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PURPOSE: Low-carbohydrate diets (LCD) are a popular dietary strategy for weight reduction. The effects of LCD on long-term outcome vary depending on type of LCD, possibly due to the fact that effects on cardiometabolic risk factors may vary with different types of LCD. Accordingly, we studied these relations. METHODS: We assessed serum concentrations of high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), high-sensitivity C-reactive protein (CRP), total cholesterol, glycated hemoglobin, and uric acid, and nutrient intakes by standardized methods in men and women ages 40–59 years from four population samples of Japanese in Japan (553 men and 544 women, combined). For people consuming usual, animal-based, and plant-based LCDs, we calculated LCD scores, based on relative level of fat, protein, and carbohydrate, by modifying the methods of Halton et al. Instead of calculating scores based on animal or vegetable fat, we used saturated fatty acids (SFA) or monounsaturated fatty acids (MUFA) + polyunsaturated fatty acids (PUFA). RESULTS: In multivariate regression analyses with adjustment for site, age, sex, BMI, smoking, alcohol intake, physical activity, and years of education, all three LCD scores were significantly positively related to HDLc (all P < 0.001), but not to LDLc. The plant-based LCD score was significantly inversely related to log CRP (coefficient = −0.010, P = 0.018). CONCLUSIONS: All three LCD scores were significantly positively related to HDLc. The plant-based LCD score was significantly inversely related to CRP. Carbohydrate intake below 50 % of total energy with higher intakes of vegetable protein and MUFA + PUFA, and lower intakes of SFA may be favorable for reducing cardiometabolic risk factors.

Introduction: Sizable numbers of people have tried low carbohydrate diets (LCD) of varied types; data are sparse on effects on cardiometabolic risk factors with different types of LCD. Hypothesis: We assessed the hypothesis that relationships of LCD score to cardiometabolic risk factors and an inflammatory marker, high-sensitivity C-reactive protein (CRP), are different among usual, animal-based, and plant-based LCD. Methods: We assessed serum concentrations of high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), high sensitivity C-reactive protein (CRP), and nutrient intakes by standardized methods in men and women ages 40 to 59 years from four population samples of Japanese in Japan (553 men and 544 women, combined). For people consuming usual, animal-based, and plant-based LCDs, we calculated LCD scores, based on relative level of fat, protein, and carbohydrate, by modifying the methods of Halton, et al. Instead of calculating scores based on animal or vegetable fat, we used saturated fatty acids (SFA) or monounsaturated fatty acids (MUFA) +polyunsaturated fatty acids (PUFA). Multiple linear regression analyses were used to examine relations of LCD scores to log-CRP and cardiometabolic risk factors. Results: In multivariate regression analyses with adjustment for site, age, sex, BMI, smoking, alcohol intake, physical activity, years of education, and Keys dietary lipid score, all three LCD scores were significantly directly related to HDLc (all Ps Conclusions: All three LCD scores were significantly directly related to HDLc, but not to LDLc. The plant-based LCD score, associated with higher PUFA and lower SFA and dietary cholesterol in comparison with the other two LCD scores, was significantly inversely related to log-CRP.