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David J. A. Jenkins, MD; Julia M. W. Wong, PhD; Cyril W. C. Kendall, PhD

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In reply

We thank Giugliano and colleagues for their kind words on the possible value of our study. We agree absolutely that the study was small, of short duration, and extreme in terms of carbohydrate restriction. As Giugliano and colleagues rightly noted, the aim of the study was proof of principle that high-fat and high-protein diets of plant origin may have advantages over animal product–based diets in terms of LDL-C level reduction, with benefits also for the total–high-density lipoprotein cholesterol ratio and blood pressure reduction.

Such diets have proved beneficial for heart disease in cohort studies.¹ Moderate– to high–vegetable protein diets have been proposed recently by Giugliano and colleagues as part of the dietary treatment of the metabolic syndrome.² Lower–glycemic load diets have been associated with greater weight loss in subjects with postprandial hyperinsulinemia³ and . . . [Full Text of this Article]

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