Low‐carbohydrate diets: nutritional and physiological aspects

Adam-Perrot, A.; Clifton, Peter M.; Brouns, Fred

doi:10.1111/j.1467-789x.2006.00222.x

Cited by 187 publications

(164 citation statements)

References 63 publications

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“…HP diets tend to have reduced carbohydrate content, in the form of fruits, vegetables (if starchy foods are not adequately replaced by other types of low-carbohydratecontaining vegetables) and grains. This may theoretically place an individual at an increased disease risk if such a diet is followed long term, and fruit and vegetable intakes remain low (90) . HP dieting is associated with increased consumption of meat, and red meat consumption has been linked to colorectal cancer (91) , but the evidence is not straightforward.…”

Section: Gut Healthmentioning

confidence: 99%

Safety and efficacy of high-protein diets for weight loss

Johnstone

2012

Proc. Nutr. Soc.

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Dietary strategies that can help reduce hunger and promote fullness are beneficial for weight control, since these are major limiting factors for success. High-protein (HP) diets, specifically those that maintain the absolute number of grams ingested, while reducing energy, are a popular strategy for weight loss (WL) due to the effects of protein-induced satiety to control hunger. Nonetheless, both the safety and efficacy of HP WL diets have been questioned, particularly in combination with low-carbohydrate advice. Nonetheless, for short-to-medium-term intervention studies (over several months), increasing the energetic contribution of protein does appear effective. The effects of HP diets on appetite, bone health, renal function, blood pressure, cardiovascular bio-markers, antioxidant status, gut health and psychological function are discussed. Further research is warranted to validate the physiological effects of HP diets over longer periods of time, including studies that modify the quality of macronutrients (i.e. the type of carbohydrate, fat and protein) and the interaction with other interventions (e.g. exercise and dietary supplements). What is a high-protein diet?An important factor to consider is the definition of a 'highprotein (HP) diet', as there are several ways to consider the protein content of a diet. The composition of the diet can be determined as the absolute amount of the protein (grams), the % of total energy as protein or the amount of protein ingested per kg body weight. Normal protein intake in the UK is approximately 16% of energy intake(1) for a sedentary adult, which is approximately 64-88 g/d at energy balance for females and males, respectively. There is no general consensus as to what a 'high'-protein diet is: the food industry use the term 'protein-enriched' for 20 % protein from energy. The HP diets reported for weight loss (WL) studies often include 30% of energy intake as protein. There are many variants such as the Zone diet (2) and the CSIRO diet (3) . In general, protein as a percentage of energy is doubled from 15 to 30%. Note, this does not mean that absolute protein intake (g) is doubled, as energy intake is reduced, with only a 20 % increase in the actual amount (g) of protein. The guidelines from the Institute of Medicine allow for the inclusion of higher amounts of protein than previously recommended in a healthy diet (4) . This Institute concluded that there is no clear evidence that an HP intake increases the risk of renal stones, osteoporosis, cancer or CVD. Thus, the acceptable protein distribution for maintenance requirements was set to 5-20% of energy for children aged 1-3 years, 10-30 % for children aged 3-18 years and 10-35 % for adults. It is not clear as to how much protein is required to maximise proteininduced satiety for energy restriction and WL or whether there is a relationship with the energy density of the diet.Both the safety (5) and efficacy (5) of HP WL diets have been questioned, particularly in combination with low-carbohydrate advice (6) . Low-ca...

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Section: Gut Healthmentioning

confidence: 99%

Safety and efficacy of high-protein diets for weight loss

Johnstone

2012

Proc. Nutr. Soc.

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Section: Articlesmentioning

confidence: 99%

“…On the other hand, a high-GI diet could conversely result in high postprandial insulin so blood glucose might rapidly decrease with an increase in counter-regulatory hormones causing declining insulin sensitivity (25). In addition, the high-GI diet also results in increasing lipid accumulation in skeletal muscle and liver which may cause insulin signaling defects and insulin resistance, and triacylglycerol accumulation in β cells also leads to decreased insulin secretion (23,26,27).Due to the difference of baseline insulin levels between the two groups, we did general linear model and multiple regression analysis to adjust for the difference of baseline fasting plasma glucose, insulin, and HOMA-IR. The baseline fasting plasma glucose, insulin, and HOMA-IR had a greater effect on the mean difference of these results compared with the type of treatments.…”

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confidence: 99%

Low-glycemic index diet may improve insulin sensitivity in obese children

et al. 2015

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ArticlesClinical Investigation nature publishing group BACKGROUND: A low-glycemic index (GI) diet may be beneficial for weight management due to its effect on insulin metabolism and satiety. METHODS: Obese children aged 9-16 y were randomly assigned either a low-GI diet or a low-fat diet (control group) for 6 mo. Body composition changes were measured by dualenergy X-ray absorptiometry and bioelectrical impedance analysis. Insulin sensitivity was measured by fasting plasma glucose and insulin. RESULTS: Fifty-two participants completed the study (mean age: 12.0 ± 2.0 y, 35 boys); both groups showed significantly decreased BMI z-score but similar changes in fat and fat-free mass. The low-GI group demonstrated a significant decline in fasting plasma insulin (22.2 ± 14.3 to 13.7 ± 10.9 mU/l; P = 0.004) and homeostatic model of assessment-insulin resistance (4.8 ± 3.3 to 2.9 ± 2.3; P = 0.007), whereas the control group did not. However, general linear model showed no significant difference in insulin resistance between groups after adjusting for baseline levels, suggesting that the greater reduction in insulin resistance in the low-GI group may be explained by higher baseline values. CONCLUSION: Despite subtle effects on body composition, a low-GI diet may improve insulin sensitivity in obese children with high baseline insulin. A bigger study in obese children with insulin resistance could be worthwhile to confirm our findings.C urrently, the prevalence of childhood obesity has been increasing worldwide (1). The Centers for Disease Control and Prevention reported that about 17% of children and adolescents in the United States aged 2-19 y were obese (2). Furthermore, the prevalence of the metabolic syndrome has been rapidly rising in obese children, and with it, the risk of cardiovascular disease (3). About 60% of overweight children have at least one cardiovascular disease risk factors such as hypertension, dyslipidemia, and insulin resistance. In addition, more than 25% of them have more than one type of cardiovascular disease risk factors (1). The common complications of childhood obesity are the metabolic syndrome (hypertension, dyslipidemia, insulin resistance, and type 2 diabetes), obstructive sleep apnea, nonalcoholic steatohepatitis, polycystic ovary syndrome, orthopedic complications, and premature atherosclerosis (4).At present, we are unable to describe the exact etiology of obesity, but one of the most common causes is an imbalance between energy intake and physical activity. Treatment of obesity is difficult and can be done by several approaches, including dietary control (such as low-fat, low-energy diet), physical activity program, behavioral modification (such as generating weight reduction goal, self-monitoring, as well as positive reinforcement by parents), and medical treatment. There are many pediatric patients seeking hospital-based obesity treatment. Most of them have one or more of the complications of obesity mentioned above as well as a loss of their self-esteem and social lives. In general, ...

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“…Analysis of the macronutrient composition of the diet has shown that individuals with SCI typically consume a diet that provides more than 30% of their total daily energy intake from fat (25,82,83). Although there is no consensus on the optimal macronutrient composition of the diet for weight loss or the role of dietary fat in the development of obesity (84,85), consumption of a diet low in fat can help with weight loss because it can be part of a lower caloric density diet, which encourages the consumption of high fiber foods that foster satiety and are compatible with diets advised for overall health (86)(87)(88). In the only published weight loss intervention study, caloric-restricted diets of 1,400 calories for men and 1,200 calories for women were used, but information on the macronutrient composition of the prescribed regimen was not provided (23).…”

Section: Management Treatmentmentioning

confidence: 99%

Clinical Assessment and Management of Obesity in Individuals With Spinal Cord Injury: A Review

Rajan

McNeely

Warms

et al. 2008

The Journal of Spinal Cord Medicine

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Background: Diagnosing and managing obesity in individuals with spinal cord injury (SCI) remain challenging. Methods: Literature on the epidemiology, impact, and management of obesity in individuals with SCI was reviewed. Findings: Although nearly 66% of individuals with SCI are either overweight or obese, little guidance is available to measure and monitor obesity in the clinical setting. The use of anthropometric indices and specific cut points available for able-bodied persons is limited by the body composition changes that follow SCI. Indices of upper body obesity warrant examination in SCI because they provide an index of central obesity, which is more closely linked to some obesity-related conditions than is overall obesity. Investigations into the sequelae of excess body fat and its distribution are also needed in SCI because past research in this area has been inconclusive. Although limited, evidence regarding obesity interventions in SCI may be promising. Conclusions:The best anthropometric tool to define obesity in the clinical setting remains unknown. SCIspecific assessment tools and a better understanding of the sequelae of excess body weight will lead to better targeting of prevention and treatment efforts. More research is needed on the individual components of a weight management program unique to SCI. Until then, providers are urged to use a team approach and draw on existing resources and applicable research in able-bodied individuals to facilitate weight management in individuals with SCI.

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Low‐carbohydrate diets: nutritional and physiological aspects

Cited by 187 publications

References 63 publications

Safety and efficacy of high-protein diets for weight loss

Safety and efficacy of high-protein diets for weight loss

Low-glycemic index diet may improve insulin sensitivity in obese children

Clinical Assessment and Management of Obesity in Individuals With Spinal Cord Injury: A Review

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