Weight reduction in patients with coronary artery disease: Comparison of traditional Tibetan medicine and Western diet

摘要

Background: To test alternativemedicine approacheswith a specifically designed Tibetan dietary and behavioral program in patients with established coronary artery disease (CAD) and manifest metabolic syndrome. Methods: This was a randomized, controlled, double-blinded, parallel group dietary and behavioral intervention study. Between December 2008 and November 2010, patients were randomly adjudicated either to evidencebased Western diet (usual care), or to Tibetan diet. We evaluated 524 patients undergoing coronary angiography. All patients were white Caucasian, presented with a body mass index (BMI) N25 kg/m2, and had evidence of metabolic syndrome. The primary endpoint was change in body weight and BMI at 6 months follow-up. Secondary endpoints included blood pressure, heart rate, intima media thickness, lipids, fasting glucose, glycated hemoglobin, fibrinogen, C-reactive protein (CRP) at 6 months follow-up and change in body weight and BMI at 12 months. Results: Both groups of patients showed significantly reduced body weight and BMI compared to baseline (6 months, usual care weight change: -3.2 ± 3.0 kg; BMI change: -1.1 ± 1.0 kg/m2; Tibetan diet weight change:-6.2 ± 4.4 kg/m2; BMI change:-2.1 ± 1.5 kg/m2), but these changesweremore pronounced in Tibetan diet compared to usual care (all, p b 0.001). Beneficial effects onweight and BMIweremaintained after 12 months of follow-up (p b 0.0001). Levels of total and LDL cholesterols, fibrinogen and CRP were decreased in both groups, but more pronounced in Tibetan diet (Tibetan diet vs. usual care (total cholesterol): 176.2 ± 43.7 vs. 185.1 ± 47.8 mg/dL; p = 0.024; LDL: 111.6 ± 37.8 vs. 119.4 ± 40.9 mg/dL; p = 0.026; fibrinogen: 318.3 ± 90.4 vs. 334.1 ± 87.9 mg/dL; p = 0.040; CRP: 1.2 ± 3.0 vs. 2.2 ± 4.5 mg/dL; p = 0.036). Conclusions: Tibetan diet reduces body weight and BMI in patients with CAD and metabolic syndrome after 6 months significantly better than Western diet and may induce lipid-modifying and anti-inflammatory effects (ClinicalTrials.gov identifier: NCT00810992).