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) >25 kg/m(2), 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/m(2); Tibetan diet weight change:-6.2 +/- 4.4 kg/m(2); BMI change: -2.1 +/- 1.5 kg/m(2)), 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 12 months 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 +/- 47.8 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). (c) 2013 Elsevier Ireland Ltd. All rights reserved.