Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials

被引:515
作者
Bueno, Nassib Bezerra [1 ]
Vieira de Melo, Ingrid Sofia [1 ]
de Oliveira, Suzana Lima [1 ]
Ataide, Terezinha da Rocha [1 ]
机构
[1] Univ Fed Alagoas, Fac Nutr, Lab Nutr Expt, BR-57072970 Maceio, AL, Brazil
关键词
Cardiovascular risk factors; Low-carbohydrate diets; Meta-analysis; Obesity; Weight loss; CARDIOVASCULAR RISK-FACTORS; BLOOD-PRESSURE; PROTEIN; INTERVENTION; OBESITY; RESTRICTION; ADHERENCE; SUCCESS; BIAS; VS;
D O I
10.1017/S0007114513000548
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
The role of very-low-carbohydrate ketogenic diets (VLCKD) in the long-term management of obesity is not well established. The present meta-analysis aimed to investigate whether individuals assigned to a VLCKD (i.e. a diet with no more than 50 g carbohydrates/d) achieve better long-term body weight and cardiovascular risk factor management when compared with individuals assigned to a conventional low-fat diet (LFD; i.e. a restricted-energy diet with less than 30% of energy from fat). Through August 2012, MEDLINE, CENTRAL, ScienceDirect, Scopus, LILACS, SciELO, ClinicalTrials.gov and grey literature databases were searched, using no date or language restrictions, for randomised controlled trials that assigned adults to a VLCKD or a LFD, with 12 months or more of follow-up. The primary outcome was body weight. The secondary outcomes were TAG, HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), systolic and diastolic blood pressure, glucose, insulin, HbA(1c) and C-reactive protein levels. A total of thirteen studies met the inclusion/exclusion criteria. In the overall analysis, five outcomes revealed significant results. Individuals assigned to a VLCKD showed decreased body weight (weighted mean difference -0.91 (95% CI -1.65, -0.17)kg, 1415 patients), TAG (weighted mean difference -0.18 (95% CI -0.27, -0.08) mmol/l, 1258 patients) and diastolic blood pressure (weighted mean difference -1.43 (95% CI -2.49, -0.37) mmHg, 1298 patients) while increased HDL-C (weighted mean difference 0.09 (95% CI 0.06, 0.12) mmol/l, 1257 patients) and LDL-C (weighted mean difference 0.12 (95% CI 0.04, 0.2) mmol/l, 1255 patients). Individuals assigned to a VLCKD achieve a greater weight loss than those assigned to a LFD in the long term; hence, a VLCKD may be an alternative tool against obesity.
引用
收藏
页码:1178 / 1187
页数:10
相关论文
共 53 条
[1]   Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal [J].
Accurso, Anthony ;
Bernstein, Richard K. ;
Dahlqvist, Annika ;
Draznin, Boris ;
Feinman, Richard D. ;
Fine, Eugene J. ;
Gleed, Amy ;
Jacobs, David B. ;
Larson, Gabriel ;
Lustig, Robert H. ;
Manninen, Anssi H. ;
McFarlane, Samy I. ;
Morrison, Katharine ;
Nielsen, Jorgen Vesti ;
Ravnskov, Uffe ;
Roth, Karl S. ;
Silvestre, Ricardo ;
Sowers, James R. ;
Sundberg, Ralf ;
Volek, Jeff S. ;
Westman, Eric C. ;
Wood, Richard J. ;
Wortman, Jay ;
Vernon, Mary C. .
NUTRITION & METABOLISM, 2008, 5 (1)
[2]   The metabolic syndrome - a new worldwide definition [J].
Alberti, KGMM ;
Zimmet, P ;
Shaw, J .
LANCET, 2005, 366 (9491) :1059-1062
[3]   Dietary adherence and weight loss success among overweight women: results from the A TO Z weight loss study [J].
Alhassan, S. ;
Kim, S. ;
Bersamin, A. ;
King, A. C. ;
Gardner, C. D. .
INTERNATIONAL JOURNAL OF OBESITY, 2008, 32 (06) :985-991
[4]  
[Anonymous], 2001, Eff Clin Pract, V4, P183
[5]  
[Anonymous], 2011, COCHRANE HDB SYSTEMA
[6]  
[Anonymous], EVERY DAY COOKING DE
[7]  
[Anonymous], 2012, Obesity and overweight, DOI 10.1007/springerreference_223608
[8]  
[Anonymous], 2009, Systematic reviews: CRD's guidancefor undertaking reviews in health care
[9]  
[Anonymous], WEIGHT WATCH NEW COM
[10]   Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids - Results of the OmniHeart randomized trial [J].
Appel, LJ ;
Sacks, FM ;
Carey, VJ ;
Obarzanek, E ;
Swain, JF ;
Miller, ER ;
Conlin, PR ;
Erlinger, TP ;
Rosner, BA ;
Laranjo, NM ;
Charleston, J ;
McCarron, P ;
Bishop, LM .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 294 (19) :2455-2464