High density lipoprotein subfractions during semistarvation in obese women.

The influence of a very low caloric diet (VLCD) on high density lipoproteins (HDL) is controversial. This study was designed to evaluate the influence of a VLCD on lipids and lipoproteins, especially on HDL subfractions (HDL2, HDL3) in obese women. After a 4-day period of isocaloric standard diet, 30 women at least 50% above ideal body weight were switched for 15 days on a protein-sparing modified diet providing 1.57 MJ per day. Mean body weight reduction was 5.6 +/- 0.7 kg. After the VLCD, total, very low density lipoproteins (VLDL), low density lipoproteins (LDL) and HDL cholesterol significantly decreased in all the subjects (p less than 0.01). Both HDL subfractions were depressed after the VLCD (p less than 0.01) but the reduction occurred predominantly in the HDL2 subfraction, thus inducing a decrease in the HDL2 to HDL3 cholesterol ratio (p less than 0.01). The VLCD was associated with a slight but not significant increase in the LDL to HDL cholesterol ratio. This increase was due mostly to the rise in the LDL to HDL2 cholesterol ratio (p less than 0.01). Further studies are needed to evaluate the long-term changes of HDL subfractions during weight-reducing regimens.