Relationship between a Low-Carbohydrate, High-Fat Diet and Risk of Metabolic Syndrome in Korean Women
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Abstract
Background: Prevalence of metabolic syndrome with aging is higher in women than in men, and it increases after menopause. Interventions to reduce the risk of metabolic syndrome in women are important. A low-carbohydrate, high-fat diet is effective in weight loss and improvement cardiovascular risk factors including abdominal circumference, blood pressure, and blood lipid profile. We aimed to determine the relationship between a low-carbohydrate, high-fat diet and the risk of metabolic syndrome in Korean women.
Methods: This cross-sectional study was conducted using secondary data from the 2014–2018 Korean National Health and Nutrition Examination Survey. Overall, 8,222 women aged >19 yr were included. The effect of a low-carbohydrate, high-fat diet on the risk of metabolic syndrome was analyzed by multiple logistic regression analysis using a complex sampling procedure.
Results: The diet significantly reduced the likelihood of metabolic syndrome development (P=0.044). In addition, regardless of the fat type, the diet significantly reduced the likelihood of low high-density lipoprotein cholesterolemia (low-carbohydrate, high-total fat, P=0.013; low-carbohydrate, high-unsaturated fat, P=0.006; low-carbohydrate, high-saturated fat, P=0.006).
Conclusion: A low-carbohydrate, high-fat diet is an important intervention that can reduce the risk of metabolic syndrome, and the reduced consumption of carbohydrates can decrease the risk of low high-density lipoprotein cholesterolemia regardless of fat type. Therefore, it is necessary to actively explore the potential of this diet, targeting Asians, including Koreans.
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12. Volek JS, Phinney SD, Forsythe CE, et al (2009). Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids, 44(4):297–309.
13. Feinman RD, Pogozelski WK, Astrup A, et al (2015). Dietary carbohydrate restriction as the first approach in diabetes man-agement: Critical review and evidence base. Nutrition, 31(1):1–13.
14. Kim J (2016). Effects of a low-carbohydrate, high-fat diet. Korean J Obes, 25(4):176–83.
15. Bazzano LA, Hu T, Reynolds K, et al (2014). Effects of low-carbohydrate and low-fat diets: A randomized trial. Ann Intern Med, 161(5):309–18.
16. Brouns F (2018). Overweight and diabetes prevention: Is a low-carbohydrate–high-fat diet recommendable? Eur J Nutr, 57(4):1301–12.
17. Nordmann AJ, Nordmann A, Briel M, et al (2006). Effects of low-carbohydrate vs low-fat diets on weight loss and cardio-vascular risk factors: A meta-analysis of randomized controlled trials. Arch Intern Med, 166(3):285–93.
18. Fung TT, van Dam RM, Hankinson SE, et al (2010). Low-carbohydrate diets and all-cause and cause-specific mortality: Two cohort studies. Ann Intern Med, 153(5):289–98.
19. Alberti KGMM, Eckel RH, Grundy SM, et al (2009). Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Pre-vention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Cir-culation, 120(16):1640–5.
20. Kim MK, Lee WY, Kang JH, et al (2014). Clinical practice guidelines for overweight and obesity in Korea. Endocrinol Metab (Seoul), 29(4):405–9.
21. Ha K, Joung H, Song Y (2018). Low-carbohydrate diet and the risk of meta-bolic syndrome in Korean adults. Nutr Metab Cardiovasc Dis, 28(11):1122–32.
22. Hoffman MA, Driscoll JM. Health promo-tion and disease prevention: A concentric biopsychosocial model of health status. In: Brown SD, Lent RW, eds. Handbook of Counseling Psychology. 3rd ed. New York: John Wiley & Sons, Inc; 2000:532–567.
23. Santos FL, Esteves SS, da Costa Pereira A, et al (2012). Systematic review and meta‐analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. Obes Rev, 13(11):1048–66.
24. Oh H, Ahn J, Jun DW (2017). Association between a high-fat low-carbohydrate diet and non-alcoholic fatty liver disease: Truth or myth? Korean J Med, 92(2):112–7.
25. Volek JS, Sharman MJ, Love DM, et al (2002). Body composition and hormonal responses to a carbohydrate-restricted di-et. Metabolism, 51(7):864–70.
26. Forsythe CE, Phinney SD, Feinman RD, et al (2010). Limited effect of dietary saturat-ed fat on plasma saturated fat in the con-text of a low carbohydrate diet. Lipids, 45(10):947–62.
27. O’Neill BJ (2020). Effect of low-carbohydrate diets on cardiometabolic risk, insulin resistance, and metabolic syndrome. Curr Opin Endocrinol Diabetes Obes, 27(5):301–7.
28. Muzio F, Mondazzi L, Harris WS, et al (2007). Effects of moderate variations in the macronutrient content of the diet on cardiovascular disease risk factors in obese patients with the metabolic syn-drome. Am J Clin Nutr, 86(4):946–51.
29. Picklo MJ, Murphy EJ (2016). A high-fat, high-oleic diet, but not a high-fat, saturat-ed diet, reduces hepatic α-linolenic acid and eicosapentaenoic acid content in mice. Lipids, 51(5):537–47.
30. Ruuth M, Lahelma M, Luukkonen PK, et al (2021). Overfeeding saturated fat increas-es LDL (low-density lipoprotein) aggre-gation susceptibility while overfeeding unsaturated fat decreases proteoglycan-binding of lipoproteins. Arterioscler Thromb Vasc Biol, 41(11):2823–36.
31. Lambert EA, Phillips S, Belski R, et al (2017). Endothelial function in healthy young in-dividuals is associated with dietary con-sumption of saturated fat. Front Physiol, 8:876.
32. Shan Z, Guo Y, Hu FB, et al (2020). Associ-ation of low-carbohydrate and low-fat di-ets with mortality among US adults. JA-MA Intern Med, 180(4):513–23.
2. Isomaa BO, Almgren P, Tuomi T, et al (2001). Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care, 24(4):683–689.
3. Kelli HM, Kassas I, Lattouf OM (2015). Cardio metabolic syndrome: A global ep-idemic. J Diabetes Metab, 6(3):1–14.
4. Kim YH (2020). Caution in the use of prevalence data of metabolic syndrome. Korean J Fam Pract, 10(1):1–2.
5. Korean Society of Lipidology and Athero-sclerosis Dyslipidemia. Dyslipidemia fact sheet in Korea 2015 [Internet]. Seoul: Ko-rean Society of Lipidology and Athero-sclerosis Dyslipidemia; 2015. Available from: https://www.lipid.or.kr/
6. Ra JS, Kim HS, Jeong YH (2019). Associat-ed factors of ischemic heart disease iden-tified among post-menopausal women. Osong Public Health Res Perspect,10(2):56–63.
7. Korean Statistical Information Service. 2017 Statistics of Cause of Death [Internet]. 2018 Sept 19 [cited 2021 April 2]. http://kostat.go.kr/assist/ syn-ap/preview/skin/doc.html?fn=synapview370710_2&rs=/assist/synap/preview
8. Ra JS, Kim HS (2017). Sex-based association between depression and metabolic syn-drome in Korean middle-aged and older adults. Osong Public Health Res Perspect, 8(2):130–7.
9. Gaillard TR (2018). The metabolic syndrome and its components in African-American women: Emerging trends and implica-tions. Front Endocrinol (Lausanne), 8:383.
10. Tran BT, Jeong BY, Oh JK (2017). The prevalence trend of metabolic syndrome and its components and risk factors in Korean adults: Results from the Korean National Health and Nutrition Examina-tion Survey 2008-2013. BMC Public Health, 17:71.
11. Na DW, Jeong E, Noh EK, et al (2010). Di-etary factors and metabolic syndrome in middle-aged men. J Agr Med Community Health, 35(4):383–94.
12. Volek JS, Phinney SD, Forsythe CE, et al (2009). Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids, 44(4):297–309.
13. Feinman RD, Pogozelski WK, Astrup A, et al (2015). Dietary carbohydrate restriction as the first approach in diabetes man-agement: Critical review and evidence base. Nutrition, 31(1):1–13.
14. Kim J (2016). Effects of a low-carbohydrate, high-fat diet. Korean J Obes, 25(4):176–83.
15. Bazzano LA, Hu T, Reynolds K, et al (2014). Effects of low-carbohydrate and low-fat diets: A randomized trial. Ann Intern Med, 161(5):309–18.
16. Brouns F (2018). Overweight and diabetes prevention: Is a low-carbohydrate–high-fat diet recommendable? Eur J Nutr, 57(4):1301–12.
17. Nordmann AJ, Nordmann A, Briel M, et al (2006). Effects of low-carbohydrate vs low-fat diets on weight loss and cardio-vascular risk factors: A meta-analysis of randomized controlled trials. Arch Intern Med, 166(3):285–93.
18. Fung TT, van Dam RM, Hankinson SE, et al (2010). Low-carbohydrate diets and all-cause and cause-specific mortality: Two cohort studies. Ann Intern Med, 153(5):289–98.
19. Alberti KGMM, Eckel RH, Grundy SM, et al (2009). Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Pre-vention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Cir-culation, 120(16):1640–5.
20. Kim MK, Lee WY, Kang JH, et al (2014). Clinical practice guidelines for overweight and obesity in Korea. Endocrinol Metab (Seoul), 29(4):405–9.
21. Ha K, Joung H, Song Y (2018). Low-carbohydrate diet and the risk of meta-bolic syndrome in Korean adults. Nutr Metab Cardiovasc Dis, 28(11):1122–32.
22. Hoffman MA, Driscoll JM. Health promo-tion and disease prevention: A concentric biopsychosocial model of health status. In: Brown SD, Lent RW, eds. Handbook of Counseling Psychology. 3rd ed. New York: John Wiley & Sons, Inc; 2000:532–567.
23. Santos FL, Esteves SS, da Costa Pereira A, et al (2012). Systematic review and meta‐analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. Obes Rev, 13(11):1048–66.
24. Oh H, Ahn J, Jun DW (2017). Association between a high-fat low-carbohydrate diet and non-alcoholic fatty liver disease: Truth or myth? Korean J Med, 92(2):112–7.
25. Volek JS, Sharman MJ, Love DM, et al (2002). Body composition and hormonal responses to a carbohydrate-restricted di-et. Metabolism, 51(7):864–70.
26. Forsythe CE, Phinney SD, Feinman RD, et al (2010). Limited effect of dietary saturat-ed fat on plasma saturated fat in the con-text of a low carbohydrate diet. Lipids, 45(10):947–62.
27. O’Neill BJ (2020). Effect of low-carbohydrate diets on cardiometabolic risk, insulin resistance, and metabolic syndrome. Curr Opin Endocrinol Diabetes Obes, 27(5):301–7.
28. Muzio F, Mondazzi L, Harris WS, et al (2007). Effects of moderate variations in the macronutrient content of the diet on cardiovascular disease risk factors in obese patients with the metabolic syn-drome. Am J Clin Nutr, 86(4):946–51.
29. Picklo MJ, Murphy EJ (2016). A high-fat, high-oleic diet, but not a high-fat, saturat-ed diet, reduces hepatic α-linolenic acid and eicosapentaenoic acid content in mice. Lipids, 51(5):537–47.
30. Ruuth M, Lahelma M, Luukkonen PK, et al (2021). Overfeeding saturated fat increas-es LDL (low-density lipoprotein) aggre-gation susceptibility while overfeeding unsaturated fat decreases proteoglycan-binding of lipoproteins. Arterioscler Thromb Vasc Biol, 41(11):2823–36.
31. Lambert EA, Phillips S, Belski R, et al (2017). Endothelial function in healthy young in-dividuals is associated with dietary con-sumption of saturated fat. Front Physiol, 8:876.
32. Shan Z, Guo Y, Hu FB, et al (2020). Associ-ation of low-carbohydrate and low-fat di-ets with mortality among US adults. JA-MA Intern Med, 180(4):513–23.
| Files | ||
| Issue | Vol 52 No 4 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i4.12439 | |
| Keywords | ||
| Metabolic syndrome Diet Carbohydrate-restricted High-fat Nutritional intake Women | ||
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How to Cite
1.
Jang T, Kim H, Kim T. Relationship between a Low-Carbohydrate, High-Fat Diet and Risk of Metabolic Syndrome in Korean Women. Iran J Public Health. 2023;52(4):713-721.
