of the incretin glucose-dependent insulinotropic peptide (GIP). Conclusions In the two-year study we found benefits for the LCD group regarding glucose control and insulin doses. Furthermore, only the LCD was found to improve the subclinical inflammatory state and there were some aspects of improved well-being in this group. Aiming for 20% of energy intake from carbohydrates is safe with respect to cardiovascular risk factors  compared with the traditional LFD and this approach could constitute a treatment alternative. In the postprandial state, the LCD induced lower insulin and glucose excursions than the LFD but at the same time a tendency of higher triglycerides. The long-term significance needs to be further examined. The accumulation of caloric intake from breakfast to lunch to a single large Mediterranean-style lunch-meal in type 2 diabetes might be advantageous from a metabolic perspective.

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