Low-carbohydrate diets may diminish triglyceride production
in the liver in response to decreased carbohydrate
delivery . The greater preservation of HDL-cholesterol
on a low-carbohydrate diet may be the result of down-regulation
by dietary fats of those hepatic receptors, which
bind HDL-cholesterol. However, it remains unclear
why HDL-cholesterol and triglycerides differed only at the
6-month visit between the two groups of our study. It may
well be that the transient effects on triglycerides and HDLcholesterol
are related to differences in macronutrient
composition in our study groups which became smaller
over time. Obviously, other variables like waist
circumference and systolic blood pressure were only influenced
by the degree of weight loss in the two groups and
not by macronutrient composition
Our results also demonstrate the general problem of
adherence to a diet with extreme nutrition relations. The
use of telemedicine permits continuous contact to participants,
individual support, and control of weight loss.
Moreover, use of this technique resulted in a low drop-out
rate of only 17% in our study participants. Nevertheless, it
was not possible to achieve the target macronutrient relations
in the two study groups in the long run. The target of
carbohydrate content in the LOGI group (< 40% energy)
was only reached within the first 3 months and the target
of carbohydrate content in the DGE group (>55% energy)
was not reached at any time. Note that earlier investigations