Weight reduction in patients with coronary artery disease: Comparison of Traditional Tibetan Medicine and Western diet.

Background: To test alternative medicine approaches with 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 evidence-based 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) >25kg/m2, and had evidence of metabolic syndrome. The primary endpoint was change in body weight and BMI at 6months follow-up. Secondary endpoints included blood pressure, heart rate, intima media thickness, lipids, fasting glucose, glycated hemoglobin, fibrinogen, C-reactive protein (CRP) at 6months follow-up and change in body weight and BMI at 12months. Results: Both groups of patients showed significantly reduced body weight and BMI compared to baseline (6months, usual care weight change: −3.2±3.0kg; BMI change: −1.1±1.0kg/m2; Tibetan diet weight change: −6.2±4.4kg/m2; BMI change: −2.1±1.5kg/m2), but these changes were more pronounced in Tibetan diet compared to usual care (all, p<0.001). Beneficial effects on weight and BMI were maintained after 12months of follow-up (p<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±47.8mg/dL; p=0.024; LDL: 111.6±37.8 vs. 119.4±40.9mg/dL; p=0.026; fibrinogen: 318.3±90.4 vs. 334.1±87.9mg/dL; p=0.040; CRP: 1.2±3.0 vs. 2.2±4.5mg/dL; p=0.036). Conclusions: Tibetan diet reduces body weight and BMI in patients with CAD and metabolic syndrome after 6months significantly better than Western diet and may induce lipid-modifying and anti-inflammatory effects (ClinicalTrials.gov identifier: NCT00810992). [ABSTRACT FROM AUTHOR]