The Effects of Very-Low-Calorie Diets on HDL: A Review

Table 2

Studies investigating the use of VLCDs followed by a maintenance phase.

Study	N	Number of males	Intervention	Duration of VLCD	Total duration of; intervention	Weight at baseline (Kg)	Weight at end of VLCD(Kg)	Weight at end of study (Kg)	HDL at baseline (mmol/L)	HDL at end of VLCD (mmol/L)	HDL at end of study; (mmol/L)
Apfelbaum et al. [25]	78	18	220–800 kcal/d followed by maintenance (hypocaloric balanced diet + placebo).	4 (± 1 week)	>12 month (4 ± 1 week of VLCD followed by 12 month double-blind treatment phase).	105.1 (20.3)	97.7 (19.7)*	Δ 0.5 (5.7)^†	—	—	Δ 0.09 (0.08)
Apfelbaum et al. [25]	82	15	220–800 kcal/d followed by maintenance (hypocaloric balanced diet + sibutramine).	4 (± 1 week)	>12 month (4 ± 1 week of VLCD followed by 12 month double-blind treatment phase).	103.4 (17.5)	95.7 (16.9)*	Δ −5.2 (7.5)^*†	—	—	Δ 0.13 (0.09)*
Christiansen et al. [17]	29	15	600 kcal/d followed by maintenance (hypocaloric balanced diet).	8 week	12 weeks (8 weeks of VLCD followed by 4 weeks of maintenance).	107.8 (12)	Δ −11.2 kg*	95.5 (11)*	1.2 (0.3)	—	1.2 (0.3)
Christiansen et al. [17]	25	13	800 kcal/d + exercise followed by maintenance (hypocaloric balanced diet + exercise).	8 week	12 weeks (8 weeks of VLCD followed by 4 weeks of maintenance). Exercise was performed over the 12 weeks.	105.8 (15)	Δ −12.1 kg*	93.5 (13)*	1.2 (0.3)	—	1.3 (0.3)*
Delbridge et al. [27]	70	35	~500–550 kcal/d followed by maintenance (high-carbohydrate diet).	12 weeks	15 months (12 weeks VLCD; 12 months maintenance).	109.4 (2.6)	Δ −17.6 (0.8)*	Δ −14.3 (2.0)* (𝑛=40)	1.2; (0.04); (𝑛=65)	Δ −0.015 (0.02); (𝑛=62)	Δ − 0.21 (0.03)*(𝑛=33)
Delbridge et al. [27]	71	35	~500–550 kcal/d followed by maintenance (high-protein diet).	12 weeks	15 months (12 weeks VLCD; 12 months maintenance).	114.0 (3.0)	Δ −17.4 (0.7)*	Δ −14.8 (0.5)*(𝑛=42)	1.2 (0.03) (𝑛=59)	Δ 0.003 (0.03) (𝑛=54)	Δ 0.19 (0.04)*; (𝑛=33)
Erondu et al. [23]	176	32	800 kcal/d followed by weight maintenance (hypocaloric diet + placebo).	6 weeks	58 weeks (6 weeks VLCD followed by 52 weeks maintenance).	101.5 (15.3)	92.3 (13.9)*	95.6 (15.7)*	1.45 (0.34)	1.26 (0.25)	1.48 (0.37)
Erondu et al. [23]	181	37	800 kcal/d followed by weight maintenance (hypocaloric diet + MK-0557).	6 weeks	58 weeks (6 weeks VLCD followed by 52 weeks maintenance).	98.4 (13.8)	89.5 (12.7)*	91.1 (14.5)*	1.41 (0.36)	1.22 (0.29)	1.48 (0.40)
Fogelholm et al. [18]	28	0	1 week LCD + 8 weeks VLCD + 3 weeks LCD.; No increase in exercise.	8 weeks	12 weeks weight loss + 40 weeks no increased exercise + 2 year followup.	92.0 (9.8)	80.0 (9.5)*	89.7 (9.6); (𝑛=27)	1.22 (0.24)	1.12 (0.18)	1.34 (0.28); (𝑛=27)
Fogelholm et al. [18]	25	0	Same weight loss intervention as above + walking program targeted to expend 4.2 MJ/wk.	8 weeks	12 weeks weight loss + 40 weeks walking program (1) + 2 year followup.	92.0 (9.8)	78.0 (8.8)*	83.9; (12.2); (𝑛=24)	1.22 (0.24)	1.12 (0.27)	1.42 (0.35); (𝑛=24)
Fogelholm et al. [18]	27	0	Same weight loss intervention as above + walking program targeted to expend 8.4 MJ/wk.	8 weeks	12 weeks weight loss + 40 weeks walking program (2) + 2 year followup.	92.0 (9.8)	78.2 (11.6)*	87.4 (15.3); (𝑛=23)	1.22 (0.24)	1.13 (0.19)	1.41 (0.25); (𝑛=23)
Haugaard et al. [28]	9	2	600–800 kcal/d followed by weight maintenance (hypocaloric balanced diet).	8 weeks	32 weeks (8 weeks VLCD + 24 weeks weight maintenance).	104.5	94.7; (SE: 4.0)*	93.5; (SE: 4.9)*	1.4	1.2 (0.1)*	1.4 (0.1)
Heinonen et al. [24]	35	19	800 kcal/d followed by weight maintenance (hypocaloric balanced diet + placebo or Orlistat).	8 weeks	8 months (8 weeks VLCD + 6 months weight maintenance).	101.7 (2.0)	86.9 (1.7)*	86.6 (1.8)*	1.17 (0.04)	1.25 (0.04)*	1.23 (0.05)*
Paisey et al. [26]	15	6	Type 2 diabetic patients 450 kcal/d for women or 650 kcal/d for men.	6 weeks	>5 years (6 week VLCD and 5 year followup).	—	—	—	1.20 (0.39)	—	1.26 (0.47)
Pekkarinen et al. [20]	29	0	429 kcal/d followed by weight maintenance (refeeding to low-energy food).; The programme included 12 sessions of behaviour methods for weight control.	8 week	52 week (8 week VLCD + 9 weeks refeeding and followup at week 52).	96.1 (10.9)	Δ −12.4 (3.3)*	Δ −10.7 (7.6)*; (𝑛=27)	1.19 (0.25)	Δ −0.20 (0.20)*	Δ 0.16 (0.18)* (𝑛=26)
Richelsen et al. [22]	156	76	600–800 kcal/d followed by weight maintenance (hypocaloric balanced diet + Placebo).	8 weeks	38 months (8 weeks VLCD + 36 months placebo and hypocaloric diet).	111.9 (16.0)	Δ −14.3 *	Δ −7.2 *	1.15 (0.26)	Δ −0.07*	Δ 0.06*
Richelsen et al. [22]	153	76	600–800 kcal/d followed by weight maintenance (hypocaloric balanced diet + Orlistat).	8 weeks	38 months (8 weeks VLCD + 36 months Orlistat and hypocaloric diet).	110.7 (17.9)	Δ −14.5*	Δ −9.4*	1.13 (0.26)	Δ −0.05*	Δ 0.04*
Rolland et al. [19]	14	5	~550 kcal/d + behaviour therapy followed by weight maintenance (refeeding, balanced diet and behaviour therapy.	Average 6.9 months	9 months (12 weeks–9 months of VLCD followed by maintenance).	129.6 (23.0)	109.1 (14.6)*	109.1 (14.6)*	1.29 (0.19)	1.47 (0.23)*	1.47 (0.23)*
Wing et. [21]	17	4	LCD (1000 to 1500 kcal/d depending on initial body weight) followed by a VLCD (400 kcal/d) followed by weight maintenance (refeeding to hypocaloric diet) + BT (for duration of the study)	8 weeks	72 weeks (1 month LCD followed by 2 months of VLCD, followed by refeeding for 8 weeks and a followup after 52 weeks).	102.1 (11.7)	83.5 (9.5)*	93.5 (10.4)*	1.11 (2.3)	1.26 (0.30)*	1.33 (0.25)*

Values reported as means (standard deviation) unless stated otherwise.
N: number of participants
* P <.05 compared to baseline
SE: standard error
Δ values reported as change
^† values do not include weight lost during the VLCD.