Dietary carbohydrate restriction improves insulin sensitivity, blood pressure, microvascular function, and cellular adhesion markers in individuals taking statins

Kevin D. Ballarda, Erin E. Quanna, Brian R. Kupchaka, Brittanie M. Volka, Diana M. Kawieckia, Maria Luz Fernandez, Richard L. Seip, Carl M. Maresha, William J. Kraemera, Jeff S.Volek

Single arm perspective with 21 participants.  The results of this study suggest that a CRD could be a sustainable lifestyle that complements statin treatment to improve overall cardio-metabolic risk, particularly for individuals with other risk factors indicative of metabolic syndrome, but future research is needed to determine the effects over a longer period of time.

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A Very Low Carbohydrate, Low Saturated Fat Diet for Type 2 Diabetes Management: A Randomized Trial

Jeannie Tay, Natalie D. Luscombe-Marsh, Campbell H. Thompson, Manny Noakes, Jon D. Buckley, Gary A. Wittert, William S. Yancy Jr., Grant D. Brinkworth

RCT with 93 participants.  Both diets achieved substantial improvements for several clinical glycemic control and CVD risk markers.  These improvements and reductions in GV and anti-glycemic medication requirements were greatest with the LC compared with HC.  This suggests an LC diet with low saturated fat may be an effective dietary approach for T2DM management if effects are sustained beyond 24 weeks.   (It should be noted that a Low-Carb/ High[er]-Saturated-Fat diet was not included in the trial).

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A Randomized Pilot Trial of a Moderate Carbohydrate Diet Compared to a Very Low Carbohydrate Diet in Overweight or Obese Individuals with Type 2 Diabetes Mellitus or Prediabetes

Laura R. Saslow, Sarah Kim, Jennifer J. Daubenmier, Judith T. Moskowitz, Stephen D. Phinney, Veronica Goldman, Elizabeth J. Murphy, Rachel M. Cox, Patricia Moran, Fredrick M. Hecht

RCT with 34 participants.  Results suggest that a very low carbohydrate diet coupled with skills to promote behavior change may improve glycemic control in type 2 diabetes while allowing decreases in diabetes medications.

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Comparison of a very low-calorie-ketogenic diet with a standard low-calorie diet in the treatment of obesity

Basilio Moreno; Diego Bellido; Ignacio Sajoux; Albert Goday; Dolores Saavedra; Ana B. Crujeiras; Felipe F. Casanueva

RCT with 53 Particpants.  In a group of obese patients, the VLCK diet was significantly more effective than a standard LC diet.  At one year followup in the group with VLCK diet, most of the patients loss more than 10 % of their initial weight and lean mass was well preserved.

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Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial

Lydia A. Bazzano, MD, PhD, MPH; Tian Hu, MD, MS; Kristi Reynolds, PhD; Lu Yao, MD, MS; Calynn Bunol, MS, RD, LDN; Yanxi Liu, MS; Chung-Shiuan Chen, MS; Michael J. Klag, MD, MPH; Paul K. Whelton, MD, MSc, MB; Jiang He, MD, PhD

RCT with 148 participants.  The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors.

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Diets with high-fat cheese, high-fat meat, or carbohydrate on cardiovascular risk markers in overweight postmenopausal women: a randomized crossover trial.

Tanja K Thorning, Farinaz Raziani, Nathalie T Bendsen, Arne Astrup, Tine Tholstrup, Anne Raben

Randomized crossover with 14 participants.  Diets with cheese and meat as primary sources of SFAs cause higher HDL cholesterol and apo A-I and, therefore, appear to be less atherogenic than is a low-fat, high-carbohydrate diet.  Also, our findings confirm that cheese increases fecal fat excretion.

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Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis

Jonathan Sackner-Bernstein, David Kanter, Sanjay Kaul

This trial-level meta-analysis of randomized controlled trials comparing LoCHO diets with LoFAT diets in strictly adherent populations demonstrates that each diet was associated with significant weight loss and reduction in predicted risk of ASCVD events. However, LoCHO diet was associated with modest but significantly greater improvements in weight loss and predicted ASCVD risk in studies from 8 weeks to 24 months in duration. These results suggest that future evaluations of dietary guidelines should consider low carbohydrate diets as effective and safe intervention for weight management in the overweight and obese, although long-term effects require further investigation.

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Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men

Kevin D Hall, Kong Y Chen, Juen Guo , Yan Y Lam, Rudolph L Leibel, Laurel ES Mayer, Marc L Reitman, Michael Rosenbaum, Steven R Smith, B Timothy Walsh, Eric Ravussin

Metabolic ward crossover with 17 subjects.  A logical consequence of the carbohydrate–insulin model is that decreasing the proportion of dietary carbohydrate to fat without altering protein or calories will reduce insulin secretion, increase fat mobilization from adipose tissue, and elevate the oxidation of circulating free fatty acids (FFAs).  For those participants following the Ketogenic Diet, insulin response was superior to comparative diet.

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Effects of Low-Carbohydrate vs Low-Fat Diets on Weight Loss and Cardiovascular Risk Factors: a meta-analysis of randomised controlled trials

Alain J. Nordmann, MD, MSc; Abigail Nordmann, BS; Matthias Briel, MD; Ulrich Keller, MD; William S. Yancy Jr, MD, MSH; Bonnie J. Brehm, PhD; Heiner C. Bucher, MD, MPH

Five trials including a total of 447 individuals.  This meta-analysis demonstrates that low-carbohydrate, non–energy-restricted diets appear to be at least as effective as low-fat, energy-restricted diets in inducing weight loss for up to 1 year. However, potential favorable changes in triglyceride and high-density lipoprotein cholesterol values should be weighed against potential unfavorable changes in low-density lipoprotein cholesterol values when low-carbohydrate diets to induce weight loss are considered.

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Dynamics of intra-pericardial and extra-pericardial fat tissues during long-term, dietary induced, moderate weight loss

Gal Tsaban, Arik Wolak, Hila Avni-Hassid, Yftach Gepner, Ilan Shelef, Yaakov Henkin, Dan Schwarzfuchs, Noa Cohen, Nitzan Bril, Michal Rein Dana Serfaty, Shira Kenigsbuch, Lilac Tene, Hila Zelicha, Anat Yaskolka-Meir, Oded Komy, Avital Bilitzky, Yoash Chassidim, Uta Ceglarek, Michael Stumvoll, Matthias Blüher , Joachim Thiery, Dror Dicker, Assaf Rudich , Meir J Stampfer, Iris Shai

RCT with 80 participants.  Moderate but persistent dietary-induced weight loss substantially decreased both IPF and EPF volumes.  Reduction of pericardial adipose tissues is independently associated with an improved lipid profile.  The Mediterranean diet, rich in unsaturated fats and restricted carbohydrates, is superior to an LF diet in terms of the IPF burden reduction.

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A very low calorie ketogenic diet improves weight loss and quality of life in patients with adjustable gastric banding.

Taus M , Fumelli D , Busni D , Borroni F , Sebastianelli S , Nicolai G , Nicolai A

Non-randomized 2 arm prospective with 20 participants.  KD can improve the weight loss and quality of life in patients who underwent LAGB and failed at losing more weight allowing a weight loss comparable to that obtained with a further calibration and it is useful to to avoid drastic calibrations and their collateral effects

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Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very lowcarbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes

Laura R. Saslow, Jennifer J. Daubenmier, Judith T. Moskowitz, Sarah Kim, Elizabeth J. Murphy, Stephen D. Phinney, Robert Ploutz-Snyder, Veronica Goldman, Rachel M. Cox, Ashley E. Mason, Patricia Moran & Frederick M. Hecht

RCT with 34 particpants.  The results suggest that adults with prediabetes or noninsulin-dependent type 2 diabetes may be able to improve glycemic control with less medication by following an ad libitum very low-carbohydrate ketogenic diet compared to a moderate-carbohydrate, calorie-restricted low-fat diet. Additional research should examine both clinical outcomes and adherence beyond 12 months.

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A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes

Amy L McKenzie, PhD ; Sarah J Hallberg, DO, MS ; Brent C Creighton, PhD ; Brittanie M Volk, RD, PhD ; Theresa M Link, RD, CDE ; Marcy K Abner, RD ; Roberta M Glon, RN, BSN ; James P McCarter, MD, PhD ; Jeff S Volek, RD, PhD ; Stephen D Phinney, MD, PhD

This study, non-randomized parallel arm prospective with 262 participants, demonstrates an individualized program delivered and supported remotely that incorporates nutritional ketosis can be highly effective in improving glycemic control and weight loss in adults with T2D while significantly decreasing medication use.

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Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet

Belinda S. Lennerz, Anna Barton, Richard K. Bernstein, R. David Dikeman, Carrie Diulus, Sarah Hallberg, Erinn T. Rhodes, Cara B. Ebbeling, Eric C. Westman, William S. Yancy Jr, David S. Ludwig

To evaluate glycemic control among children and adults with type 1 diabetes mellitus (T1DM) who consume a very low–carbohydrate diet (VLCD).

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Neuro-protective and disease-modifying effects of the ketogenic diet

Maciej Gasior, Michael A. Rogawski, and Adam L. Hartman

The ketogenic diet has been in clinical use for over 80 years, primarily for the symptomatic treatment of epilepsy. A recent clinical study has raised the possibility that exposure to the ketogenic diet may confer long-lasting therapeutic benefits for patients with epilepsy. Moreover, there is evidence from uncontrolled clinical trials and studies in animal models that the ketogenic diet can provide symptomatic and disease-modifying activity in a broad range of neuro-degenerative disorders including Alzheimer’s disease and Parkinson’s disease, and may also be protective in traumatic brain injury and stroke.

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Long-term effects of a ketogenic diet in obese patients

Hussein M Dashti, MD PhD FICS FACS, Thazhumpal C Mathew, MSc PhD FRCPath, Talib Hussein, MB ChB, Sami K Asfar, MB ChB MD FRCSEd FACS, Abdulla Behbahani, MB ChB FRCS FACSI PhD FICS FACS, Mousa A Khoursheed, MB ChB FRCS FICS, Hilal M Al-Sayer, MD PhD FICS FACS, Yousef Y Bo-Abbas, MD FRCPC, and Naji S Al-Zaid, BSc PhD

To determine the effects of a 24-week ketogenic diet (consisting of 30 g carbohydrate, 1 g/kg body weight protein, 20% saturated fat, and 80% polyunsaturated and monounsaturated fat) in obese patients.

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Insulin Sensitivity and Glucose Tolerance Are Altered by Maintenance on a Ketogenic Diet

Kimberly P. Kinzig, Mary Ann Honors, and Sara L. Hargrave

Low-carbohydrate, ketogenic diets (KD) are frequently implemented in efforts to reduce or maintain body weight, although the metabolic effects of long-term exposure to this type of diet remain controversial. This study assessed the responsiveness to peripheral and central insulin, glucose tolerance, and meal-induced effects of consuming a KD in the rat.

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