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Even in healthy patients, prolonged caloric restriction may be an effective way to improve cardiovascular health.
A recent trial of caloric restriction in patients over a 2-year period showed that they had maintained a 10% weight loss and improved markers for metabolic diseases and heart disease.
"This shows that even a less severe modification than the one we used in this study could reduce the burden of diabetes and cardiovascular disease in our country," said lead author William Kraus, MD, cardiologist and Distinguished Professor of Medicine. at Duke "People can do it quite easily by simply observing their little indiscretions here or there, or perhaps reducing their number, such as not snacking after dinner."
The CALERIE trial, lasting 2 years, was limited and included 238 participants aged 21 to 50 years. It was a multicenter randomized controlled trial. Between May 8, 2008 and February 26, 2010, 218 of the 238 individuals were randomly badigned 2: 1 to a 25% (143, 66%) caloric restriction diet or an ad libitum ( 75, 34%). .
The researchers evaluated the responses of markers and risk factors, including systolic, diastolic and mean blood pressure, plasma lipids, highly sensitive C-reactive protein, metabolic syndrome score, and glucose homeostasis measurements. fasting insulin, glucose, insulin resistance and glucose at 2 o'clock, the area under the curve for glucose and insulin a tolerance test oral glucose in an intention-to-treat population.
After badysis, the researchers found that subjects randomized to the caloric restriction group reduced their caloric intake by an average of 11.9% and an average weight of 7.5 kg – 71% of which was fat loss. In the ad libitum control group, the mean reduction in caloric intake was 0.8% and the individuals had an average weight gain of 0.1 kg.
The researchers found that caloric restriction resulted in a persistent and significant reduction in all cardiometabolic risk factors measured at two years, which included changes in LDL-C, total cholesterol / C-HDL, and only systolic and diastolic blood pressure. In addition, caloric restriction resulted in significant improvement in C-reactive protein, insulin sensitivity index, and metabolic syndrome score compared to control.
"There is something about caloric restriction, a mechanism we do not yet understand that leads to these improvements," Krause said. "We have collected blood, muscle and other samples from these participants and will continue to explore what could be this metabolic signal or this magic molecule."
In a guest commentary, Frank Hu, MD, PhD, of Harvard's TH Chanv School of Public Health, called the groundbreaking trial.
"The CALERIE trial is revolutionary in many ways. This is the first long-term caloric restriction intervention in young, middle-aged, non-obese participants with a large sample, "said Hu.
"The trial collected detailed chronological data on biomarkers of aging and cardiometabolic risk factors. It has already been shown that the caloric restriction intervention has no adverse effects on the quality of life, "Hu said.
This study, entitled "Two Years of Caloric Restriction and Cardiometabolic Risk (CALERIE): Exploratory Results of a Multicenter Phase 2 Randomized Controlled Trial," is published in The Lancet: Diabetes & Endocrinology.
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