Efficacy Of Low-carbohydrate Diets Research Articles

Efficacy of low carbohydrate diet (LCD) on obesity and alcohol intake from bio-psycho-social points of view

Background: There is a bidirectional relationship between COVID-19 and diabetes. New-onset diabetes and severe metabolic complications of pre-existing diabetes in patients with COVID-19 have been observed. Steroids are medications used for treatment of several diseases, including COVID-19. Its pharmacological action increases blood glucose and poses additional challenges in the management. Aim: To study the impact of steroids on newly detected diabetes patients with a history of COVID-19 in a cohort group. Method: 2263 patients from 15 different sites across India were analysed following a specific eligibility criterion. The patients were segregated into three groups - No steroids, Low steroids [less than or equal to the median dose (50mg)], and High steroids [greater than the median dose (50mg)]. Two-way Analysis of Variance (ANOVA) test was used to test the relationship between Diabetes status and Steroid usage. Results: The steroid dosage for the management of COVID-19 in the Newly-Detected Diabetes (NDD) group received higher doses of steroids. All steroid doses were adjusted and standardized to prednisolone 5mg. The average maximum doses of steroids used in the management of COVID-19 for NDD was 86.6 mg/day. Within the NDD group, those who received a lower steroid dose had a higher HRCT score as compared to the No steroid and High steroid groups. Also, amongst all patients who did not receive steroids for management of COVID-19, NDD had a statistically higher HRCT score. Conclusion: The prevailing hypothesis that increased application of steroids causes diabetes-like disease spectrums in patients recovering from COVID-19. The findings however require reconsidering steroid usage as the leading cause of COVID-induced diabetes.

Clinical Efficacy of Low Carbohydrate Diet (LCD) For Detail Analysis of Daily Meal and Blood Glucose

Clinical Efficacy of Low Carbohydrate Diet (LCD) For Detail Analysis of Daily Meal and Blood Glucose

2167-PUB: Effect of Low-Available Carbohydrate Diet Containing Okara and Konjac on Blood Glucose Levels in Spontaneous Diabetic Torii Fatty Rats

Background: The ADA and Diabetes UK reported the efficacy of low-carbohydrate diets (LCD) in medical nutrition therapy for blood glucose and lipid management. However, following an LCD may be difficult for many people with diabetes, especially those who consume noodles regularly. To remedy this, we developed a low-available carbohydrate noodle (LACN) using a by-product of Soybean (Glycine max) processing (commonly called “okara”) and Amorphophallus konjac (commonly called Konjac). In this initial study, the effects of the LACN (Figure A) on blood glucose levels (GL) were investigated in Spontaneously Diabetic Torii fatty rats (SDT-fr). Methods: Male, 5-week-old SDT-fr were allocated into two groups based on diet; Group I was fed standard chow (SC) as a control group (n = 6), while Group II was fed SC with 50% LACN (n = 6). The animals were allowed free access to food for 28 days. Results: The plasma GL in the LACN group (Group II) were significantly lower than those in the control group (Figure C), in which body weight (BW) gain was observed (Figure B). Our results, in concurrence with other papers, provide evidence that BW increase in Group II was associated with increase in lean body mass, and that the change in muscle mass of SDT-fr was mainly caused by the LACN intake. Conclusions: LACN might be useful for patients with diabetes or celiac disease who wish to maintain a noodle-based diet. Disclosure K. Suruga: None. T. Tomita: None. M. Kobayashi: None. T. Mitsui: None. K. Kadokura: None.

Ejercicio aeróbico y dieta baja en hidratos de carbono en la obesidad: estudio de caso

Objectives. To compare the efficacy of low carbohydrate diet and aerobic exercise alone or combined for the treatment of obesity and metabolic syndrome in a subject without other comorbilities.Methodology. An intervention based on aerobic exercise and low carbohydrate diet both alone and combined was used as a treatment for obesity and metabolic syndrome in an otherwise healthy subject. Parameters related to these pathologies such as body fat percentage, lipid profile, fasting glucose or body mass index were registered.Results. Both the combined program and nutritional intervention induced reductions in total weight, body mass index, waist to hip ratio, total cholesterol, triglycerides and fasting glucose blood levels. The intervention based only on aerobic exercise did not result in any improvement.Conclusions. A combination of aerobic exercise together with a low carbohydrate diet was effective for the treatment of obesity and metabolic syndrome in this case. The intervention based on the low carbohydrate diet was also effective. The intervention based only on aerobic exercise did not provide any beneficial results, contrary to the results obtained by previous research. More research with larger samples and especially including a control group is needed in order to evaluate whether the results obtained in this study could be extrapolated to the general obese population.

Impact of Low-Carbohydrate Diet (LCD) and Obesity Management Program on Obese Patients

The past two decades witnessed a rapid escalation in the prevalence of obesity. Ayurvedic physicians use a multi-faceted strategy to treat obesity which includes a combination of Low-Carbohydrate Diet and Obesity Management Procedure. The present study was conducted to demonstrate the efficacy of low carbohydrate diet and the Ayurvedic obesity management procedure in reducing obesity. A retrospective observational study was conducted in Madhavbaug Clinics from September 2017 to March 2018. All patients with BMI > 30 kg/m² were included in the study. During the study, the patients received seven sessions of obesity management procedure which included a combination of <i>Snehana</i> / external oleation or massage, <i>Swedana</i> / passive heat therapy and <i>Basti kadha</i>. Simultaneously, patients were prescribed supervised low carbohydrate diet daily for 90 days. The primary efficacy end point was reduction in body weight while secondary end points included changes in abdominal girth, systolic and diastolic blood pressure, heart rate after 90-day follow-up as compared to baseline. A total of 48 patients were enrolled and after screening, 31 were included in the study. Most of the patients were middle aged (51.35 ± 11.44 years) and females (65.8%). The primary end-point used in the present study (body weight) decreased significantly from 89.87± 18.58 kg on Day 1 to 82.01± 20.55 kg on day 90 (p<0.001). Such significant changes were also appreciable in the BMI, SBP, DBP, abdominal girth values measured on day 1 and day 90 respectively (p<0.001 for all). The present study demonstrates that the combination of low carbohydrate diet and Ayurvedic obesity management procedures are effective in reducing obesity.

Critical appraisal for low-carbohydrate diet in nonalcoholic fatty liver disease: Review and meta-analyses

Weight loss by lifestyle modification is the cornerstone therapy of Non Alcoholic Fatty Liver Disease. Low carbohydrate diet has showed favorable effects for body weight as well as hepatic fat content in several reports. In this meta-analysis, we review clinical studies article to date regarding the composition of the diet and analyzed the impact of low carbohydrate diet comparing to low calorie diet on hepatic fat change, AST and ALT using Forest plot. We aimed to investigate the efficacy of low carbohydrate diet on NAFLD. We collected studies that were conducted with various amounts of carbohydrate and different methods for changing the hepatic fat and fibrosis. Eleven clinical studies (seven randomized controlled trials) were selected on the efficacy and safety of low carbohydrate diet on NAFLD patients. Four studies evaluated hepatic fat by magnetic resonance imaging and two evaluated hepatic fat using computed tomography. However, the pools of subjects were small, the criterion for low carbohydrate was variable, and there is yet an established standard method of evaluation of liver. In meta-analysis, there was no significant difference between low carbohydrate diet group and low fat diet group on the improvement of hepatic fat content and transaminases in NAFLD. So far there's little evidence that low-carbohydrate diet has more beneficial effect on NAFLD than low calorie diet in similar calorie intake.

Comparison of Effects of Low-Carbohydrate Diet and Calorie-Restricted Diet on Nonalcoholic Fatty Liver Disease in Japanese Patients with Type 2 Diabetes

Background: Nutrition therapies for type 2 diabetes (T2DM) and nonalcoholic fatty liver disease (NAFLD) are recommended for calorie-restricted diet (CRD) in Japan. Recently, the efficacy of low-carbohydrate diet (LCD) has been reported in these diseases. This study aimed to determine the effects of LCD on NAFLD in Japanese patients with T2DM compared with CRD. Methods: We assigned 28 patients of NAFLD with T2DM in this 3-month prospective open-label randomized comparative trial. They were randomly allocated to either LCD (70-130 g/day of carbohydrate) group (n =14) or CRD (calories of 25 kcal/kg of ideal body weight per day) group (n =14). Abdominal computed tomography (CT) scan evaluated liver fat deposition by the liver-to-spleen attenuation ratio (L/S ratio) and visceral fat accumulation as the visceral fat area (VFA). Results: The average age of patients at the start was 50 years old, BMI was 31 kg/m2, L/S ratio was 0.7, VFA was 163 cm2. The total intake energy of LCD after 3 months was 1,389 kcal (δ-386 kcal from the start, carbohydrate was 42% of the total energy), CRD was 1,513 kcal (δ-633 kcal, carbohydrate was 54%). Both diets achieved significantly improvement of L/S ratio, VFA, liver transaminase, body weight and HbA1c from baseline within groups after 3 months (P &amp;lt; 0.05). Between the two diets, L/S ratio, liver transaminase, body weight and HbA1c showed a large tendency to improve in LCD, but no significant difference was noted. Significant improvement was observed in VFA of LCD. In the QoL score, "anxiety and dissatisfaction with treatment" was significantly improved in LCD. Conclusions: Our findings suggest that LCD may be as effective as CRD in improving fatty liver in Japanese patients of NAFLD with T2DM, and that LCD may be less burdensome on patients than CRD. Disclosure E. Nishimori: None. S. Ogata: None. M. Naka: None.

Efficacy of low carbohydrate diet for type 2 diabetes mellitus management: A systematic review and meta-analysis of randomized controlled trials.

The objective of this systematic review and meta-analysis is to assess the efficacy of Low Carbohydrate Diet (LCD) compared with a normal or high carbohydrate diet in patients with type 2 diabetes. We searched MEDLINE, EMBASE, and Cochrane Library database for randomized controlled trials. Researches which reported the change in weight loss, blood glucose, and blood lipid levels were included. A total of 9 studies with 734 patients with diabetes were included. Pooled results suggested that LCD had a significantly effect on HbA1c level (WMD: -0.44; 95% CI: -0.61, -0.26; P=0.00). For cardiovascular risk factors, the LCD intervention significantly reduced triglycerides concentration (WMD: -0.33; 95% CI: -0.45, -0.21; P=0.00) and increased HDL cholesterol concentration (WMD: 0.07; 95% CI: 0.03, 0.11; P=0.00). But the LCD was not associated with decreased level of total cholesterol and LDL cholesterol. Subgroup analyses indicated that short term intervention of LCD was effective for weight loss (WMD: -1.18; 95% CI: -2.32, -0.04; P=0.04). The results suggested a beneficial effect of LCD intervention on glucose control in patients with type 2 diabetes. The LCD intervention also had a positive effect on triglycerides and HDL cholesterol concentrations, but without significant effect on long term weight loss.

A critical review of low-carbohydrate diets in people with Type 2 diabetes.

The efficacy of low-carbohydrate diets (LCD) in people with Type 2 diabetes has divided the nutrition community. This review seeks to re-examine the available data to clarify understanding. A comprehensive search of databases was used to identify meta-analyses of LCD in Type 2 diabetes. To improve the quality of the studies analysed, the following inclusion criteria were applied: randomized control trials ≥ 4 weeks in people aged > 18 years with Type 2 diabetes; a carbohydrate intake ≤ 45% of total energy intake per day; and a dietary intake assessment at the end of the study. The resulting studies were subjected to a thematic analysis. Nine meta-analyses were identified containing 153 studies. Twelve studies met our amended inclusion criteria. There were no significant differences in metabolic markers, including glycaemic control, between the two diets, although weight loss with a LCD was greater in one study. Carbohydrate intake at 1 year in very LCD (< 50 g of carbohydrates) ranged from 132 to 162 g. In some studies, the difference between diets was as little as 8 g/day of carbohydrates. Total energy intake remains the dietary predictor of body weight. A LCD appears no different from a high-carbohydrate diet in terms of metabolic markers and glycaemic control. Very LCDs may not be sustainable over a medium to longer term as carbohydrate intake in diets within studies often converged toward a more moderate level. The variable quality of studies included in earlier meta-analyses likely explains the previous inconsistent findings between meta-analyses.

Comparative Effects of Carbohydrate versus Fat Restriction on Serum Levels of Adipocytokines, Markers of Inflammation, and Endothelial Function among Women with the Metabolic Syndrome: A Randomized Cross-Over Clinical Trial

Background and Aims: Despite the efficacy of low-carbohydrate diets in the management of metabolic syndrome (MetS), it remains unknown if these favorable effects are mediated through changes in inflammation and endothelial dysfunction. We aimed to assess the effects of moderate substitution of dietary fats for carbohydrates on serum levels of adipocytokines, inflammatory indices, and biomarkers of endothelial function among women with the MetS. Methods: In a randomized cross-over clinical trial, 30 overweight or obese (BMI >25) women with the MetS were randomly allocated to follow either a high-carbohydrate (HC) (60-65% carbohydrates, 20-25% fats) diet or a moderately restricted carbohydrate (MRC) (43-47% carbohydrate, 36-40% fats) diet, each for 6 weeks. After a 2-week washout period, individuals were switched to the alternate diet for an additional 6 weeks. In a fasted state, markers of inflammation [high-sensitivity C-reactive protein (hs-CRP), high-sensitivity interleukin-6 (hs-IL-6), high-sensitivity tumor necrosis factor-α (hs-TNF-α), and serum amyloid A (SAA)], endothelial function [E-selectin, serum intercellular adhesion molecule 1 (sICAM-1), and serum vascular cell adhesion molecule 1 (sVCAM-1)], and adipocytokines (leptin and adiponectin) were measured in both study arms at baseline and after 6 weeks. Results: Consumption of an HC diet was associated with increased levels of SAA (3.27 ± 1.22 μg/ml) and decreased levels of adiponectin (-1.68 ± 2.30 ng/ml), while consumption of an MRC diet did not result in such unfavorable effects. Serum concentrations of leptin were reduced by the HC diet (p = 0.02), while they were not affected by the MRC diet. Changes in serum leptin levels were not significant between the two diets (p = 0.09). Serum concentrations of hs-CRP, hs-TNF-α, and IL-6 were not influenced by either diet. No significant differences between the two diets were found in terms of their effect on sICAM-1 and sVCAM-1 concentrations. Adherence to both diets resulted in a 9 ng/ml decrease in serum E-selectin levels (p < 0.05 for both). Conclusions: Partial replacement of dietary carbohydrates by unsaturated fats prevents the increased levels of markers of systemic inflammation among women with the MetS.

Decrease of aminotransferase levels in obese women is related to body weight reduction, irrespective of type of diet

Objective. To evaluate the efficacy of low carbohydrate diet (LCD) as compared with low fat diet (LFD) to decrease aminotransferase levels in obese women with nonalcoholic fatty liver disease.Material and methods. A total of 59 women were randomly enrolled in a non-controlled clinical intervention study to receive either LCD or LFD during six months. Apparently healthy non-pregnant obese women aged 20 to 65 years were eligible to participate. Previous diagnosis of hepatic disease, serum creatinine level > 1.5 mg/dL, severe life-limiting medical illness, pregnancy, active participation in other dietary program, use of weight loss drugs, or alcohol consumption ≥ 30 g per day were exclusion criteria.Results. A total of 31 obese women who received LCD were compared with 28 women allocated in the LFD group. There were 3 (LCD group) and 2 (LFD group) women with lost of follow-up. No differences in the proportion of type 2 diabetes, hypertension and hyperlipidemia were noted between women in the LCD and LFD groups. At end of follow-up, there were not significant statistical differences in the anthropometric and biochemical characteristics between women in both groups. The weight loss was 5.7 and 5.5% for women in the LCD LFD groups. Although the decrease of AST (31.7 and 22.4%) and ALT (41 and 33.3%) levels was more elevated in the women of LCD group, as compared with the LFD group, there were not significant statistical differences.Conclusions. Our results show that weight loss, irrespective of the type of diet, reduces aminotransferase levels in obese women with NAFLD.

The Skinny on Low-Carbohydrate Diets

One in four adults living in the United States has metabolic syndrome, a constellation of risk factors associated with increased risk for developing type 2 diabetes and cardiovascular disease. A common characteristic in patients with metabolic syndrome is abdominal obesity along with an increased body mass index. Traditional dietary recommendations for treating the metabolic syndrome and associated obesity include high-carbohydrate, low-fat regimens. Despite the widespread use of these dietary guidelines, the rates of metabolic syndrome and obesity continue to rise in the United States. As a result, public interest in alternative dietary approaches to weight loss has escalated, sparking renewed interest in low-carbohydrate diet regimens, most notably Dr. Atkins' New Diet Revolution, a New York Times bestseller. Despite this renewed interest, there is little scientific evidence to determine the safety and efficacy of low-carbohydrate diets on cardiovascular health. Because most energy in a low-carbohydrate diet are derived from protein and fat, there is considerable concern that such diets will raise lipid levels and overall risk for coronary disease. In this article, we review the sparse literature on the impact of low-carbohydrate diets on weight loss and lipid parameters.

The effect of low carbohydrate on energy metabolism

To investigate whether low-carbohydrate diets are efficient for reduction of body weight and through which mechanism. A couple of studies using low-carbohydrate diets in the treatment of obesity are reviewed. Mechanisms for explaining the reduced appetite are described in relation to knowledge on regulation of appetite for fat and carbohydrate. Studies with low-carbohydrate diets demonstrate a rapid weight loss, being more pronounced after 3 and 6 months compared to low-fat diets. After 12 months there is no difference between the low-carbohydrate and the conventional low-fat diet on weight loss. Both diets lead to improvements in risk factors for coronary heart disease, the low-carbohydrate diet leading to a greater decrease in serum triglycerides and increase in HDL cholesterol compared to the low-fat diet. Blood pressure, insulin sensitivity and LDL cholesterol were improved to a similar degree by the two diets. The mechanism for the rapid weight loss with the low-carbohydrate diet is a suppressed appetite, first through the high-protein content of the diet, second through the ketogenic nature of the diet with satiety signals for fat being active and third through the absence of hunger-promoting carbohydrate components like sucrose and/or fructose. A rapid initial weight loss occurs with a low-carbohydrate diet due to a suppressed appetite. There is as yet no indication of an increased metabolic rate and an increased thermogenesis by the low-carbohydrate diet. The safety and efficacy of low-carbohydrate diets have to await further studies.

Low-Carb, Low-Fat Diet Gurus Face Off

LAST SUMMER, AN ARTICLE IN THE July 7 New York Times Sunday Magazine challenged conventional thinking about weight loss, questioning the efficacy of low-fat diets and sparking a resurgence of interest in socalled high-protein or low-carbohydrate diets. In this issue of JAMA (page 1837), a systematic review of studies published between 1966 and February 2003 on the safety and efficacy of lowcarbohydrate diets finds that there is insufficient evidence to recommend or advise against the use of such diets, and that weight loss was associated with length of the diet, prediet weight, and the number of calories consumed, but not reduced carbohydrate content. JAMA asked proponents of lowcarbohydrate and low-fat diets, and an obesity researcher who has explored many interventions, to comment on weight loss approaches and the obesity epidemic.