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Low carbohydrate diet: are concerns with saturated fat, lipids, and cardiovascular disease risk justified?

Current opinion in endocrinology, diabetes, and obesity
October 1, 2020
David M Diamond et al. (3 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to assess concerns about the low-carbohydrate diet (LCD), particularly its impact on LDL-C levels and cardiovascular disease (CVD) risk, while evaluating its efficacy in improving CVD risk factors.

Results Summary

The study found that the LCD effectively improves markers of insulin resistance, inflammation, atherogenic dyslipidemia, hypertension, and hyperglycemia, while long-term trials (2-10 years) support its safety and effectiveness. Critics' concerns about LDL-C increases were deemed less relevant due to the diet's positive impact on more reliable CVD risk factors.

Population

General population and epileptics (in one long-term study).

Effective Dosage

Not specified

Duration

2-3 years (up to 10 years in one study)

Interactions

None mentioned

Extracted Claims (12)
InterventionDirectionEndpointPopulationDosageImpactClaim #
low carbohydrate diet (LCD)
decrease
weight loss
-
-
efficacy for
#1
low carbohydrate diet (LCD)
improvement
markers of the insulin-resistant phenotype
-
-
improvement of
#2
low carbohydrate diet (LCD)
decrease
inflammation
-
-
reduction in
#3
low carbohydrate diet (LCD)
decrease
atherogenic dyslipidemia
-
-
reduction in
#4
low carbohydrate diet (LCD)
decrease
hypertension
-
-
reduction in
#5
low carbohydrate diet (LCD)
decrease
hyperglycemia
-
-
reduction in
#6
low carbohydrate diet (LCD)
increase
saturated fat
-
-
promotes unrestricted consumption of
#7
saturated fat consumption in the context of an LCD
increase
low-density lipoprotein (LDL-C) levels
-
-
may increase
#8
diet-induced increase in LDL-C
increase
cardiovascular disease (CVD)
-
-
increases the risk of
#9
low carbohydrate diet (LCD)
improvement
the most reliable CVD risk factors
-
-
improves
#10
low carbohydrate diet (LCD)
neutral
-
epileptics
10 years
safety and effectiveness of
#11
consumption of saturated fat, in the context of an LCD
increase
CVD
-
-
will increase risk for
#12
Abstract

PURPOSE OF REVIEW: There is an extensive literature on the efficacy of the low carbohydrate diet (LCD) for weight loss, and in the improvement of markers of the insulin-resistant phenotype, including a reduction in inflammation, atherogenic dyslipidemia, hypertension, and hyperglycemia. However, critics have expressed concerns that the LCD promotes unrestricted consumption of saturated fat, which may increase low-density lipoprotein (LDL-C) levels. In theory, the diet-induced increase in LDL-C increases the risk of cardiovascular disease (CVD). The present review provides an assessment of concerns with the LCD, which have focused almost entirely on LDL-C, a poor marker of CVD risk. We discuss how critics of the LCD have ignored the literature demonstrating that the LCD improves the most reliable CVD risk factors. RECENT FINDINGS: Multiple longitudinal clinical trials in recent years have extended the duration of observations on the safety and effectiveness of the LCD to 2-3 years, and in one study on epileptics, for 10 years. SUMMARY: The present review integrates a historical perspective on the LCD with a critical assessment of the persistent concerns that consumption of saturated fat, in the context of an LCD, will increase risk for CVD.

Medical Subject Headings (MeSH)
AtherosclerosisCardiovascular DiseasesDiet, Carbohydrate-RestrictedDyslipidemiasFatty AcidsHumansLipidsLipoproteins, LDLRisk FactorsWeight Loss
Study Links
Quality Scores
Safety85
Efficacy90/10
Quality80/10
Citation Metrics
Total Citations19
Citations/Year3.8
Relative Citation Ratio1.32
NIH Percentile60.4%
Research Impact Scores
APT Score0.75
Weight Score2.42
Normalized Score0.86
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