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 .
A Very Low-Carbohydrate, Low–Saturated Fat Diet for Type 2 Diabetes Management: A Randomized Trial
OBJECTIVE To comprehensively compare the effects of a very low-carbohydrate , high – unsaturated/low – saturated fat diet ( LC ) with those of a high – unrefined carbohydrate , low-fat diet ( HC ) on glycemic control and cardiovascular disease ( CVD ) risk factors in type 2 diabetes ( T2DM ) . RESEARCH DESIGN AND METHODS Obese adults ( n = 115 , BMI 34.4 ± 4.2 kg/m2 , age 58 ± 7 years ) with T2DM were r and omized to a hypocaloric LC diet ( 14 % carbohydrate [ < 50 g/day ] , 28 % protein , and 58 % fat [ < 10 % saturated fat ] ) or an energy-matched HC diet ( 53 % carbohydrate , 17 % protein , and 30 % fat [ < 10 % saturated fat ] ) combined with structured exercise for 24 weeks . The outcomes measured were as follows : glycosylated hemoglobin ( HbA1c ) , glycemic variability ( GV ; assessed by 48-h continuous glucose monitoring ) , antiglycemic medication changes ( antiglycemic medication effects score [ MES ] ) , and blood lipids and pressure . RESULTS A total of 93 participants completed 24 weeks . Both groups achieved similar completion rates ( LC 79 % , HC 82 % ) and weight loss ( LC −12.0 ± 6.3 kg , HC −11.5 ± 5.5 kg ) ; P ≥ 0.50 . Blood pressure ( −9.8/−7.3 ± 11.6/6.8 mmHg ) , fasting blood glucose ( −1.4 ± 2.3 mmol/L ) , and LDL cholesterol ( −0.3 ± 0.6 mmol/L ) decreased , with no diet effect ( P ≥ 0.10 ) . LC achieved greater reductions in triglycerides ( −0.5 ± 0.5 vs. −0.1 ± 0.5 mmol/L ) , MES ( −0.5 ± 0.5 vs. −0.2 ± 0.5 ) , and GV indices ; P  ≤ 0.03 . LC induced greater HbA1c reductions ( −2.6 ± 1.0 % [ −28.4 ± 10.9 mmol/mol ] vs. −1.9 ± 1.2 % [ −20.8 ± 13.1 mmol/mol ] ; P = 0.002 ) and HDL cholesterol ( HDL-C ) increases ( 0.2 ± 0.3 vs. 0.05 ± 0.2 mmol/L ; P = 0.007 ) in participants with the respective baseline values HbA1c > 7.8 % ( 62 mmol/mol ) and HDL-C < 1.29 mmol/L. CONCLUSIONS Both diets achieved substantial improvements for several clinical glycemic control and CVD risk markers . These improvements and reductions in GV and antiglycemic medication requirements were greatest with the LC compared with HC . This suggests an LC diet with low saturated fat may be an effective dietary approach for T2DM management if effects are sustained beyond 24 weeks
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 .