Based on the evidence review ed , low-CHO and very-low-CHO diets are not superior to other dietary approaches for weight loss .
These diets may have advantages related to appetite control , triglyceride reduction , and reduction in the use of medication in T2D management .
The evidence review ed showed mixed effects on low-density lipoprotein cholesterol levels with some studies showing an increase .
There was no clear evidence for advantages regarding effects on other cardiometabolic risk markers .
Historically , low-carbohydrate ( CHO ) and very-low-CHO diets have been used for weight loss .
Recently , these diets have been promoted for type 2 diabetes ( T2D ) management .
This scientific statement provides a comprehensive review of the current evidence base available from recent systematic review s and meta-analyses on the effects of low-CHO and very-low-CHO diets on body weight , lipoprotein lipids , glycemic control , and other cardiometabolic risk factors .
Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial
Abstract Objective To determine the effects of diets varying in carbohydrate to fat ratio on total energy expenditure . Design R and omized trial . Setting Multicenter collaboration at US two sites , August 2014 to May 2017 . Participants 164 adults aged 18 - 65 years with a body mass index of 25 or more . Interventions After 12 % ( within 2 % ) weight loss on a run-in diet , participants were r and omly assigned to one of three test diets according to carbohydrate content ( high , 60 % , n=54 ; moderate , 40 % , n=53 ; or low , 20 % , n=57 ) for 20 weeks . Test diets were controlled for protein and were energy adjusted to maintain weight loss within 2 kg . To test for effect modification predicted by the carbohydrate-insulin model , the sample was divided into thirds of pre-weight loss insulin secretion ( insulin concentration 30 minutes after oral glucose ) . Main outcome measures The primary outcome was total energy expenditure , measured with doubly labeled water , by intention-to-treat analysis . Per protocol analysis included participants who maintained target weight loss , potentially providing a more precise effect estimate . Secondary outcomes were resting energy expenditure , measures of physical activity , and levels of the metabolic hormones leptin and ghrelin . Results Total energy expenditure differed by diet in the intention-to-treat analysis ( n=162 , P=0.002 ) , with a linear trend of 52 kcal/d ( 95 % confidence interval 23 to 82 ) for every 10 % decrease in the contribution of carbohydrate to total energy intake ( 1 kcal=4.18 kJ=0.00418 MJ ) . Change in total energy expenditure was 91 kcal/d ( 95 % confidence interval −29 to 210 ) greater in participants assigned to the moderate carbohydrate diet and 209 kcal/d ( 91 to 326 ) greater in those assigned to the low carbohydrate diet compared with the high carbohydrate diet . In the per protocol analysis ( n=120 , P<0.001 ) , the respective differences were 131 kcal/d ( −6 to 267 ) and 278 kcal/d ( 144 to 411 ) . Among participants in the highest third of pre-weight loss insulin secretion , the difference between the low and high carbohydrate diet was 308 kcal/d in the intention-to-treat analysis and 478 kcal/d in the per protocol analysis ( P<0.004 ) . Ghrelin was significantly lower in participants assigned to the low carbohydrate diet compared with those assigned to the high carbohydrate diet ( both analyses ) . Leptin was also significantly lower in participants assigned to the low carbohydrate diet ( per protocol ) . Conclusions Consistent with the carbohydrate-insulin model , lowering dietary carbohydrate increased energy expenditure during weight loss maintenance . This metabolic effect may improve the success of obesity treatment , especially among those with high insulin secretion . Trial registration Clinical Trials.gov NCT02068885
Based on the evidence review ed , low-CHO and very-low-CHO diets are not superior to other dietary approaches for weight loss .
These diets may have advantages related to appetite control , triglyceride reduction , and reduction in the use of medication in T2D management .
The evidence review ed showed mixed effects on low-density lipoprotein cholesterol levels with some studies showing an increase .
There was no clear evidence for advantages regarding effects on other cardiometabolic risk markers .
Historically , low-carbohydrate ( CHO ) and very-low-CHO diets have been used for weight loss .
Recently , these diets have been promoted for type 2 diabetes ( T2D ) management .
This scientific statement provides a comprehensive review of the current evidence base available from recent systematic review s and meta-analyses on the effects of low-CHO and very-low-CHO diets on body weight , lipoprotein lipids , glycemic control , and other cardiometabolic risk factors .