J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Review

Volume 6, Number 5, October 2014, pages 321-326

Effects of Carbohydrate and Dietary Fiber Intake, Glycemic Index and Glycemic Load on HDL Metabolism in Asian Populations

**Table 1.** Meta-Analysis and Systematic Reviews About Effects of Carbohydrate Intake on HDL-C
Authors	Study design	Subjects studied	Results/conclusions
BMI: body mass index; HDL-C: high-density lipoprotein-cholesterol; HFLC: high-fat low-carbohydrate; LFHC: low-fat high-carbohydrate.
Hu et al [8]	Low-carbohydrate diets (≤ 45%) vs. low-fat diets (≤ 30%) on metabolic risk factors	2,788 participants	Compared with low-fat diets, low-carbohydrate diets induced a greater increase in HDL-C (3.3 mg/dL; 95% CI, 1.9 - 4.7)
Huth et al [9]	The relationship between milk fat containing dairy foods and cardiovascular risk factors		A diet higher in saturated fat from whole milk and butter increase HDL-C when substituted for carbohydrates or unsaturated fatty acids
Hession et al [10]	Low-carbohydrate diets vs. low-fat/low-calorie diets	Adults with BMI ≥ 28 kg/m²	There were significant differences between the groups for HDL-C, favoring the low-carbohydrate diet
Crawford et al [11]	Systemic review on dietary factors on metabolic parameters		Low-carbohydrate diets raise HDL-C by approximately 10%
Kodama et al [12]	Influence of fat and carbohydrate proportions on metabolic parameters	306 patients with type 2 diabetes	LFHC diet significantly lowered HDL-C by 6% (P < 0.001) compared with HFLC diet
Nordmann et al [13]	Low-carbohydrate vs. low-fat diets on cardiovascular risk factors	447 individuals	HDL-C changed more favorably in individuals assigned to low-carbohydrate diets after 6 months by 4.6 mg/dL (95% CI, 1.5 - 8.1)
Mensink et al [14]	Effect of changes in carbohydrate and fatty acid intake on serum lipid and lipoprotein levels	27 controlled trials	All fatty acids elevated HDL-C when substituted for carbohydrates

Table 1. Meta-Analysis and Systematic Reviews About Effects of Carbohydrate Intake on HDL-C

Authors

Study design

Subjects studied

Results/conclusions

BMI: body mass index; HDL-C: high-density lipoprotein-cholesterol; HFLC: high-fat low-carbohydrate; LFHC: low-fat high-carbohydrate.

Hu et al [8]

Low-carbohydrate diets (≤ 45%) vs. low-fat diets (≤ 30%) on metabolic risk factors

2,788 participants

Compared with low-fat diets, low-carbohydrate diets induced a greater increase in HDL-C (3.3 mg/dL; 95% CI, 1.9 - 4.7)

Huth et al [9]

The relationship between milk fat containing dairy foods and cardiovascular risk factors

A diet higher in saturated fat from whole milk and butter increase HDL-C when substituted for carbohydrates or unsaturated fatty acids

Hession et al [10]

Low-carbohydrate diets vs. low-fat/low-calorie diets

Adults with BMI ≥ 28 kg/m²

There were significant differences between the groups for HDL-C, favoring the low-carbohydrate diet

Crawford et al [11]

Systemic review on dietary factors on metabolic parameters

Low-carbohydrate diets raise HDL-C by approximately 10%

Kodama et al [12]

Influence of fat and carbohydrate proportions on metabolic parameters

306 patients with type 2 diabetes

LFHC diet significantly lowered HDL-C by 6% (P < 0.001) compared with HFLC diet

Nordmann et al [13]

Low-carbohydrate vs. low-fat diets on cardiovascular risk factors

447 individuals

HDL-C changed more favorably in individuals assigned to low-carbohydrate diets after 6 months by 4.6 mg/dL (95% CI, 1.5 - 8.1)

Mensink et al [14]

Effect of changes in carbohydrate and fatty acid intake on serum lipid and lipoprotein levels

27 controlled trials

All fatty acids elevated HDL-C when substituted for carbohydrates

**Table 2.** Clinical Trials to Study Effects of Dietary Fiber Intake on HDL-C, Performed in Asian Populations
Authors	Nationality of subjects	Study design	Subjects studied	Results/conclusions
HDL-C: high-density lipoprotein-cholesterol; TC: total cholesterol.
Zhang et al [18]	China	Daily 100 g of instant oat cereal vs. 100 g of wheat flour-based noodles for 6 weeks	Adults with mild to moderate hypercholesterolemia	HDL-C decreased significantly in the control group vs. the oat group
Singh et al [19]	India	Soluble dietary fiber and a potassium-rich diet containing 0.5 - 1.0 kg of guava daily (group A) vs. an usual diet (group B) for 4 weeks	145 hypertensive patients	An insignificant increase in HDL-C (4.6%) with a mild increase in TC/ HDL-C in group A patients compared with group B
Singh et al [20]	India	Guava fruit preferably before meals in a foods-to-eat approach rather than foods-to-restrict, in a randomized and single-blind fashion for 12 weeks	120 patients with essential hypertension	A significant net increase in HDL-C (8.0%) after 12 weeks of guava fruit substitution
Zhang et al [21]	China	An ordinary diet plus foods containing refined konjac meal vs. the ordinary diet for 45 days	110 elderly people with hyperlipidemia	In the experimental group, HDL-C was significantly elevated (P < 0.01). In the control group, the change in HDL-C was insignificant. The difference in HDL-C between the two groups was statistically significant

Table 2. Clinical Trials to Study Effects of Dietary Fiber Intake on HDL-C, Performed in Asian Populations

Authors

Nationality of subjects

Study design

Subjects studied

Results/conclusions

HDL-C: high-density lipoprotein-cholesterol; TC: total cholesterol.

Zhang et al [18]

China

Daily 100 g of instant oat cereal vs. 100 g of wheat flour-based noodles for 6 weeks

Adults with mild to moderate hypercholesterolemia

HDL-C decreased significantly in the control group vs. the oat group

Singh et al [19]

India

Soluble dietary fiber and a potassium-rich diet containing 0.5 - 1.0 kg of guava daily (group A) vs. an usual diet (group B) for 4 weeks

145 hypertensive patients

An insignificant increase in HDL-C (4.6%) with a mild increase in TC/ HDL-C in group A patients compared with group B

Singh et al [20]

India

Guava fruit preferably before meals in a foods-to-eat approach rather than foods-to-restrict, in a randomized and single-blind fashion for 12 weeks

120 patients with essential hypertension

A significant net increase in HDL-C (8.0%) after 12 weeks of guava fruit substitution

Zhang et al [21]

China

An ordinary diet plus foods containing refined konjac meal vs. the ordinary diet for 45 days

110 elderly people with hyperlipidemia

In the experimental group, HDL-C was significantly elevated (P < 0.01). In the control group, the change in HDL-C was insignificant. The difference in HDL-C between the two groups was statistically significant

**Table 3.** Clinical Trials to Study Effects of GI and GL on HDL-C, Performed in Asian Populations
Authors	Nationality of subjects	Study design	Subjects studied	Results/conclusions
CI: confidence interval; CVD: cardiovascular disease; GI: glycemic index; GL: glycemic load; HDL-C: high-density lipoprotein-cholesterol.
Choi et al [28]	Korea	The association between dietary carbohydrates and low HDL-C prevalence	A total of 9,947 Korean adults older than 20 years	Odds ratios for having low HDL-C in the highest quintile were 1.66 (95% CI, 1.24 - 2.22) for total carbohydrate, 1.34 (1.02 - 1.75) for percentage of energy from carbohydrate, and 1.54 (1.17 - 2.03) for GL in men as compared with the second quintile as a reference. Odds ratio for low HDL-C was 1.38 (1.12 - 1.71) for percentage of energy from carbohydrate in women.
Murakami et al [29]	Japan	The associations between dietary GI and GL and metabolic risk factors	1,354 Japanese female farmers aged 20 - 78 years from five regions of Japan	Dietary GL was independently negatively correlated with HDL-C (n = 1,354; P = 0.004)
Amano et al [30]	Japan	The associations between dietary GI, GL and CVD risk factors	A total of 32 women aged 52.5 ± 7.2 years participated in the weight-reduction program	In the lowest GI tertile, the highest concentration of HDL-C was observed (P < 0.01). In the lowest GL tertile, the highest concentration of HDL-C was observed (P < 0.05)

Table 3. Clinical Trials to Study Effects of GI and GL on HDL-C, Performed in Asian Populations

Authors

Nationality of subjects

Study design

Subjects studied

Results/conclusions

CI: confidence interval; CVD: cardiovascular disease; GI: glycemic index; GL: glycemic load; HDL-C: high-density lipoprotein-cholesterol.

Choi et al [28]

Korea

The association between dietary carbohydrates and low HDL-C prevalence

A total of 9,947 Korean adults older than 20 years

Odds ratios for having low HDL-C in the highest quintile were 1.66 (95% CI, 1.24 - 2.22) for total carbohydrate, 1.34 (1.02 - 1.75) for percentage of energy from carbohydrate, and 1.54 (1.17 - 2.03) for GL in men as compared with the second quintile as a reference. Odds ratio for low HDL-C was 1.38 (1.12 - 1.71) for percentage of energy from carbohydrate in women.

Murakami et al [29]

Japan

The associations between dietary GI and GL and metabolic risk factors

1,354 Japanese female farmers aged 20 - 78 years from five regions of Japan

Dietary GL was independently negatively correlated with HDL-C (n = 1,354; P = 0.004)

Amano et al [30]

Japan

The associations between dietary GI, GL and CVD risk factors

A total of 32 women aged 52.5 ± 7.2 years participated in the weight-reduction program

In the lowest GI tertile, the highest concentration of HDL-C was observed (P < 0.01). In the lowest GL tertile, the highest concentration of HDL-C was observed (P < 0.05)