Macro partitioning
In overweight and obese adults, low-carbohydrate diets (LCD) produce greater reductions in triglycerides, diastolic blood pressure, and body weight, along with greater increases in HDL cholesterol, compared to low-fat diets (LFD) over a duration of 6 to 23 months.
If you are overweight or obese, switching to a diet with less than 40% of your calories from carbohydrates (instead of less than 30% from fat) is likely to help you lose more weight, lower your triglycerides, raise your 'good' HDL cholesterol, and lower your diastolic blood pressure over the next 6-23 months. However, this benefit disappears after 24 months, where both diets are equally effective.
Compared with participants on LFD, participants on LCD had a greater reduction in triglycerides (–0.14 mmol/L; 95% CI, –0.18 to –0.10 mmol/L), diastolic blood pressure (–0.87 mmHg; 95% CI, –1.41 to –0.32 mmHg), weight loss (–1.33 kg; 95% CI, –1.79 to –0.87 kg), and a greater increase in high-density lipoprotein cholesterol (0.07 mmol/L; 95% CI, 0.06 to 0.09 mmol/L) in 6–23 months.
Why this rating
Based on a meta-analysis of 33 RCTs with 3,939 participants, though GRADE quality was assessed as low or very low for some outcomes.
Source
Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors in overweight and obese adults: A meta-analysis of randomized controlled trials
Lifu Lei et al. · Frontiers in Nutrition · 2022
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