A Systematic Review and Meta‐Analysis Comparing Heterogeneity in Body Mass Responses Between Low‐Carbohydrate and Low‐Fat Diets

Abstract

Objective An important notion in personalized medicine is that there is clinically relevant treatment response heterogeneity. Low‐carbohydrate (CHO) and low‐fat diets are widely adopted to reduce body mass. To compare individual differences in responses between two dietary interventions, a formal statistical comparison of response variances between study arms in a randomized controlled trial (RCT) is crucial. Methods The change in variances in RCTs for the body mass responses to low‐CHO dietary interventions versus change variances for the low‐fat groups (typically considered as the comparator intervention) were compared. A literature search identified relevant RCTs (n = 25; 3,340 participants). The means and SDs of body mass change in low‐CHO and low‐fat study arms were extracted to calculate the variances of individual responses. These were meta‐analyzed in a random‐effects model and converted to the SD for individual responses. Results The pooled SD for individual responses for body mass was 1.4 kg (95% CI: −1.1 to 2.3) with a wide 95% prediction interval of −6.3 to 10.4 kg. Conclusions Evidence is insufficient to suggest the response heterogeneity to low‐CHO diets differs from that observed with low‐fat diets.

Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors in overweight and obese adults: A meta-analysis of randomized controlled trials

“…On the other hand, some studies reduced dietary fats and replaced them with carbohydrates such as fruits and grains. However, this replacement did not affect atherogenic dyslipidemia among individuals with metabolic syndrome ( 62 , 63 ).…”

“…Reduction of carbohydrate intake has attracted more and more attention in recent years for its potential in health promotion and treatment of diseases, including decreasing body mass, improving fat and carbohydrate metabolism, producing clinical improvements in the management of type 2 diabetes mellitus, and reducing the predicted risk of atherosclerotic cardiovascular disease events ( 65 , 67 , 68 ). However, there are still controversial effects of LCD or the comparison between LCD and LFD ( 63 , 65 , 69 ). Some reasons that may be involved are as follows: (1) the criteria for included subjects are different.…”

Physiological responses to carbohydrate overfeeding

“…However, many studies observe that these responses can be highly variable, with some indications that the effect of carbohydrate overfeeding may differ according to (and so perhaps may explain) a person's natural propensity to gain weight. Given the emergent scientific literature on this topic, further novel insight may now be gained by comparing the response heterogeneity between relevant experimental conditions, thus establishing whether inter-individual differences truly exist in relation to the effects of carbohydrate overfeeding, as has recently been applied in relation to the effects of carbohydrate restriction [42]. Future research should also examine whether the particular volume, intensity, type and/or timing of physical activity or exercise is important in counteracting the negative effects of carbohydrate overfeeding.…”

Manfaat Diet Ketogenik pada Tata Laksana Obesitas

“…Dikhawatirkan bahwa pola makan tinggi lemak justru dapat menyebabkan obesitas dan berisiko beragam penyakit, seperti diabetes, kanker, dan penyakit arteri koroner. 18,26 Berikut dugaan beberapa mekanisme diet ketogenik dalam menurunkan berat badan: 15,18,27 Efek Diuretik. Dalam kondisi ketosis, pengurangan asupan kalori secara keseluruhan dapat meningkatkan penurunan berat badan.…”

“…Namun, hal ini masih inkonklusif. 12,27 Protein nampaknya memiliki efek mengenyangkan lebih besar dibandingkan karbohidrat. Diet ketogenik menekan rasa lapar lebih besar dibandingkan diet nonketogenik dengan asupan jumlah protein yang sama, sehingga diduga ketosis memiliki efek tersendiri, terlepas dari efek protein.…”