Low Carbohydrate and Low-Fat Diets: What We Don't Know and Why we Should Know It.

Seid Seid,Rosenbaum Rosenbaum

doi:10.3390/nu11112749

Abstract

In the 1940s, the diet-heart hypothesis proposed that high dietary saturated fat and cholesterol intake promoted coronary heart disease in “at-risk” individuals. This hypothesis prompted federal recommendations for a low-fat diet for “high risk” patients and as a preventive health measure for everyone except infants. The low carbohydrate diet, first used to treat type 1 diabetes, became a popular obesity therapy with the Atkins diet in the 1970s. Its predicted effectiveness was based largely on the hypothesis that insulin is the causa prima of weight gain and regain via hyperphagia and hypometabolism during and after weight reduction, and therefore reduced carbohydrate intake would promote and sustain weight loss. Based on literature reviews, there are insufficient randomized controlled inpatient studies examining the physiological significance of the mechanisms proposed to support one over the other. Outpatient studies can be confounded by poor diet compliance such that the quality and quantity of the energy intake cannot be ascertained. Many studies also fail to separate macronutrient quantity from quality. Overall, there is no conclusive evidence that the degree of weight loss or the duration of reduced weight maintenance are significantly affected by dietary macronutrient quantity beyond effects attributable to caloric intake. Further work is needed.

Highlights

According to the Center for Disease Control and Prevention, in 2015–2016, 39.8% of American adults were obese (BMI> 30 Kg/m2 ) [1]
Theoretical formulations implicating dysmetabolic consequences of high carbohydrate diets on insulin-adipocyte physiology have resulted in increasing interest in the actively debated hypothesis that obesity and its co-morbidities can be restrained by reducing dietary carbohydrates [6,7,8]
This review focused on the relative quantity of dietary fat and carbohydrate without a discussion of quality

Summary

Introduction

According to the Center for Disease Control and Prevention, in 2015–2016, 39.8% of American adults were obese (BMI> 30 Kg/m2 ) [1]. This report emphasized the health benefits of lower fat higher carbohydrate diets. The USDA partnered with the Department of Health and Human Services to issue the Dietary Guidelines for Americans, which eventually became the UDSA Food Pyramid [4]. These guidelines seem ineffective since the prevalence of obesity and its co-morbidities have continued to increase [5]. Theoretical formulations implicating dysmetabolic consequences of high carbohydrate diets on insulin-adipocyte physiology have resulted in increasing interest in the actively debated hypothesis that obesity and its co-morbidities can be restrained by reducing dietary carbohydrates [6,7,8]. The debate continues over whether a low Nutrients 2019, 11, 2749; doi:10.3390/nu11112749 www.mdpi.com/journal/nutrients

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