Benefit of Low-Fat Over Low-Carbohydrate Diet on Endothelial Health in Obesity*

Low-carbohydrate diets (Atkins) work. People lose weight. Blood pressure improves. Cholesterol levels, especially triglycerides, come down. Sounds great, but is there any other information to the contrary?

This study (Benefit of Low-Fat Over Low-Carbohydrate Diet on endothelial Health in Obesity*) looked at Flow-Mediated Brachial Artery Dilation (FMBAD), which is a marker for the health of the cells lining your arteries. Your arteries need to be pliable and flexible. They need to dilate when there is increased blood flow, for example, when you exercise. An impaired FMBAD is associated with the development of cardiovascular disease over time.

This wasn’t a big study. The researchers put 20 healthy, but obese, people on one of two diets: low-fat or low-carbohydrate (Atkins). At 30% fat, the low-fat diet wasn’t really very low in fat content. Thirty percent of daily calories from fat is in-line with the American Heart Association recommendations.

This wasn’t a long study either: only 6 weeks.

Everyone lost weight. Blood pressures improved. Cholesterol did not change in either group after 6 weeks. Triglycerides improved in the low-carbohydrate group (Atkins) as it always does. Fasting insulin (a marker for pre-diabetes) also improved in the low-carb group.

The problem in the low-carbohydrate group was a decline in FMBAD.

Yes, the study was only 6 weeks in duration. Yes, there were only 20 patients. But, maybe we can draw some broad conclusions. Low-carbohydrate is a great diet, especially for diabetics, but you may not want to stay on it forever. We don’t know what the decline in FMBAD means for you over a lifetime.

* Phillips SA, et al. Hypertension, Feb 2008;51:376

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