Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials - PubMed (original) (raw)
Review
Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials
Alain J Nordmann et al. Arch Intern Med. 2006.
Erratum in
- Arch Intern Med. 2006 Apr 24;166(8):932
Abstract
Background: Low-carbohydrate diets have become increasingly popular for weight loss. However, evidence from individual trials about benefits and risks of these diets to achieve weight loss and modify cardiovascular risk factors is preliminary.
Methods: We used the Cochrane Collaboration search strategy to identify trials comparing the effects of low-carbohydrate diets without restriction of energy intake vs low-fat diets in individuals with a body mass index (calculated as weight in kilograms divided by the square of height in meters) of at least 25. Included trials had to report changes in body weight in intention-to-treat analysis and to have a follow-up of at least 6 months. Two reviewers independently assessed trial eligibility and quality of randomized controlled trials.
Results: Five trials including a total of 447 individuals fulfilled our inclusion criteria. After 6 months, individuals assigned to low-carbohydrate diets had lost more weight than individuals randomized to low-fat diets (weighted mean difference, -3.3 kg; 95% confidence interval [CI], -5.3 to -1.4 kg). This difference was no longer obvious after 12 months (weighted mean difference, -1.0 kg; 95% CI, -3.5 to 1.5 kg). There were no differences in blood pressure. Triglyceride and high-density lipoprotein cholesterol values changed more favorably in individuals assigned to low-carbohydrate diets (after 6 months, for triglycerides, weighted mean difference, -22.1 mg/dL [-0.25 mmol/L]; 95% CI, -38.1 to -5.3 mg/dL [-0.43 to -0.06 mmol/L]; and for high-density lipoprotein cholesterol, weighted mean difference, 4.6 mg/dL [0.12 mmol/L]; 95% CI, 1.5-8.1 mg/dL [0.04-0.21 mmol/L]), but total cholesterol and low-density lipoprotein cholesterol values changed more favorably in individuals assigned to low-fat diets (weighted mean difference in low-density lipoprotein cholesterol after 6 months, 5.4 mg/dL [0.14 mmol/L]; 95% CI, 1.2-10.1 mg/dL [0.03-0.26 mmol/L]).
Conclusions: Low-carbohydrate, non-energy-restricted diets appear to be at least as effective as low-fat, energy-restricted diets in inducing weight loss for up to 1 year. However, potential favorable changes in triglyceride and high-density lipoprotein cholesterol values should be weighed against potential unfavorable changes in low-density lipoprotein cholesterol values when low-carbohydrate diets to induce weight loss are considered.
Comment in
- Definition of low-fat diets.
Baschetti R. Baschetti R. Arch Intern Med. 2006 Jul 10;166(13):1419-20; author reply 1420. doi: 10.1001/archinte.166.13.1419-b. Arch Intern Med. 2006. PMID: 16832011 No abstract available.
Similar articles
- Comparison of 4 diets of varying glycemic load on weight loss and cardiovascular risk reduction in overweight and obese young adults: a randomized controlled trial.
McMillan-Price J, Petocz P, Atkinson F, O'neill K, Samman S, Steinbeck K, Caterson I, Brand-Miller J. McMillan-Price J, et al. Arch Intern Med. 2006 Jul 24;166(14):1466-75. doi: 10.1001/archinte.166.14.1466. Arch Intern Med. 2006. PMID: 16864756 Clinical Trial. - Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors.
Nordmann AJ, Suter-Zimmermann K, Bucher HC, Shai I, Tuttle KR, Estruch R, Briel M. Nordmann AJ, et al. Am J Med. 2011 Sep;124(9):841-51.e2. doi: 10.1016/j.amjmed.2011.04.024. Am J Med. 2011. PMID: 21854893 - High protein diets decrease total and abdominal fat and improve CVD risk profile in overweight and obese men and women with elevated triacylglycerol.
Clifton PM, Bastiaans K, Keogh JB. Clifton PM, et al. Nutr Metab Cardiovasc Dis. 2009 Oct;19(8):548-54. doi: 10.1016/j.numecd.2008.10.006. Epub 2009 Jan 29. Nutr Metab Cardiovasc Dis. 2009. PMID: 19179060 - Comparison of effects of long-term low-fat vs high-fat diets on blood lipid levels in overweight or obese patients: a systematic review and meta-analysis.
Schwingshackl L, Hoffmann G. Schwingshackl L, et al. J Acad Nutr Diet. 2013 Dec;113(12):1640-61. doi: 10.1016/j.jand.2013.07.010. Epub 2013 Oct 17. J Acad Nutr Diet. 2013. PMID: 24139973 Review. - Almonds have a neutral effect on serum lipid profiles: a meta-analysis of randomized trials.
Phung OJ, Makanji SS, White CM, Coleman CI. Phung OJ, et al. J Am Diet Assoc. 2009 May;109(5):865-73. doi: 10.1016/j.jada.2009.02.014. J Am Diet Assoc. 2009. PMID: 19394473 Review.
Cited by
- Obesity in South and Southeast Asia-A new consensus on care and management.
Tham KW, Abdul Ghani R, Cua SC, Deerochanawong C, Fojas M, Hocking S, Lee J, Nam TQ, Pathan F, Saboo B, Soegondo S, Somasundaram N, Yong AML, Ashkenas J, Webster N, Oldfield B. Tham KW, et al. Obes Rev. 2023 Feb;24(2):e13520. doi: 10.1111/obr.13520. Epub 2022 Dec 1. Obes Rev. 2023. PMID: 36453081 Free PMC article. Review. - Meta-analysis of variance: an illustration comparing the effects of two dietary interventions on variability in weight.
Senior AM, Gosby AK, Lu J, Simpson SJ, Raubenheimer D. Senior AM, et al. Evol Med Public Health. 2016 Aug 11;2016(1):244-55. doi: 10.1093/emph/eow020. Print 2016. Evol Med Public Health. 2016. PMID: 27491895 Free PMC article. - Treatment of NAFLD with intermittent calorie restriction or low-carb high-fat diet - a randomised controlled trial.
Holmer M, Lindqvist C, Petersson S, Moshtaghi-Svensson J, Tillander V, Brismar TB, Hagström H, Stål P. Holmer M, et al. JHEP Rep. 2021 Feb 17;3(3):100256. doi: 10.1016/j.jhepr.2021.100256. eCollection 2021 Jun. JHEP Rep. 2021. PMID: 33898960 Free PMC article. - Low calorie and carbohydrate diet: to improve the cardiovascular risk indicators in overweight or obese adults with prediabetes.
Velázquez-López L, González-Figueroa E, Medina-Bravo P, Pineda-Del Aguila I, Avila-Jiménez L, Ramos-Hernández R, Klunder-Klunder M, Escobedo-de la Peña J. Velázquez-López L, et al. Endocrine. 2013 Jun;43(3):593-602. doi: 10.1007/s12020-012-9775-z. Epub 2012 Sep 1. Endocrine. 2013. PMID: 22941424 - Reversing Type 2 Diabetes: A Narrative Review of the Evidence.
Hallberg SJ, Gershuni VM, Hazbun TL, Athinarayanan SJ. Hallberg SJ, et al. Nutrients. 2019 Apr 1;11(4):766. doi: 10.3390/nu11040766. Nutrients. 2019. PMID: 30939855 Free PMC article. Review.