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 .
Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial
Importance Dietary modification remains key to successful weight loss . Yet , no one dietary strategy is consistently superior to others for the general population . Previous research suggests genotype or insulin-glucose dynamics may modify the effects of diets . Objective To determine the effect of a healthy low-fat ( HLF ) diet vs a healthy low-carbohydrate ( HLC ) diet on weight change and if genotype pattern or insulin secretion are related to the dietary effects on weight loss . Design , Setting , and Participants The Diet Intervention Examining The Factors Interacting with Treatment Success ( DIETFITS ) r and omized clinical trial included 609 adults aged 18 to 50 years without diabetes with a body mass index between 28 and 40 . The trial enrollment was from January 29 , 2013 , through April 14 , 2015 ; the date of final follow-up was May 16 , 2016 . Participants were r and omized to the 12-month HLF or HLC diet . The study also tested whether 3 single-nucleotide polymorphism multilocus genotype responsiveness patterns or insulin secretion ( INS-30 ; blood concentration of insulin 30 minutes after a glucose challenge ) were associated with weight loss . Interventions Health educators delivered the behavior modification intervention to HLF ( n = 305 ) and HLC ( n = 304 ) participants via 22 diet-specific small group sessions administered over 12 months . The sessions focused on ways to achieve the lowest fat or carbohydrate intake that could be maintained long-term and emphasized diet quality . Main Outcomes and Measures Primary outcome was 12-month weight change and determination of whether there were significant interactions among diet type and genotype pattern , diet and insulin secretion , and diet and weight loss . Results Among 609 participants r and omized ( mean age , 40 [ SD , 7 ] years ; 57 % women ; mean body mass index , 33 [ SD , 3 ] ; 244 [ 40 % ] had a low-fat genotype ; 180 [ 30 % ] had a low-carbohydrate genotype ; mean baseline INS-30 , 93 & mgr;IU/mL ) , 481 ( 79 % ) completed the trial . In the HLF vs HLC diets , respectively , the mean 12-month macronutrient distributions were 48 % vs 30 % for carbohydrates , 29 % vs 45 % for fat , and 21 % vs 23 % for protein . Weight change at 12 months was −5.3 kg for the HLF diet vs −6.0 kg for the HLC diet ( mean between-group difference , 0.7 kg [ 95 % CI , −0.2 to 1.6 kg ] ) . There was no significant diet-genotype pattern interaction ( P = .20 ) or diet-insulin secretion ( INS-30 ) interaction ( P = .47 ) with 12-month weight loss . There were 18 adverse events or serious adverse events that were evenly distributed across the 2 diet groups . Conclusions and Relevance In this 12-month weight loss diet study , there was no significant difference in weight change between a healthy low-fat diet vs a healthy low-carbohydrate diet , and neither genotype pattern nor baseline insulin secretion was associated with the dietary effects on weight loss . In the context of these 2 common weight loss diet approaches , neither of the 2 hypothesized predisposing factors was helpful in identifying which diet was better for whom . Trial Registration clinical trials.gov Identifier :
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 .