Dietary intervention to reverse carotid atherosclerosis

Area of Science:

• Cardiovascular Medicine
• Nutritional Science
• Medical Imaging

Background:

• The potential for dietary weight loss interventions to reverse carotid atherosclerosis remains unclear.
• Carotid atherosclerosis is a significant risk factor for cardiovascular events.

Purpose of the Study:

• To investigate whether dietary weight loss interventions can induce regression of carotid atherosclerosis.
• To compare the effects of low-fat, Mediterranean, and low-carbohydrate diets on carotid atherosclerosis progression.

Main Methods:

• A 2-year randomized controlled trial (DIRECT-Carotid study) involving 140 participants.
• Participants were assigned to low-fat, Mediterranean, or low-carbohydrate diets.
• Carotid artery intima-media thickness and carotid vessel wall volume (VWV) were measured using ultrasound.

Main Results:

• A significant 5% regression in mean carotid vessel wall volume (VWV) was observed after 2 years of dietary intervention.
• No significant differences in VWV regression were found between the three diet groups.
• A reduction in systolic blood pressure was the strongest independent predictor of carotid VWV and intima-media thickness regression.

Conclusions:

• Two-year weight loss diets effectively induce regression of measurable carotid VWV.
• The observed regression is independent of the specific dietary strategy (low-fat, Mediterranean, or low-carbohydrate).
• Weight loss-induced reduction in blood pressure is the primary mechanism driving carotid atherosclerosis regression.