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The Effect of a Plant-Based Low-Carbohydrate ("Eco-Atkins") Diet on Body Weight and Blood Lipid Concentrations in Hyperlipidemic Subjects
David J. A. Jenkins, MD;
Julia M. W. Wong, RD;
Cyril W. C. Kendall, PhD;
Amin Esfahani, MSc;
Vivian W. Y. Ng, RD;
Tracy C. K. Leong, BASc;
Dorothea A. Faulkner, PhD;
Ed Vidgen, BSc;
Kathryn A. Greaves, PhD;
Gregory Paul, PhD;
William Singer, MD
Arch Intern Med. 2009;169(11):1046-1054.
Background Low-carbohydrate, high–animal protein diets, which are advocated for weight loss, may not promote the desired reduction in low-density lipoprotein cholesterol (LDL-C) concentration. The effect of exchanging the animal proteins and fats for those of vegetable origin has not been tested. Our objective was to determine the effect on weight loss and LDL-C concentration of a low-carbohydrate diet high in vegetable proteins from gluten, soy, nuts, fruits, vegetables, cereals, and vegetable oils compared with a high-carbohydrate diet based on low-fat dairy and whole grain products.
Methods A total of 47 overweight hyperlipidemic men and women consumed either (1) a low-carbohydrate (26% of total calories), high–vegetable protein (31% from gluten, soy, nuts, fruit, vegetables, and cereals), and vegetable oil (43%) plant-based diet or (2) a high-carbohydrate lacto-ovo vegetarian diet (58% carbohydrate, 16% protein, and 25% fat) for 4 weeks each in a parallel study design. The study food was provided at 60% of calorie requirements.
Results Of the 47 subjects, 44 (94%) (test, n = 22 [92%]; control, n = 22 [96%]) completed the study. Weight loss was similar for both diets (approximately 4.0 kg). However, reductions in LDL-C concentration and total cholesterol–HDL-C and apolipoprotein B–apolipoprotein AI ratios were greater for the low-carbohydrate compared with the high-carbohydrate diet (–8.1% [P = .002], –8.7% [P = .004], and –9.6% [P = .001], respectively). Reductions in systolic and diastolic blood pressure were also seen (–1.9% [P = .052] and –2.4% [P = .02], respectively).
Conclusion A low-carbohydrate plant-based diet has lipid-lowering advantages over a high-carbohydrate, low-fat weight-loss diet in improving heart disease risk factors not seen with conventional low-fat diets with animal products.
Trial Registration clinicaltrials.gov Identifier: NCT00256516
Author Affiliations: Clinical Nutrition & Risk Factor Modification Center (Drs Jenkins, Kendall, Faulkner, and Singer, Mss Wong, Ng, and Leong, and Messrs Esfahani and Vidgen) and Division of Endocrinology and Metabolism, Department of Medicine (Drs Jenkins and Singer), St Michael's Hospital, Toronto, Ontario, Canada; Departments of Nutritional Sciences (Drs Jenkins, Kendall, Faulkner, and Singer, Mss Wong, Ng, and Leong, and Messrs Esfahani and Vidgen), and Medicine, Faculty of Medicine (Drs Jenkins and Singer), University of Toronto, Toronto; and Solae, LLC, St Louis, Missouri (Drs Greaves and Paul). Dr Greaves is now with Kellogg’s, Battle Creek, Michigan.
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