A low-carbohydrate diet in overweight patients undergoing stable statin therapy raises high-density lipoprotein and lowers triglycerides substantially

BACKGROUND: A low-carbohydrate diet remains controversial, especially in patients with arteriosclerotic heart disease. HYPOTHESIS: This study was undertaken to evaluate the effect of a low-carbohydrate diet on the lipid levels in obese patients with known arteriosclerotic heart disease on chronic statin therapy. METHODS: Thirty-eight overweight patients with angiographically documented arteriosclerotic heart disease were followed in a private cardiology practice setting. All patients were undergoing stable statin therapy. Patients received a 15-min consultation and a 4-page pamphlet explaining a low-carbohydrate diet; no other diet instruction was given. Patients were followed weekly for 2 weeks, then monthly for 3 months, then every third month. A fasting finger stick lipid panel (cholesterol, high-density and low-density lipoprotein [HDL/ LDL], triglycerides, and glucose) was obtained with each visit and patients were weighed in street clothes. RESULTS: The 38 patients were followed for a average of 11.8 months (range 6-22 months). Average body mass index declined from 33.5 kg/m2 before to 27.9 kg/m2 at the end of the study. Weight loss averaged 31 lbs (range 16-107 lbs). Triglyceride levels were lowered by 29.5%, HDL raised by 17.6%, and cholesterol decreased by 8.4%. The cholesterol/ HDL ratio changed from 5.31 to 3.78 and LDL cholesterol decreased by 5%. CONCLUSION: The addition of a low-carbohydrate diet for overweight patients with known coronary artery disease undergoing stable statin therapy causes significant weight loss and a favorable change in the lipid panel.