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Benefits of Low Carbohydrate Diets: a Settled Question or Still Controversial?

  • Obesity Treatment (D Bessesen, Section Editor)
  • Published:
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Abstract

Purpose of Review

The purpose of this review was to provide an update on the available data on the benefits of low-carbohydrate (low-carb) diets for weight management and type 2 diabetes (T2DM) and determine if low-carb diets were a settled question or still controversial.

Recent Findings

Most of the recent published literature in this area consists of reviews of past trials, with a relatively smaller number of recent trials. Low-carb is most commonly compared to low-fat, with problematically inconsistent definitions of both. There are numerous challenges in trying to draw clear conclusions about efficacy and effectiveness. Short-term vs. long-term effects can differ, which is likely impacted by adherence. Adherence is very different between metabolic chamber or feeding studies vs. free-living. Body weight alone is a crude measure that fails to capture potentially important differences in lean-mass, fat-mass, and body water. Benefits for glycemic control need to be balanced with impacts on non-glycemic outcomes such as LDL-cholesterol, the microbiome, and inflammation. It is important to differentiate between low-carb and very-low carbohydrate diets (VLCD). To date no large-scale long-term clinical trials have been conducted testing whether low-carb diets can prevent T2DM.

Summary

Many issues regarding benefits and risks of low-carb diets remain controversial or unresolved, particularly for VLCD. Some of the recent, better studies highlighted in this review suggest strategies for resolving these controversies.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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This work was supported by a training grant from the NIH National Heart, Lung, and Blood Institute [T32 HL007034] and by the Stanford Diabetes Research Center [NIH P30DK116074].

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  1. Matthew J. Landry and Anthony Crimarco are co-first authors. Both authors have equally contributed to the manuscript.

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  1. Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, USA

    Matthew J. Landry, Anthony Crimarco & Christopher D. Gardner

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Landry, M.J., Crimarco, A. & Gardner, C.D. Benefits of Low Carbohydrate Diets: a Settled Question or Still Controversial?. Curr Obes Rep 10, 409–422 (2021). https://doi.org/10.1007/s13679-021-00451-z

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