Expert consensus on nutrition and lower-carbohydrate diets: An evidence- and equity-based approach to dietary guidance

Abstract

There is a substantial body of clinical evidence supporting the beneficial effects of lower-carbohydrate dietary patterns on multiple established risk factors associated with insulin resistance and cardiovascular diseases in adult populations. Nutrition and health researchers, clinical practitioners, and stakeholders gathered for, “The Scientific Forum on Nutrition, Wellness, and Lower-Carbohydrate Diets: An Evidence- and Equity-Based Approach to Dietary Guidance” to discuss the evidence base around lower-carbohydrate diets, health outcomes, and dietary guidance. Consensus statements were agreed upon to identify current areas of scientific agreement and spotlight gaps in research, education, and practice to help define and prioritize future pathways. Given the evidence base and considering that most American adults are living with at least one nutrition-related chronic disease, there was consensus that including a lower-carbohydrate dietary pattern as one part of the Dietary Guidelines for Americans could help promote health equity among the general population.

The Lipid–Heart Hypothesis and the Keys Equation Defined the Dietary Guidelines but Ignored the Impact of Trans-Fat and High Linoleic Acid Consumption

“…A more recent expert panel on diet and insulin resistance has recommended that the DGA reconsider the current Acceptable Macronutrient Distribution Range (AMDR) for carbohydrate of 45 to 65% because it does not align with the cumulative evidence on low-carbohydrate diets and health outcomes showing that carbohydrate intakes of less than 130 g daily can have a positive impact on body weight and other cardiovascular risk factors, and diets with less than 50 g of carbohydrate could be therapeutic for some metabolic disorders like type 2 diabetes and metabolic syndrome. Glucose can be produced endogenously as needed by several different mechanisms, and therefore, there is no essential requirement for dietary carbohydrate [155]. The consensus of the Volek et al panel is in alignment with the recommendations of 130 g daily of carbohydrate for children and adults aged 1 year and above published in the Dietary Reference Intakes (DRIs) by the Institute of Medicine (IOM) in 2006.…”