Archives of Obesity and Metabolism (비만대사연구학술지)

The Study of Obesity and Metabolic Syndrome, KAFM (대한가정의학회 비만대사증후군연구회)
권호 표지
DOI QR코드

DOI QR Code

Benefits and Limitations of Low-Carbohydrate Diets: Healthy Carbohydrate Control

저탄수화물식의 효과와 한계: 건강한 탄수화물 조절

  • Minjung Kim (Department of Nutrition Services, Gachon University Gil Medical Center)
  • Received : 2024.02.01
  • Accepted : 2024.06.15
  • Published : 2024.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

The prevalence of obesity has been increasing worldwide. Several dietary treatments have been suggested to control weight, and recent guidelines recommend individualizing the composition of macronutrients. Carbohydrates are the most important nutrients in meals, and carbohydrate restriction is a dietary strategy that promotes weight loss. A low-carbohydrate diet is effective for short-term weight loss and can help improve glycated hemoglobin, systolic blood pressure, diastolic blood pressure, and triglyceride levels; however, the long-term effects and safety of this diet remains doubtful. In the short term, there is a risk of gastrointestinal symptoms such as vomiting, diarrhea, constipation, and gastroesophageal reflux, and type 1 diabetes patients are at risk of severe hypoglycemia, while in the long term, it can lead to malnutrition and decreased exercise capacity. Thus, rather than limiting the intake of carbohydrates, it is important to limit the intake of refined grains, sugar, honey, syrup, and sweetened beverages while maintaining the planned carbohydrate intake rate and improving meal quality.

Keywords

References

  1. Korean Society for the Study of Obesity. 2022 Obesity fact sheet. Seoul: Korean Society for the Study of Obesity; 2022.
  2. Korean Society for the Study of Obesity. Clinical practice guidelines for obesity 2022. Seoul: Korean Society for the Study of Obesity; 2022.
  3. Korea Disease Control and Prevention Agency. Korea National Health and Nutrition Examination Survey (KNHANES IX-1). Cheongju: Korea Disease Control and Prevention Agency; 2022.
  4. Wilder R. The effects of ketonemia on the course of epilepsy. Mayo Clin Proc 2021;2:307-8.
  5. Sampaio LP. Ketogenic diet for epilepsy treatment. Arq Neuropsiquiatr 2016;74:842-8. https://doi.org/10.1590/0004-282X20160116
  6. Atkins RC. Dr. Atkins' diet revolution. Med Lett Drugs Ther 1973;15:41-2. https://doi.org/10.1119/1.1987435
  7. Brouns F. Overweight and diabetes prevention: is a low-carbohydrate-high-fat diet recommendable? Eur J Nutr 2018;57:1301-12. https://doi.org/10.1007/s00394-018-1636-y
  8. Fechner E, Smeets ETHC, Schrauwen P, Mensink RP. The effects of different degrees of carbohydrate restriction and carbohydrate replacement on cardiometabolic risk markers in humans-a systematic review and meta-analysis. Nutrients 2020;12:991. https://doi.org/10.3390/nu12040991
  9. Johnston CS, Tjonn SL, Swan PD, White A, Hutchins H, Sears B. Ketogenic low-carbohydrate diets have no metabolic advantage over non-ketogenic low-carbohydrate diets. Am J Clin Nutr 2006;83:1055-61. https://doi.org/10.1093/ajcn/83.5.1055
  10. Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA 2005;293:43-53. https://doi.org/10.1001/jama.293.1.43
  11. Papadopoulou SK, Nikolaidis PT. Low-carbohydrate diet and human health. Nutrients 2023;15:2004.
  12. Feinman RD, Pogozelski WK, Astrup A, et al. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition 2015;31:1-13. https://doi.org/10.1016/j.nut.2014.06.011
  13. Barber TM, Hanson P, Kabisch S, Pfeiffer AFH, Weickert MO. The low-carbohydrate diet: short-term metabolic efficacy versus longer-term limitations. Nutrients 2021;13:1187.
  14. Malik VS, Hu FB. Popular weight-loss diets: from evidence to practice. Nat Clin Pract Cardiovasc Med 2007;4:34-41. https://doi.org/10.1038/ncpcardio0726
  15. Chawla S, Tessarolo Silva F, Amaral Medeiros S, Mekary RA, Radenkovic D. The effect of low-fat and low-carbohydrate diets on weight loss and lipid levels: a systematic review and meta-analysis. Nutrients 2020;12:3774.
  16. Hession M, Rolland C, Kulkarni U, Wise A, Broom J. Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obes Rev 2009;10:36-50. https://doi.org/10.1111/j.1467-789X.2008.00518.x
  17. Boden G, Sargrad K, Homko C, Mozzoli M, Stein TP. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Ann Intern Med 2005;142:403-11. https://doi.org/10.7326/0003-4819-142-6-200503150-00006
  18. Currenti W, Losavio F, Quiete S, et al. Comparative evaluation of a low-carbohydrate diet and a Mediterranean diet in overweight/obese patients with type 2 diabetes mellitus: a 16-week intervention study. Nutrients 2023;16:95. https://doi.org/10.3390/nu16010095
  19. Sainsbury E, Kizirian NV, Partridge SR, Gill T, Colagiuri S, Gibson AA. Effect of dietary carbohydrate restriction on glycemic control in adults with diabetes: a systematic review and meta-analysis. Diabetes Res Clin Pract 2018;139:239-52. https://doi.org/10.1016/j.diabres.2018.02.026
  20. Santos FL, Esteves SS, da Costa Pereira A, Yancy WS Jr, Nunes JP. Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. Obes Rev 2012;13:1048-66. https://doi.org/10.1111/j.1467-789X.2012.01021.x
  21. Nordmann AJ, Nordmann A, Briel M, et al. Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med 2006;166:285-93. https://doi.org/10.1001/archinte.166.3.285
  22. McClernon FJ, Yancy WS Jr, Eberstein JA, Atkins RC, West-man EC. The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms. Obesity (Silver Spring) 2007;15:182-7. https://doi.org/10.1038/oby.2007.516
  23. Hu T, Yao L, Reynolds K, et al. The effects of a low-carbohydrate diet on appetite: a randomized controlled trial. Nutr Metab Cardiovasc Dis 2016;26:476-88. https://doi.org/10.1016/j.numecd.2015.11.011
  24. Turton JL, Raab R, Rooney KB. Low-carbohydrate diets for type 1 diabetes mellitus: a systematic review. PLoS One 2018;13:e0194987.
  25. Merrill JD, Soliman D, Kumar N, Lim S, Shariff AI, Yancy WS Jr. Low-carbohydrate and very-low-carbohydrate diets in patients with diabetes. Diabetes Spectr 2020;33:133-42. https://doi.org/10.2337/ds19-0070
  26. Ma Y, Zheng Z, Zhuang L, et al. Dietary macronutrient intake and cardiovascular disease risk and mortality: a systematic review and dose-response meta-analysis of prospective cohort studies. Nutrients 2024;16:152.
  27. Mansoor N, Vinknes KJ, Veierod MB, Retterstol K. 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 2016;115:466-79. https://doi.org/10.1017/S0007114515004699
  28. Scott PM. Which diet is better--low-fat or low-carb? JAAPA 2006;19:49.
  29. Drummond S. Obesity: a diet that is acceptable is more likely to succeed. J Fam Health Care 2007;17:219-21.
  30. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393-403. https://doi.org/10.1056/NEJMoa012512
  31. Korean Society for the Study of Obesity. Healthy low-carbohydrate diet practice guide for weight control. Seoul: Korean Society for the Study of Obesity; 2023.
  32. Aune D, Keum N, Giovannucci E, et al. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ 2016;353:i2716.
  33. Ma X, Tang WG, Yang Y, Zhang QL, Zheng JL, Xiang YB. Association between whole grain intake and all-cause mortality: a meta-analysis of cohort studies. Oncotarget 2016;7:61996-2005. https://doi.org/10.18632/oncotarget.11491
  34. Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med 2008;359:229-41. https://doi.org/10.1056/NEJMoa0708681
  35. The Korean Society of Lipid and Atherosclerosis. Korean guidelines for the management of dyslipidemia. 5th ed. Seoul: The Korean Society of Lipid and Atherosclerosis; 2022.
  36. Oh DJ. Life style and coronary artery disease. Korean J Med 2003;65:130-6.