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Additional file 1. Supplementary material.

Worldwide, cardiovascular disease (CVD) is the number 1 cause of mortality and is associated with insulin resistance (IR). Emerging biomarkers such as FGF21 and adiponectin are associated with cardiometabolic risk. Low carbohydrate, high fat (LCHF) diets have been reported to reduce cardiometabolic risk markers; however, few studies have compared a LCHF diet vs. a high carbohydrate (HC), lower fat diet under ad libitum conditions on adiponectin and FGF21. The purpose of this study was to investigate the effects of an ad libitum LCHF vs. HC diet on IR, FGF21 and adiponectin in 16 healthy adults. Ethical approval: Liverpool John Moores University Research Ethics Committee (16/ELS/029); registered with ClinicalTrials.gov (Ref. NCT03257085). Participants were randomly assigned to a HC diet (n=8, the UK Eatwell guidelines; u226550% of energy from carbohydrates) or a LCHF diet (n=8, consume 0.05) were observed between groups. Adiponectin was significantly (P=0.03) different at week 4 only between groups. Adiponectin increased after 4 weeks (Mdn, IQR:13.44, 9.12-25.47 to 16.64, 11.96-21.51 ng/ml) but was only significantly (P=0.03) different by 8 weeks vs. baseline in the HC group (Mdn, IQR:16, 10.8-27.43 ng/ml). Adiponectin remained unchanged (P=0.96) in the LCHF group. HOMA significantly decreased with both diets after 8 weeks only (mean u00b1 SD, LCHF: 2.9 u00b1 1.3 to 1.8 u00b1 0.8, HC: 2.5 u00b1 0.6 to 1.9 u00b1 0.6, P=0.008) but was not significantly (P=0.60) different between groups. These preliminary data reveal that while both diets improved insulin sensitivity, they may do so by different mechanisms. Future studies are warranted to investigate further, how a LCHF vs. HC diet affects FGF21 and adiponectin, and the subsequent regulation of IR. Furthermore, studies that extend these findings by determining the impact of LCHF vs. HC on peripheral metabolism to determine potential nutrition-mediated mechanisms of metabolic adaptation are warranted.

Cardiovascular disease (CVD) is the number 1 disease to cause mortality worldwide and is associated with alterations in lipid metabolism. Apolipoproteins regulate lipoprotein characteristics and recent evidence has shown apolipoproteins (apo) to be important CVD risk predictors. Poor lifestyle habits can lead to unhealthy alterations in lipid metabolism. A low carbohydrate high fat (LCHF) diet has shown to improve lipid metabolism and metabolic health markers however; few studies have compared a LCHF diet to a high carbohydrate (HC), lower fat diet under ad libitum conditions, particularly their effect on apoC-III. The aims of this investigation was to measure the effect of a LCHF diet vs. a HC diet on apoC-III, apoA1, apoB and apoB/apoA1 in 16 healthy Caucasian adults aged 19-64. Ethics was approved from Liverpool John Moores University Research Ethics Committee (16/ELS/029) and was registered with ClinicalTrials.gov (Ref. NCT03257085). Participants randomly assigned to either a HC diet (the UK Eatwell guidelines; u226550% of energy from carbohydrates) (n=8), or a LCHF diet (consume