Table 3.
Factorial-Design Estimates of Effect of Diet Type on Mean Changes from Baseline in Risk Factors, Nutrient Intake, and Biomarkers of Adherence.*
| Variable | Change with High Fat minus Change with Low Fat | Change with High Protein minus Change with Average Protein | Change with Highest Carbohydrate minus Change with Lowest Carbohydrate | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| At 6 Mo | P Value | At 2 Yr | P Value | At 6 Mo | P Value | At 2 Yr | P Value | At 6 Mo | P Value | At 2 Yr | P Value | |
| Risk factors† | ||||||||||||
| Cholesterol (mg/dl) | ||||||||||||
| Total | 4.7±1.8 | 0.01 | 5.6±1.9 | 0.003 | 2.3±1.8 | 0.20 | 0.2±1.9 | 0.92 | −7.0±2.6 | 0.007 | −5.8±2.6 | 0.02 |
| LDL | 4.4±1.6 | 0.005 | 5.1±1.6 | 0.001 | 2.4±1.6 | 0.13 | 0.5±1.6 | 0.74 | −6.8±2.3 | 0.003 | −5.7±2.2 | 0.01 |
| HDL | 1.1±0.5 | 0.01 | 0.7±0.5 | 0.12 | 1.1±0.5 | 0.02 | 0.9±0.5 | 0.05 | −2.2±0.6 | 0.001 | −1.7±0.7 | 0.01 |
| Triglycerides (mg/dl) | −2.8±4.3 | 0.52 | −1.2±4.0 | 0.76 | −5.4±4.3 | 0.21 | −6.7±4.0 | 0.10 | 8.1±5.0 | 0.10 | 7.9±6.0 | 0.19 |
| Blood pressure (mm Hg) | ||||||||||||
| Systolic | 0.4±0.7 | 0.59 | 0.3±0.7 | 0.64 | −1.0±0.7 | 0.14 | −0.2±0.7 | 0.77 | 0.6±0.9 | 0.51 | −0.1±0.9 | 0.89 |
| Diastolic | 0.1±0.5 | 0.77 | 0.1±0.5 | 0.85 | −0.5±0.5 | 0.32 | 0.2±0.5 | 0.59 | 0.3±0.7 | 0.62 | −0.3±0.7 | 0.61 |
| Glucose (mg/dl) | 1.2±0.6 | 0.04 | 1.1±0.5 | 0.05 | 0.5±0.6 | 0.38 | 0.5±0.6 | 0.34 | −1.7±0.9 | 0.04 | −1.6±0.8 | 0.06 |
| Insulin (μU/ml) | 0.2±0.4 | 0.68 | −0.1±0.4 | 0.77 | 0.0±0.4 | 0.91 | −0.7±0.4 | 0.07 | −0.2±0.7 | 0.74 | 0.8±0.6 | 0.19 |
| HOMA | 0.13±0.13 | 0.31 | 0.03±0.10 | 0.78 | 0.03±0.13 | 0.84 | −0.16±0.10 | 0.12 | −0.15±0.21 | 0.46 | 0.13±0.16 | 0.42 |
| Nutrient intake per day | ||||||||||||
| Energy (kcal) | 11.4±53.9 | 0.83 | −75.6±70.9 | 0.29 | −23.2±53.9 | 0.67 | −35.5±71.0 | 0.62 | 11.1±71.8 | 0.88 | 118.1±96.6 | 0.23 |
| Carbohydrate (%) | −9.5±1.0 | <0.001 | −6.4±1.5 | <0.001 | −5.2±1.1 | <0.001 | −3.6±1.5 | 0.02 | 14.4±1.4 | <0.001 | 10.2±2.1 | <0.001 |
| Protein (%) | 0.9±0.5 | 0.06 | 0.2±0.7 | 0.77 | 4.2±0.4 | <0.001 | 1.4±0.7 | 0.05 | −5.0±0.6 | <0.001 | −1.6±1.0 | 0.10 |
| Fat (%) | 8.0±0.8 | <0.001 | 6.7±1.2 | <0.001 | 0.2±0.9 | 0.82 | 1.8±1.3 | 0.15 | −8.1±1.2 | <0.001 | −8.6±1.6 | <0.001 |
| Saturated fat (%) | 1.3±0.3 | <0.001 | 1.7±0.5 | <0.001 | 0.2±0.3 | 0.43 | 0.8±0.5 | 0.12 | −1.5±0.4 | 0.001 | −2.5±0.6 | <0.001 |
| Biomarkers of adherence | ||||||||||||
| Urinary nitrogen (g)‡ | −0.11±0.39 | 0.77 | 0.08±0.42 | 0.84 | 1.64±0.38 | <0.001 | 0.81±0.42 | 0.06 | −1.50±0.55 | 0.006 | −0.89±0.65 | 0.18 |
| Respiratory quotient§ | −0.01±0.00 | 0.005 | −0.02±0.00 | 0.002 | 0.00±0.00 | 0.52 | 0.00±0.00 | 0.51 | 0.01±0.01 | 0.13 | 0.01±0.01 | 0.07 |
Plus–minus values are means ±SE. Nutrient intake was determined by three 24-hour recalls. To convert the values for cholesterol to millimoles per liter, multiply by 0.02586. To convert the values for triglycerides to millimoles per liter, multiply by 0.01129. To convert the values for glucose to millimoles per liter, multiply by 0.05551. HDL denotes high-density lipoprotein, HOMA homeostasis model assessment of insulin sensitivity, and LDL low-density lipoprotein.
Data were included for 201 participants per group; missing values were imputed.
Data were included for 200 to 204 participants per group at baseline, 139 to 153 at 6 months, and 88 to 109 at 2 years.
Data were included for 201 to 204 participants per group at baseline, 157 to 164 at 6 months, and 113 to 132 at 2 years.