BEER-SHEVA, Israel—According to an Israeli study at Ben-Gurion University of the Negev, a two-year low-fat, low-carb or Mediterranean weight-loss diet can similarly induce a significant regression of measurable carotid vessel wall volume (VWV) and appears to be mediated mainly by the weight loss–induced decline in blood pressure (Circulation. 2010;121:1200-08). In the two-year Dietary Intervention Randomized Controlled Trial–Carotid (DIRECT-Carotid) study, participants were randomized to low-fat, Mediterranean or low-carbohydrate diets and were followed for changes in carotid artery intima-media thickness
Of 140 complete images of participants (aged 51 years), higher baseline carotid VWV was associated with increased intima-media thickness, age, male sex, baseline weight, blood pressure and insulin levels (P<0.05 for all). After two years of dietary intervention, researchers observed a significant 5-percent regression in mean carotid VWV, with no differences in the low-fat, Mediterranean or low-carb groups. Mean change in intima-media thickness was –1.1 percent (P=0.18). A reduction in the ratio of apolipoprotein B100 to apolipoprotein A1 was observed in the low-carb compared with the low-fat group (P=0.001). Participants who exhibited carotid VWV regression compared with participants who exhibited progression had achieved greater weight loss, greater decreases in systolic blood pressure and total homocysteine and a higher increase of apolipoprotein A1. In multivariate regression models, only the decrease in systolic blood pressure remained a significant independent modifiable predictor of subsequent greater regression in both carotid VWV and intima-media thickness levels.
