Low-Carb kein Risiko für die Gefäßwandfunktion
Im Gegensatz zu der zur Zeit von den Medien häufig zitierten Studie (Phillips SA, et al. Benefit of Low-Fat Over Low-Carbohydrate Diet on Endothelial Health in Obesity. Hypertension. 2008;51:376-382.), finden zwei weitere neue kontrollierte Diätstudien nicht nur keinen ungünstigen Effekt von Low-Carb auf die „endothelvermittelte Vasodilatation der Armarterie“, sondern ein Verbesserung von kardiovaskulären Risikofaktoren.

Nicolai Worm

Keogh JB, et al. Effects of weight loss on a low-carbohydrate diet on flow-mediated dilatation, adhesion molecules and adiponectin. Br J Nutr 2007;98:852–859.

Our aim was to determine whether short-term weight loss on a low-carbohydrate/low-saturated fat diet improved endothelial function compared with a conventional high-carbohydrate diet, as this diet is expected to lower both blood glucose and LDL-cholesterol. In a randomised parallel design of two energy-restricted diets in an outpatient setting, thirty-six subjects (BMI 33 (SEM 4) kg/m2) were randomised to a low- or high-carbohydrate diet both low in saturated fat. Flow-mediated dilatation (FMD), fasting glucose, insulin, lipids, adiponectin and adhesion molecules were measured at baseline, during weight loss and at 52 weeks. FMD did not change with either diet (5·2 (SEM 0·6) to 5·5 (SEM 0·6) %) despite weight loss of 5% and significant reductions in glucose and insulin and LDL-cholesterol and was not different after sustained weight loss of 5% at 52 weeks. Adiponectin fell by 6% at 12 weeks (P1/40·1) with weight loss but rose by 17% at 12 months (P,0·05) with 5% weight loss. There were no effects of diet. In contradistinction, adhesion molecules fell at 12 weeks, vascular cell adhesion molecule-1 by 14% and intracellular adhesion molecule-1 by 13% (both P,0·05). There were correlations between change in adiponectin at 12 months and change in HDL (r 0·778, P,0·01) and glucose (r 2 0·563, P1/40·057). In summary, weight loss does not improve FMD. Novel cardiovascular risk factors improved at 12 weeks but the improvement in adiponectin was delayed.

Keogh JB, et al. Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity. Am J Clin Nutr 2008;87:567–76.

Background: The effects of a very-low-carbohydrate, high-saturated-fat weight-loss diet (LC) on brachial artery flow-mediated dilatation (FMD) and markers of endothelial function are unknown.
Objective: The effect of an LC on markers of endothelial function and cardiovascular disease (CVD) risk was compared with that of an isocaloric high-carbohydrate, low-saturated-fat diet (HC).
Design: FMD and markers of endothelial function (n = 70) and CVD risk were measured before and after 8 wk of weight loss. Ninety-nine subjects aged 50.0 +/- 8.3 y with a body mass index (in kg/m2) of 33.7 +/- 4.1 completed the study.
Results: Mean (SD) FMD did not change significantly (P=0.55) with either diet. Pulse wave velocity improved with both diets (P <0.01). Endothelial markers, E- and P selectin, intracellular and cellular-adhesion molecule-1, tissue-type plasminogen activator, and plasminogen activator inhibitor-1 decreased (P < 0.001), with no diet effect. Adiponectin did not change significantly. More weight (P<0.05 for diet x time interaction) and more abdominal fat mass (P <0.05 for diet x time interaction) were lost with the LC than with the HC. LDL cholesterol decreased more with the HC than with the LC (P <0.05, time x diet), and C-reactive protein decreased more with theHCthan with the LC (P<0.05 for diet x time interaction). Homocysteine increased more with the LC (P x 0.01 for diet x time interaction). Folate decreased with the LC and increased with the HC (P<0.05, time; P<0.001 for diet x time interaction).
Conclusion: An LC does not impair FMD. We observed beneficial effects of both diets on most of the CVD risk factors measured.

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