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Carbohydrate restriction bests low-fat diets for managing dyslipidaemia in high-risk populations

10 Jan 2019

A dietary strategy of carbohydrate restriction proves superior to low-fat diets in terms of improving lipid markers in individuals with cardiometabolic risk, owing to its strong effects on high-density lipoprotein cholesterol (HDL-C) and triglycerides, according to a meta-analysis.

Researchers searched multiple online databases for large randomized controlled trials (RCTs; n=100) evaluating the effects of consuming very low, low and moderate carbohydrate, higher fat diets vs high-carbohydrate, low-fat diets for ≥6 months on low-density lipoprotein cholesterol (LDL-C) and other lipid markers in overweight/obese adults.

The meta-analysis included eight RCTs representing 1,633 participants, 818 in the carbohydrate-restricted diet group and 815 in the low-fat diet group. Pooled data revealed that carbohydrate-restricted diets yielded no significant effect on LDL-C after 6, 12 and 24 months. On the other hand, low-fat diets showed a more favourable result (0.07 mmol/L; 95 percent CI, 0.02–0.13; p=0.009), although this was clinically insignificant.

Results for HDL-C and plasma TG at 6 and 12 months favoured carbohydrate-restricted diets (0.08 mmol/L; 0.06–0.11; p<1×10−5 and −0.13 mmol/L; −0.19 to −0.08; p<1×10−5, respectively). These beneficial effects were more pronounced in the subgroup of participants with very-low carbohydrate levels (<50 g/d; 0.12 mmol/L; 0.10–0.14; p<1×10−5 and −0.19 mmol/L; −0.26 to −0.12; p=0.02, respectively).

The present data suggest that carbohydrate-restricted diets should be considered for the prevention and management of dyslipidaemia in individuals at high risk of cardiovascular disease, such as those with obesity/overweight, metabolic syndrome, prediabetes or type 2 diabetes, researchers said.

Considering the epidemics of obesity and obesity-related comorbidities, researchers highlighted a need for new nutritional approaches and more focused innovative interventions in order to achieve lasting behavioural changes.

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