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Article

Associations of Changes in Blood Lipid Concentrations with Changes in Dietary Cholesterol Intake in the Context of a Healthy Low-Carbohydrate Weight Loss Diet: A Secondary Analysis of the DIETFITS Trial

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Department of Health Research & Policy, Stanford University School of Medicine, Stanford, CA 94305, USA
2
General Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
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Medical Service-Obesity Medicine, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
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Internal Medicine-Primary Care, Fair Oaks Health Center, San Mateo County Health System, Redwood City, CA 94063, USA
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Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA 94305, USA
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Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, CA 94305, USA
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Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Jogchum Plat
Nutrients 2021, 13(6), 1935; https://doi.org/10.3390/nu13061935
Received: 20 April 2021 / Revised: 26 May 2021 / Accepted: 29 May 2021 / Published: 4 June 2021
(This article belongs to the Section Clinical Nutrition)
In 2015, the Dietary Guidelines for Americans (DGA) eliminated the historical upper limit of 300 mg of dietary cholesterol/day and shifted to a more general recommendation that cholesterol intake should be limited. The primary aim of this secondary analysis of the Diet Intervention Examining the Factors Interacting With Treatment Success (DIETFITS) weight loss diet trial was to evaluate the associations between 12-month changes in dietary cholesterol intake (mg/day) and changes in plasma lipids, particularly low-density lipoprotein (LDL) cholesterol for those following a healthy low-carbohydrate (HLC) diet. Secondary aims included examining high-density lipoprotein (HDL) cholesterol and triglycerides and changes in refined grains and added sugars. The DIETFITS trial randomized 609 healthy adults aged 18–50 years with body mass indices of 28–40 kg/m2 to an HLC or healthy low-fat (HLF) diet for 12 months. Linear regressions examined the association between 12-month change in dietary cholesterol intake and plasma lipids in 208 HLC participants with complete diet and lipid data, adjusting for potential confounding variables. Baseline dietary cholesterol intake was 322 ± 173 (mean ± SD). At 12 months, participants consumed an average of 460 ± 227 mg/day of dietary cholesterol; 76% consumed over the previously recommended limit of 300 mg/day. Twelve-month changes in cholesterol intake were not significantly associated with 12-month changes in LDL-C, HDL-C, or triglycerides. Diet recall data suggested participants’ increase in dietary cholesterol was partly due to replacing refined grains and sugars with eggs. An increase in daily dietary cholesterol intake to levels substantially above the previous 300 mg upper limit was not associated with a negative impact on lipid profiles in the setting of a healthy, low-carbohydrate weight loss diet. View Full-Text
Keywords: dietary cholesterol; low-carbohydrate; LDL cholesterol; HDL cholesterol; triglycerides; human study; weight loss trial; healthy adults; diet quality; eggs dietary cholesterol; low-carbohydrate; LDL cholesterol; HDL cholesterol; triglycerides; human study; weight loss trial; healthy adults; diet quality; eggs
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MDPI and ACS Style

Vergara, M.; Hauser, M.E.; Aronica, L.; Rigdon, J.; Fielding-Singh, P.; Shih, C.W.; Gardner, C.D. Associations of Changes in Blood Lipid Concentrations with Changes in Dietary Cholesterol Intake in the Context of a Healthy Low-Carbohydrate Weight Loss Diet: A Secondary Analysis of the DIETFITS Trial. Nutrients 2021, 13, 1935. https://doi.org/10.3390/nu13061935

AMA Style

Vergara M, Hauser ME, Aronica L, Rigdon J, Fielding-Singh P, Shih CW, Gardner CD. Associations of Changes in Blood Lipid Concentrations with Changes in Dietary Cholesterol Intake in the Context of a Healthy Low-Carbohydrate Weight Loss Diet: A Secondary Analysis of the DIETFITS Trial. Nutrients. 2021; 13(6):1935. https://doi.org/10.3390/nu13061935

Chicago/Turabian Style

Vergara, Monica, Michelle E. Hauser, Lucia Aronica, Joseph Rigdon, Priya Fielding-Singh, Cynthia W. Shih, and Christopher D. Gardner. 2021. "Associations of Changes in Blood Lipid Concentrations with Changes in Dietary Cholesterol Intake in the Context of a Healthy Low-Carbohydrate Weight Loss Diet: A Secondary Analysis of the DIETFITS Trial" Nutrients 13, no. 6: 1935. https://doi.org/10.3390/nu13061935

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