The Effects of Different Degrees of Carbohydrate Restriction and Carbohydrate Replacement on Cardiometabolic Risk Markers in Humans—A Systematic Review and Meta-Analysis

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URL: https://res.mdpi.com/d_attachment/nutrients/nutrients-12-00991/article_deploy/nutrients-12-00991.pdf

Journal: Nutrients

Publication Date: 04/2020

Summary: Low-carbohydrate diets (LCDs) often differ in their diet composition, which may lead to conflicting results between randomized controlled trials. Therefore, we aimed to compare the effects of different degrees of carbohydrate (CHO) restriction on cardiometabolic risk markers in humans. The experimental LCDs of 37 human trials were classified as (1) moderate-low CHO diets (<45–40 E%, n = 13), (2) low CHO diets (<40–30 E%, n = 16), and (3) very-low CHO diets (<30–3 E%; n = 8). Summary estimates of weighted mean differences (WMDs) in selected risk markers were calculated using random-effect meta-analyses. Differences between the LCD groups were assessed with univariate meta-regression analyses. Overall, the LCDs resulted in significant weight loss, reduced diastolic blood pressure BP, and increased total cholesterol and high-density lipoprotein cholesterol (HDL-C), without significant differences between the three LCD groups. Higher low-density lipoprotein cholesterol (LDL-C) concentrations were found with the very-low CHO diets compared to the moderate-low CHO diets. Decreases in triacylglycerol (TAG) concentrations were more pronounced with the low and very-low CHO diets, compared to the moderate-low CHO diets. Substitution of CHO by mainly saturated fatty acids (SFAs) increased total cholesterol, LDL-C, and HDL-C concentrations. Except for LDL-C and TAGs, effects were not related to the degree of CHO restriction. Potential effects of nutrient exchanges should be considered when following LCDs.

Key Takeaways

When comparing moderate carbohydrate intake to low and very low carbohydrate intake, the lower the carbohydrate intake the lower a person's triglycerides, and greater the increase in LDL when carbohydrates are replaced by saturated fatty acids. HDL and Total cholesterol increased when carbohydrates were replaced with saturated fat, but outcomes did not differ between moderately low and very low carbohydrate.

Replacing Carbohydrates with Fat Can Reduce Triglycerides and Raise HDL, LDL, and Total Cholesterol

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