For Lower Blood Pressure, Low-Carb Diet May Be Best

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Over 48 weeks, the low-carbohydrate group lost 9.5 percent of their body weight, while the orlistat group lost 8.5 percent. "Good" cholesterol (HDL) and triglyceride levels improved in both groups. LDL, or "bad" cholesterol, was only reduced in the orlistat group. Insulin and glucose markers improved only in the low-carb group, and there was a significant drop in blood pressure in the low-carb group compared to the orlistat group -- systolic blood pressure (the top number) dropped by 5.9 mm Hg on the low-carb diet vs. 1.5 mm Hg for the orlistat group. Similar reductions were seen for diastolic blood pressure.

Yancy said the blood pressure and cholesterol drops might have been even more impressive if people had stayed on their medications, but as they lost weight and normalized these readings, the doctors took them off blood-pressure and cholesterol drugs.

Two other studies in the same issue of the journal looked at the effects of the DASH diet and a physician-supervised plan.

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Researchers compared the DASH (Dietary Approaches to Stop Hypertension) diet alone and in combination with exercise and weight management on blood pressure. The researchers found that combining the DASH diet with weight management and exercise resulted in a 16.1 mm Hg drop in systolic blood pressure compared to 11.2 mm Hg on the DASH diet alone. Additionally, those in the exercise, weight management and DASH plan lost an average of 19 pounds over four months vs. less than one pound for the DASH diet alone.

The third study compared an Internet weight-management program with a physician-managed program for extremely obese people that included a liquid diet component, followed by a structured diet, behavioral counseling and diet medications. The more intensive intervention was more successful with 31 percent losing more than 5 percent of their body weight, compared to just 9 percent of the Internet group.

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