The role of a low carbohydrate — high fat diet in treatment and prevention of diabetes and obesity
- 1University of Maastricht (Maastricht University), Netherlands
- 2The Russian Peoples Friendship University, Moscow
Summary. In the past, different types of diet with a low-carbohydrate content, even containing <50 g/day ketosis inducing levels, have been promoted, for weight loss and diabetes. The long term effectiveness of a very low dietary carbohydrate content has always been a matter of debate. A significant reduction in the amount of carbohydrates in the diet is usually accompanied by an increase in the amount of fat and, to a lesser extent, also protein. This review highlights metabolic and clinical outcomes of the «low carb — high fat» (LCHF) diet. Relevant observations are as follows: 1) any diet type will initially result in reduced energy intake, weight loss and related favorable metabolic and functional changes; 2) short-term LCHF studies show both favorable and less desirable effects; 3) sustained adherence to a ketogenic LCHF diet appears to be difficult; a non-ketogenic diet supplying 100–150 g carbohydrate/day, under good control, may be more practical; 4) there is lack of data supporting long-term efficacy, safety and health benefits of LCHF diets; 5) lifestyle intervention in people at high risk of developing type 2 diabetes, while maintaining a relative carbohydrate-rich diet, results in long-term prevention of progression to type 2 diabetes and is generally seen as safe.
- Martyishin O.O. (2017) Saharnyiy diabet: obnaruzhena novaya osobennost bolezni. Ukr. med. chasopis, 26 oktyabrya (https://www.umj.com.ua/article/115960).
- Martyishin O.O. (2018) Saharnyiy diabet: pravilnaya modifikatsiya obraza zhizni. Ukr. med. chasopis, 8 maya (https://www.umj.com.ua/article/124863).
- Sokolova L.K. (2012) Saharnyiy diabet 2-go tipa. Rol semeynogo vracha. Ukr. med. chasopis, 1(87): 70–74 (https://www.umj.com.ua/article/27172).
- Accurso A., Bernstein R.K., Dahlqvist A. et al. (2008) Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutr. Metab., 5(1): 9.
- Astrup A., Grunwald G., Melanson E. et al. (2000) The role of low-fat diets in body weight control: a meta-analysis of ad libitum dietary intervention studies. Int. J. Obes., 24(12): 1545.
- Brinkworth G.D., Noakes M., Clifton P.M., Bird A.R. (2009) Comparative effects of very low-carbohydrate, high-fat and highcarbohydrate, low-fat weight-loss diets on bowel habit and faecal short-chain fatty acids and bacterial populations. Br. J. Nutr., 101(10): 1493–1502.
- Brouns F. (2018) Overweight and diabetes prevention: is a low-carbohydrate — high-fat diet recommendable? Eur. J. Nutr. 57: 1301–1312.
- Buyken A.E., Mela D.J., Dussort P. et al. (2018) Dietary carbohydrates: a review of international recommendations and the methods used to derive them. Eur. J. Clin. Nutr., Apr. 25 [Epub. ahead of print].
- DeSalvo K.B., Olson R., Casavale K.O. (2016) Dietary guidelines for Americans. JAMA, 315(5): 457–458.
- Dyson P. (2015) Low carbohydrate diets and type 2 diabetes: what is the latest evidence? Diabetes Ther., 6(4): 411–424.
- Feinman R.D., Pogozelski W.K., Astrup A. et al. (2015) Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition, 31(1): 1–13.
- Kaplan H., Thompson R.C., Trumble B.C. et al. (2017) Coronary atherosclerosis in indigenous South American Tsimane: a cross-sectional cohort study. Lancet, 389(10080): 1730–1739.
- Hall K.D. (2017) A review of the carbohydrate-insulin model of obesity. Eur. J. Clin. Nutr., 71(5): 679.
- Hall K.D., Bemis T., Brychta R. et al. (2015) Calorie for calorie, dietary fat restriction results in more body fat loss than carbohydrate restriction in people with obesity. Cell Metab., 22(3): 427–436.
- Hauner H., Bechthold A., Boeing H. et al. (2012) Evidence-based guideline of the German Nutrition Society: carbohydrate intake and prevention of nutrition-related diseases. Ann. Nutr. Metab., 60(Suppl. 1): 1–58.
- Hjorth M.F., Ritz C., Blaak E.E. et al. (2017) Pretreatment fasting plasma glucose and insulin modify dietary weight loss success: results from 3 randomized clinical trials. Am. J. Clin. Nutr., 106(2): 499–505.
- Hu T., Mills K.T., Yao L. et al. (2012) Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: a metaanalysis of randomized controlled clinical trials. Am. J. Epidemiol., 176(Suppl. 7): S44–SS54.
- Mansoor N., Vinknes K.J., Veierшd M.B., Retterstøl K. (2016) Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. Br. J. Nutr., 115(03): 466–479.
- Martin K., Jackson C.F., Levy R.G., Cooper P.N. (2016) Ketogenic diet and other dietary treatments for epilepsy. Cochrane Database Syst. Rev., 2: CD001903.
- McKenzie M.R., Illingworth S. (2017) Should a low carbohydrate diet be recommended for diabetes management? Proc. Nutr. Soc., 76(OCE1): E19.
- Noto H., Goto A., Tsujimoto T., Noda M. (2013) Low-carbohydrate diets and all-cause mortality: a systematic review and meta-analysis of observational studies. PLoS One, 8(1): e55030.
- Volek J.S., Fernandez M.L., Feinman R.D., Phinney S.D. (2008) Dietary carbohydrate restriction induces a unique metabolic state positively affecting atherogenic dyslipidemia, fatty acid partitioning, and metabolic syndrome. Prog. Lipid. Res., 47(5): 307–318.
- Westman E.C., Feinman R.D., Mavropoulos J.C. et al. (2007) Low-carbohydrate nutrition and metabolism. Am. J. Clin. Nutr., 86(2): 276–284.
- WHO (2014) Global status report on noncommunicable diseases (http://apps.who.int/iris/bitstream/handle/10665/148114/9789241564854_eng.pdf?sequence=1).
- WHO (2015) Guideline: sugars intake for adults and children (http://apps.who.int/iris/bitstream/handle/10665/149782/9789241549028_eng.pdf;jsessionid=D476F07A3966D6DB987D3AE86A7D3A80?sequence=1).
- Wyk H., Davis R., Davies J. (2016) A critical review of low-carbohydrate diets in people with type 2 diabetes. Diabet. Med., 33(2): 148–157.
- Yamazaki T., Okawa S., Takahashi M. (2016) The effects on weight loss and gene expression in adipose and hepatic tissues of very low carbohydrate and low-fat isoenergetic diets in diet-induced obese mice. Nutr. Metab., 13(1): 78.