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YearAuthorTitleJournalSummaryPrimary outcomesparticipant#TypeDuration>= 6 months>= 2 yearsPopulation typeNOTE: Meta-analysis studies denoted in green text.
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2017McKenzieA Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 DiabetesJMIR DiabetesThis study demonstrates an individualized program delivered and supported remotely that incorporates nutritional ketosis can be highly effective in improving glycemic control and weight loss in adults with T2D while significantly decreasing medication use. Type 2 diabetes, obesity, hypoglycemic medications262non-randomized parallel arm prospective70 daysT2D
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2017SaslowTwelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetesNutrition & DiabetesThe results suggest that adults with prediabetes or noninsulin-dependent type 2 diabetes may be able to improve glycemic control with less medication by following an ad libitum very low-carbohydrate ketogenic diet compared to a moderate-carbohydrate, calorie-restricted low-fat diet. Additional research should examine both clinical outcomes and adherence beyond 12 months.glycemic control34RCT1 year1T2D
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2017TausA very low calorie ketogenic diet improves weight loss and quality of life in patients with adjustable gastric banding.Ann Ital Chir.KD can improve the weight loss and quality of life in patients who underwent LAGB and failed at losing more weight allowing a weight loss comparable to that obtained with a further calibration and it is useful to avoid drastic calibrations and their collateral effects.post Gastric banding weight loss20non-randomized 2 arm prospective8 weekss/p gastric banding for weight loss
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2017TsabanDynamics of intrapericardial and extrapericardial fat tissues during long-term, dietary-induced, moderate weight loss Am J Clin NutrModerate but persistent dietary-induced weight loss substantially decreased both IPF and EPF volumes. Reduction of pericardial adipose tissues is independently associated with an improved lipid profile. The Mediterranean diet, rich in unsaturated fats and restricted carbohydrates, is superior to an LF diet in terms of the IPF burden reduction. IPF and EPF changes during weight loss80RCT18 months1Patient with moderate abdoinal obesity
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2016MansoorEffects of low-carbohydrate diets v. low-fat diets on body weight and
cardiovascular risk factors: a meta-analysis of randomised controlled trials		British Journal of NutritionThis meta-analysis demonstrates opposite change in two important cardiovascular risk factors on LC diets –
greater weight loss and increased LDL-cholesterol.		Weight lossMeta-analysisn/a
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2016HallEnergy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese menAm J Clin NutrA logical consequence of the carbohydrate–insulin model is that decreasing the proportion of dietary carbohydrate to fat without altering protein or calories will reduce insulin secretion, increase fat mobilization from adipose tissue, and elevate the oxidation of circulating free fatty acids (FFAs). For those participants following the Ketogenic Diet, insulin response was superior to comparative diet.EE, RQ and body composition17metabolic ward crossover8 weeksobese men
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2016WycherleyLong-term effects of weight loss with a very-low carbohydrate, low saturated fat diet on flow mediated dilatation in patients with type 2 diabetes: A randomised controlled trial.AtherosclerosisIn patients with obesity and T2DM, HighCHO diet and LowCHO diet have similar effects on endothelial function.Bodyweight, HbA1c and FMD were assessed.115RCT1 year1obese patients with T2D
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2015Sackner-BernsteinDietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-AnalysisPlosOneThis trial-level meta-analysis of randomized controlled trials comparing LoCHO diets with LoFAT diets in strictly adherent populations demonstrates that each diet was associated with significant weight loss and reduction in predicted risk of ASCVD events. However, LoCHO diet was associated with modest but significantly greater improvements in weight loss and predicted ASCVD risk in studies from 8 weeks to 24 months in duration. These results suggest that future evaluations of dietary guidelines should consider low carbohydrate diets as effective and safe intervention for weight management in the overweight and obese, although long-term effects require further investigation.Weight lossMeta-analysisn/a
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2015GardnerWeight Loss on Low-Fat vs. Low-Carbohydrate Dietsby Insulin Resistance Status Among Overweight Adultsand Adults With Obesity: A Randomized Pilot TrialObesityBoth diets demonstrated significant weight loss, as well as improved biomarkers for many disease risk factors. Weight loss61RCT6 months1obese adults
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2015ThroningDiets with high-fat cheese, high-fat meat, or carbohydrate on cardiovascular risk markers in overweight postmenopausal women: a randomized crossover trial.Am J Clin NutrDiets with cheese and meat as primary sources of SFAs cause higher HDL cholesterol and apo A-I and, therefore, appear to be less atherogenic than is a low-fat, high-carbohydrate diet. Also, our findings confirm that cheese increases fecal fat excretion. blood lipids, lipoproteins, and fecal excretion of fat and bile acids14randomized crossover12 weeksoverweight postmenopausal women
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2014BazzanoEffects of Low-Carbohydrate and Low-Fat DietsAnnals of Internal MedicineThe low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for ersons seeking to lose weight and reduce cardiovascular risk factors.weight, CVD risk factors 148RCT1 year1Adults without CVD or DM
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2014JonassonAdvice to follow a low-carbohydrate diet has a favourable impact on low-grade infl ammation in type 2 diabetes compared with advice
to follow a low-fat diet		Annals of MedicineLow Carbohydrate Diet was found significantly to improve the subclinical inflammatory state in type 2 diabetes.inflammation in T2D61RCT6 months1Adults with T2D
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2014MaekwaRetrospective Study on the Efficacy of a Low-Carbohydrate Diet for Impaired Glucose ToleranceDiabetes, Metabolic Syndrome and Obesity: Targets and TherapyThe LCD is effective for normalizing blood glucose and preventing progression to type-2 diabetes in patients with IGT.normalizing blood glucose in IGT patients and preventing progression from IGT to type 2 diabetes722 arm Retrospective12 months1Japanese patients with impaired glucose tolerance
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2014MorenoComparison of a very low-calorie-ketogenic diet with a standard
low-calorie diet in the treatment of obesity		EndocrineIn a group of obese patients, the VLCK diet was significantly more effective than a standard LC diet. At one year followup in the group with VLCK diet, most of the patients loss more than 10 % of their initial weight and lean mass was well preserved.Weight loss53RCT12 months1obesity
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2014SaslowA Randomized Pilot Trial of a Moderate Carbohydrate
Diet Compared to a Very Low Carbohydrate Diet in
Overweight or Obese Individuals with Type 2 Diabetes
Mellitus or Prediabetes		PlosOneResults suggest that a very low carbohydrate diet coupled with skills to promote behavior change may improve glycemic control in type 2 diabetes while allowing decreases in diabetes medications.glycemic control and CVD risk factors34RCT3 monthsoverweight of obese adults with T2d or prediabetes
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2014TayA Very Low Carbohydrate, Low
Saturated Fat Diet for Type 2
Diabetes Management: A
Randomized Trial		Diabetes CareBoth diets achieved substantial improvements for several clinical glycemic control and CVD risk markers. These improvements and reductions in GV and antiglycemic medication requirements were greatest with the LC compared with HC. This suggests an LC diet with low saturated fat may be an effective dietary approach for T2DM management if effects are sustained beyond 24 weeks.glycemic control and cardiovascular disease (CVD) risk factors in type 2 diabetes93RCT6 months1obese patients with T2D
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2014YamadaA Non-calorie-restricted Low-carbohydrate Diet is Effective as an Alternative Therapy for Patients with Type 2 DiabetesInternal MedicineFindings suggest that a low-carbohydrate diet is effective in lowering the HbA1c and triglyceride levels in patients with type 2 diabetes who are unable to adhere to a calorie-restricted diet.glycemic control and meatabolic profiles24RCT6 months1Japanese patients with T2D
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2013AjalaSystematic review and meta-analysis of different dietary approaches to the management of type 2 diabetesAm J Clin NutrLow-carbohydrate are as effective as low-GI, Mediterranean, and highproteindiets in improving various markers of cardiovascular risk in people with diabetes and should be considered in the overall strategy of diabetes management.Type 2 diabetesMeta-analysisn/a
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2013BallardDietary carbohydrate restriction improves insulin sensitivity,
blood pressure, microvascular function, and cellular adhesion
markers in individuals taking statins		Nutrition ResearchThe results of this study suggest that a CRD could be a sustainable lifestyle that complements statin treatment to improve overall cardiometabolic risk, particularly for individuals with other risk factors indicative of metabolic syndrome, but future research is needed to determine the effects over a longer period of time. lipids, inflammation, insulin sensitivity, blood pressure, microvascular function, cellular ahehesion21single arm prospective6 weeksstatin users
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2013BuenoVery-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trialsBritish Journal of NutritionIndividuals 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.Weight lossMeta-analysisn/a
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2013PaoliLong Term Successful Weight Loss with a Combination Biphasic Ketogenic Mediterranean Diet and Mediterranean Diet Maintenance ProtocolNutrientsThe data from this study demonstrate that the majority of subjects showed significant weight loss (10%) as a result of a two-phase VLCKD and were compliant both during the six month weight loss phase and the six month normocaloric maintenance phase, with no weight regain. We can suggest that the proposed protocol was generally successful because of (a) the protein mass protective effects of a VLCKD and (b) the prescription of a traditional Mediterranean diet in the post weight-loss phase was especially important for achieving “weight loss success”, i.e., continued weight loss for at least one year.Weight and body composition89single arm prospective12 months1healthy obese adults
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2013RuthConsuming a hypocaloric high fat low carbohydrate diet for 12 weeks lowers C-reactive protein, and raises serum adiponectin and high density lipoprotein-cholesterol in obese subjectsMetabolism: Clinical and ExperimentalRelative to the Low Fat/High Carb group, the High Fat/Low Carb group had greater improvements in blood lipids and systemic inflammation with similar changes in body weight and composition. This small-scale study suggests that HFLC diets may be more beneficial to cardiovascular health and inflammation in free-living obese adults compared to LFHC diets.weight loss, CVD risk factors, Inflammation55RCT12 weeksobese adults
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2013TiroshRenal Function Following Three Distinct Weight Loss Dietary Strategies During 2Years of a Randomized Controlled TrialDiabetes CareA low-carbohydrate diet is as safe as Mediterranean or low-fat diets in preserving/improving renal function among moderately obese participants with or without type 2 diabetes, with baseline serum creatinine <176 μmol/L. Potential improvement is likely to be mediated by weight loss-induced improvements in insulin sensitivity and blood pressure.renal function318RCT - 3 arm2 years1obese adults with or without T2d with mild to moderate renaal dysfunction
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2013WalshEffects of Diet Composition on Postprandial Energy
Availability during Weight Loss Maintenance		PlosOneThese findings suggest that a Low Fat diet may adversely affect postprandial Energy Availability and risk for weight regain during weight loss maintenance.exergy availability post prandially during weight maintenance8Randomized crossover 12 weeksoverweight and obese young adults
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2012EbbelingEffects of Dietary Composition on Energy Expenditure During Weight-Loss MaintenanceJAMA Individuals on the very low carb diet had the highest resting metabolism. REE, TEE, hormones, metabolic syndrome criteria213 way randomized crossover12 weeks
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2012FriedmanComparative Effects of Low-Carbohydrate High-Protein Versus Low-Fat Diets on the KidneyClin J Am Soc NephrolIn healthy obese individuals, a low-carbohydrate high-protein weight-loss diet over 2 years was not associated with noticeably harmful effects on GFR, albuminuria, or fluid and electrolyte balance compared with a low-fat diet.GFR) indices (serum creatinine, cystatin C, creatinine clearance); 24-hour urinary volume; albumin; calcium excretion; and serum solutes 307RCT2 years1healthy obese adults
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2012HussainEffect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetesNutritionThis study shows the beneficial effects of a ketogenic diet over the conventional LCD in obese diabetic subjects. The ketogenic diet appears to improve glycemic control. Therefore, diabetic patients on a ketogenic diet should be under strict medical supervision because the LCKD can significantly lower blood glucose levels.glucemic control and diabetes medication363non-randomized 2 arm prospective6 months1overweight or obese adults with T2d in Kuwait
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2012SantosSystematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factorsObesity ReviewsLCD was shown to have favourable effects on body weight and major cardiovascular risk factors.CVDMeta-analysisn/a
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2011SaskabeEffects of a moderate low-carbohydrate diet on preferential abdominal fat loss and cardiovascular risk factors in patients with type 2 diabetesDiabetes, Metabolic Syndrome and Obesity: Targets and TherapySix months of a moderate LCD resulted in preferential VAT (visceral adipose tissue) loss only in women, with significant correlations between % change SAT (subcutaneous adipose tissue) and both change HDL and change FBG (fasting blood glucose), as well as between % change VAT and change TG. Authors results suggest that an LCD has the potential to reduce abdominal fat in patients with T2DM and deterioration of serum lipid profiles.Abdominal fat and CVD risk factors52single arm prospective6 months1Japanese non-obese patients with T2D
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2010FosterWeight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat Diet: A Randomized TrialAnnals of Internal MedicineSuccessful weight loss can be achieved with either a low-fat or low-carbohydrate diet when coupled with behavioral treatment. A low-carbohydrate diet is associated with favorable changes in cardiovascular disease risk factors at 2 years. Weight loss was approximately 11 kg (11%) at 1 year and 7 kg (7%) at 2 years. During the first 6 months, the low-carbohydrate diet group had greater reductions in diastolic blood pressure, triglyceride levels, and very-low-density lipoprotein cholesterol levels, lesser reductions in low-density lipoprotein cholesterol levels, and more adverse symptoms than did the low-fat diet group. The low-carbohydrate diet group had greater increases in high-density lipoprotein cholesterol levels at all time points, approximating a 23% increase at 2 years.weight loss307RCT2 years1overweight adults
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2010IqbalEffects of a Low-intensity Intervention That Prescribed a Low-carbohydrate vs. a Low-fat Diet in Obese, Diabetic ParticipantsObesityAt this time, participants in the low-carbohydrate group lost 1.5 kg, compared to 0.2 kg in the low-fat group (P = 0.147). Lipids, glycemic indexes, and dietary intake did not differ between groups at month 24 (or at months 6 or 12).Weight,, A1c, lipids104RCT2 years1obese patients with T2D
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2010KrebsEfficacy and Safety of a High Protein, Low Carbohydrate Diet for Weight Loss in Severely Obese AdolescentsJ PediatrSignificant reduction in BMI-Z-score was achieved in both groups during intervention, and was significantly greater for the HPLC (high protein low carbohydrate) group. Both groups maintained significant BMI-Z reduction at follow-up; changes were not significantly different between groups. The HPLC diet is a safe and effective option for medically supervised weight loss in severely obese adolescents. weight loss, metabolic markers, body composition, and cardiac function tests46RCT13 weeksseverely obese adolescents
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2010ThomsonChanges in Body Weight and Metabolic Indexes in Overweight Breast Cancer Survivors Enrolled in a Randomized Trial of Low-Fat vs. Reduced Carbohydrate DietsNutrition and CancerA group of overweight female breast cancer survivors were assigned either a low-fat diet or Modified Atkins Diet. All subjects demonstrated improvements in total/HDL cholesterol ratio, and significant reductions inHbA1c, insulin, and HOMA. Triglycerides levels were significantly reduced only in the low-carbohydrate diet group. Significant improvements in weight and metabolic indexes can be demonstrated among overweight breast cancer survivors adherent to either the Modified Atkins Diet or fatrestricted diet.weight loss, body composition, and changes in metabolic indexes40RCT6 months1Overweight and post-menopausal Breast cancer survivors
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2010VolekLimited Effect of Dietary Saturated Fat on Plasma Saturated Fat in the Context of a Low Carbohydrate DietLipidsAuthors showed that a hypocaloric carbohydrate restricted diet (CRD) had two striking effects: (1) a reduction in plasma saturated fatty acids (SFA) despite higher intake than a low fat diet, and (2) a decrease in inflammation despite a significant increase in arachidonic acid (ARA). These findings are consistent with the concept that dietary saturated fat is efficiently metabolize in the presence of low carbohydrate, and that a CRD results in better preservation of plasma ARA.Cholesterol8randomized cross-over12 weeksweight stable men
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2010YancyA randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss.Arch Intern MedObese and overweight outpatients were assigned to either a low-carbohydrate ketogenic diet (LCKD) or Orlistat therapy combined with a low fat diet (O + LFD). In a sample of medical outpatients, an LCKD led to similar improvements as O + LFD for weight, serum lipid, and glycemic parameters and was more effective for lowering blood pressure. body weight, blood pressure, fasting serum lipid, and glycemic parameters146RCT48 weeks1overweight or obese Veterans
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2009BrinkworthLong-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 moAm J Clin Nutr.Low Carb group (over a isocaloric low fat diet) had greater decreases in triglycerides, increases in HDL cholesterol, and LDL cholesterol, and a greater but nonsignificant increase in apolipoprotein B. Both dietary patterns resulted in similar weight loss and changes in body composition. The LC diet may offer clinical benefits to obese persons with insulin resistance. Weight, body composition, and cardiometabolic risk markers69RCT12 months1Adults with abdominal obesity and at least 1 other metabolic syndrome criteria
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2009DavisComparative Study of the Effects of a 1-Year Dietary Intervention of a Low-Carbohydrate Diet Versus a Low-Fat Diet on Weight and Glycemic Control in Type 2 DiabetesDiabetes CareAmong patients with type 2 diabetes, after 1 year a low-carbohydrate diet had effects on weight and A1C similar to those seen with a low-fat diet. There was no significant effect on blood pressure, but the low-carbohydrate diet produced a greater increase in HDL cholesterol. Weight loss occurred faster in the low-carbohydrate group than in the low-fat group in the first 3 months. weight and A1C105RCT1 year1overweight adults with T2D
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2009SiegelA 6-Month, Office-Based, Low-Carbohydrate Diet Intervention in Obese TeensClinical PediatricsThe LCD appears to an effective and practical office-based intervention in obese teenagers.weightsingle arm prospective6 months1Obese teens
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2009VolekEffects of Dietary Carbohydrate Restriction Versus Low-fat Diet on Flow-mediated Dilation.MetabolismThese findings show that a 12-week low-carbohydrate diet improves postprandial vascular function more than a LFD in individuals with atherogenic dyslipidemia.vascular function measured by peak flow mediated dilation40RCT12 weeksoverweight men and women with moderate hypertriacylglycerolemia 
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2009SacksComparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and CarbohydratesNew England J of Medicine811 overweight adults to one of four diets; the targeted percentages of energy derived from fat, protein, and carbohydrates in the four diets were 20, 15, and 65%; 20, 25, and 55%; 40, 15, and 45%; and 40, 25, and 35%. At end of study, diets higher in protein and fat showed greater weight loss and reduced waist circumference than diet high in carbohdyrates. Body weight811randomized, three arms2 years1
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2008MorganComparison of the Effects of Four Commercially Available Weight-loss Programmes on Lipid-based Cardiovascular Risk FactorsPublic Health NutritionThe Atkins (low-carbohydrate) diet was followed by marked reductions in plasma TAG (–38.2% 6 months). This diet was associated with an increase in LDL particle size, a change that has been linked to reduced CVD risk. plasma lipids and lipoproteins300RCT - 4 arm6 months1overweight and obese adults
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2008ShaiWeight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat DietThe New England Journal of MedicineMediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions.Weight loss + CVD risk factors322RCT - 3 arm2 years1overweight or obese adults or T2D or pre-existing CVD
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2008VolekCarbohydrate Restriction has a More Favorable Impact on the Metabolic Syndrome than a Low Fat DietLipidsBoth interventions led to improvements in several metabolic markers, but subjects following the CRD had consistently reduced glucose (-12%) and insulin (-50%) concentrations, insulin sensitivity (-55%), weight loss (-10%), decreased adiposity (-14%), and more favorable triacylglycerol (TAG) (-51%), HDL-C (13%) and total cholesterol/HDL-C ratio (-14%) responses. In addition to these markers for MetS, the CRD subjects showed more favorable responses to alternative indicators of cardiovascular risk: postprandial lipemia (-47%), the Apo B/Apo A-1 ratio (-16%), and LDL particle distribution. The results support the use of dietary carbohydrate restriction as an effective approach to improve features of MetS and cardiovascular risk.Metabolic Syndrome criteria, lipids, and postprandial lipemia40RCT12 weeksadults with athrerogenic dyslipidemia
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2008WestmanThe Effect of a Low-carbohydrate, Ketogenic Diet Versus a Low-glycemic Index Diet on Glycemic Control in Type 2 Diabetes MellitusNutrition & MetabolismDietary modification led to improvements in glycemic control and medication reduction/elimination in motivated volunteers with type 2 diabetes. The diet lower in carbohydrate led to greater improvements in glycemic control, and more frequent medication reduction/elimination than the low glycemic index diet. Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes.Type 2 diabetes - glycemic control84RCT6 months1obesity and T2D
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2007GardnerComparison of the Atkins, Zone, Ornish, and LEARN Diets For Change in Weight and Related Risk Factors Among Overweight Premenopausal Women: the A TO Z Weight Loss Study: a Randomized Trial.JAMAIn this study, premenopausal overweight and obese women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight at 12 months than women assigned to follow the Zone diet, and had experienced comparable or more favorable metabolic effects than those assigned to the Zone, Ornish, or LEARN diets.Weight loss311RCT1 year1overweight or obese non-diabetic premenopausal women
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2006DalyShort-Term Effects of Severe Dietary Carbohydrate-Restriction Advice in Type 2 Diabetes--a Randomized Controlled TrialDiabet MedWeight loss and high-density lipoprotein (HDL) ratio improved was greater in the low-carbohydrate (LC) group over low fat group. Carbohydrate restriction was an effective method of achieving short-term weight loss compared with standard advice.Weight, glycaemic control, lipids and blood pressure102RCT3 monthsadults with T2d
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2005BodenEffect of a Low-Carbohydrate Diet on Appetite, Blood Glucose Levels, and Insulin Resistance in Obese Patients with Type 2 DiabetesAnnals of Internal MedicineIn a small group of obese patients with type 2 diabetes, a low-carbohydrate diet followed for 2 weeks resulted in spontaneous reduction in energy intake to a level appropriate to their height; weight loss that was completely accounted for by reduced caloric intake; much improved 24-hour blood glucose profiles, insulin sensitivity, and hemoglobin A1c; and decreased plasma triglyceride and cholesterol levels. body weight, body water, energy intake and expenditure, glycemic control, insulin sensitivity, and lipid10single arm metabolic ward3 weeksobese adults with T2D
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2005BrehmThe Role of Energy Expenditure in the Differential Weight Loss in Obese Women on Low-fat and Low-carbohydrate DietsJ Clin Endocrinol MetabThese results confirm that short-term weight loss is greater in obese women on a low-carbohydrate diet than in those on a low-fat diet even when reported food intake is similar.Weight loss, REE, TEF50RCT4 monthshealthy moderatley obese women
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2005ColemanUrinary Ketones Reflect Serum Ketone Concentration But Do Not Relate to Weight Loss in Overweight Premenopausal Women Following a Low-carbohydrate/High-protein DietJ Am Diet AssocThirteen overweight premenopausal women aged 32 to 45 years consumed <20 g carbohydrate/day with liberal intakes of protein and fat for 2 weeks; thereafter, carbohydrate intake increased 5 g/week for 10 weeks. Serum-hydroxybutyrate was correlated with presence of urinary ketones, but no relationship was found between weekly weight change and serum ketone production. Urinary ketones are detected in premenopausal women complying with a low-carbohydrate/high-protein diet and are associated with serum ketone concentration. Weight loss BHOB levels13single arm12 weeksoverweight premenopausal young women
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2005DansingerComparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk ReductionJournal of the American Medical AssociationEach popular diet modestly reduced body weight and several cardiac risk factors at 1 year. Overall dietary adherence rates were low, although increased adherence was associated with greater weight loss and cardiac risk factor reductions for each diet group.Weight loss + CVD risk factors and self reported diet adherence160RCT1 year1Overweight or obese adults withwith known hypertension, dyslipidemia, or fasting hyperglycemia
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2005MavropoulosThe Effects of a Low-Carbohydrate, Ketogenic Diet on The Polycystic Ovary Syndrome: a Pilot StudyNutrition and MetabolismIn this pilot study, a LCKD led to significant improvement in weight, percent free testosterone, LH/FSH ratio, and fasting insulin in women with obesity and PCOS over a 24 week period.PCOS - weight, percent free testosterone, LH/FSH ratio, and fasting insulin11single arm24 weeks1women with a body mass index >27 kg/m2 and a clinical diagnosis of PCOS 
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2005McAuleyComparison of High-Fat and High-Protein Diets With a High-Carbohydrate Diet in Insulin-Resistant Obese WomenDiabetologiaIn routine practice a reduced-carbohydrate, higher protein diet may be the most appropriate overall approach to reducing the risk of cardiovascular disease and type 2 diabetes. To achieve similar benefits on a HC diet, it may be necessary to increase fibre-rich wholegrains, legumes, vegetables and fruits, and to reduce saturated fatty acids to a greater extent than appears to be achieved by implementing current guidelines. body comp and CVD risk factors96RCT16 weeksnormoglycaemic, insulin-resistant women (BMI >27 kg/m(2)
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2005O’BrienDiet-Induced Weight Loss Is Associated with Decreases in Plasma Serum Amyloid A and C-Reactive Protein Independent of Dietary Macronutrient Composition in Obese SubjectsThe Journal of Clinical Endocrinology & MetabolismThe very low-carbohydrate dieters had a significantly greater decrease in LogSAA, but their weight loss also was significantly greater. In this study, the decreases in inflammatory markers correlated significantly with weight loss. Also, change in LogSAA correlated with change in insulin resistance. Thus, in otherwise healthy, obese women, weight loss was associated with significant decreases in both SAA and CRP. These effects were proportional to the amount of weight lost but independent of dietary macronutrient composition.Weight loss and inflammatory markers41RCT3 monthsobese women
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2005YancyA Low-carbohydrate, Ketogenic Diet to Treat Type 2 DiabetesNutrition and MetabolismIn a study of overweight individuals with type 2 diabetes, the LCKD (low carbohydrate ketogenic diet) improved glycemic control in patients with type 2 diabetes such that diabetes medications were discontinued or reduced in most participants. Other results include: mean body weight decreased by 6.6% and fasting serum triglyceride decreased 42%. Type 2 diabetes28single arm16 weeksoverweight adults with T2D
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2004AudeThe National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated FatArch Intern MedCompared with the NCEP diet, the MLC diet, which is lower in total carbohydrates but higher in complex carbohydrates, protein, and monounsaturated fat, caused significantly greater weight loss over 12 weeks. Weight loss was significantly greater in the Modified Low Carbohydrate (13.6 lb) than in the National Cholesterol Education Program group (7.5 lb), a difference of 6.1 lb. There were significantly favorable changes in all lipid levels within the MLC but not within the NCEP group. Waist-to-hip ratio was significantly decreased within the MLC group.weight loss60RCT12 weeksadults with BMI over 27
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2004DashtiLong Term Effects of a Ketogenic Diet in Obese PatientsClinical CardiologyThe present study shows the beneficial effects of a long-term ketogenic diet. It significantly reduced the body weight and body mass index of the patients. Furthermore, it decreased the level of triglycerides, LDL cholesterol and blood glucose, and increased the level of HDL cholesterol. Administering a ketogenic diet for a relatively longer period of time did not produce any significant side effects in the patients. Therefore, the present study confirms that it is safe to use a ketogenic diet for a longer period of time than previously demonstrated.obesity and obesity-related risk factors83single arm prospective6 months1Obese adults in Kuwait
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2004GannA Low-carbohydrate Diet in Overweight Patients Undergoing Stable Statin Therapy Raises High-density Lipoprotein and Lowers Triglycerides SubstantiallyClin CardiolThis study was undertaken to evaluate the effect of a low-carbohydrate diet on the lipid levels in obese patients with known arteriosclerotic heart disease on chronic statin therapy. Triglyceride levels were lowered by 29.5%, HDL raised by 17.6%, and cholesterol decreased by 8.4%. The cholesterol/ HDL ratio changed from 5.31 to 3.78 and LDL cholesterol decreased by 5%. The addition of a low-carbohydrate diet for overweight patients with known coronary artery disease undergoing stable statin therapy causes significant weight loss and a favorable change in the lipid panel.lipids38single arm prospective11.8 months, on average1overweight patients with angiographically documented arteriosclerotic heart disease on statins
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2004GannonEffect of a High-Protein, Low-Carbohydrate Diet on Blood Glucose Control in People With Type 2 DiabetesDiabetesA LoBAG (low-biologically-available-glucose) diet ingested for 5 weeks dramatically reduced the circulating glucose concentration in people with untreated type 2 diabetes. Potentially, this could be a patient-empowering way to ameliorate hyperglycemia without pharmacological intervention.percentage glycohemoglobin and 24-h glucose, insulin, C-peptide, β-hydroxybutyrate, glucagon, triacylglycerol, and nonesterified fatty acid (NEFA)8randomized cross over5 weeksmen with untreated T2D
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2004MecklingComparison of a Low-fat Diet to a Low-carbohydrate Diet on Weight Loss, Body Composition, and Risk Factors for Diabetes and Cardiovascular Disease in Free-living, Overweight Men and WomenJ Clin Endocrinol MetabBoth groups of subjects had significant weight loss over the 10 wk of diet intervention and nearly identical improvements in body weight and fat mass. Only the LC group had a significant decrease in circulating insulin concentrations. Group results indicated that the diets were equally effective in reducing systolic blood pressure by about 10 mm Hg and diastolic pressure by 5 mm Hg and decreasing plasminogen activator inhibitor-1 bioactivity. These data suggest that energy restriction achieved by a very LC diet is equally effective as a LF diet strategy for weight loss and decreasing body fat in overweight and obese adults.Weight, blood pressure, and body composition31RCT10 weeksoverweight adults
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2004SeshadriA Randomized Study Comparing the Effects of a Low-carbohydrate Diet and a Conventional Diet on Lipoprotein Subfractions and C-reactive Protein Levels in Patients With Severe ObesityAm J MedIn this 6-month study involving severely obese subjects, we found an overall favorable effect of a low-carbohydrate diet on lipoprotein subfractions, and on inflammation in high-risk subjects. Both diets had similar effects on LDL and HDL subfractions.lipids and inflammation78RCT6 months1Severly obese some with T2D or metabolic syndrome
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2004SharmanVery Low-carbohydrate and Low-fat Diets Affect Fasting Lipids and Postprandial Lipemia Differently in Overweight MenJ NutrThe primary purpose of this study was to compare the effects of a very low-carbohydrate and a low-fat diet on fasting blood lipids and postprandial lipemia in overweight men. In a balanced, randomized, crossover design, overweight men consumed 2 experimental diets for 2 consecutive 6-wk periods. One was a very low-carbohydrate (<10% energy as carbohydrate) diet and the other a low-fat (<30% energy as fat) diet. Both diets had the same effect on serum total cholesterol, serum insulin, and homeostasis model analysis-insulin resistance (HOMA-IR). Neither diet affected serum HDL cholesterol (HDL-C) or oxidized LDL (oxLDL) concentrations. The very low-carbohydrate diet was more effective at improving characteristics of the metabolic syndrome as shown by a decrease in fasting serum TAG, the TAG/HDL-C ratio, postprandial lipemia, serum glucose, an increase in LDL particle size, and also greater weight loss.lipids and postprandial lipemia15randomized crossover12 weeksoverweight men
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2004VolekComparison of a Very Low-Carbohydrate and Low-Fat Diet on Fasting Lipids, LDL Subclasses, Insulin Resistance, and Postprandial Lipemic Responses in Overweight WomenJ Am Coll NutrCompared to a low-fat weight loss diet, a short-term very low-carbohydrate diet did not lower LDL-C but did prevent the decline in HDL-C and resulted in improved insulin sensitivity in overweight and obese, but otherwise healthy women. Small decreases in body mass improved postprandial lipemia, and therefore cardiovascular risk, independent of diet composition.weight, lipids, postprandial lipemia, insulin sensitivity13randomized crossover8 weeksoverweight women
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2004VolekComparison of Energy-restricted Very Low-carbohydrate and Low-fat Diets on Weight Loss and Body Composition in Overweight Men and WomenNutr Metab (Lond)This study shows a clear benefit of a VLCK over LF diet for short-term body weight and fat loss, especially in men. A preferential loss of fat in the trunk region with a VLCK diet is novel and potentially clinically significant but requires further validation. weight loss, body composition, trunk fat mass, and resting energy expenditure28RCT21 daysoverweight menaand women
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2004YancyA Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet To Treat Obesity and Hyperlipidemia: A Randomized, Controlled TrialAnn Intern MedCompared with a low-fat diet, a low-carbohydrate diet program had better participant retention and greater weight loss. During active weight loss, serum triglyceride levels decreased more and high-density lipoprotein cholesterol level increased more with the low-carbohydrate diet than with the low-fat diet.Body weight, body composition, fasting serum lipid levels, and tolerability.120RCT24 weeks1overweight with high cholesterol
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2003BailesEffect of Low-Carbohydrate, Unlimited Calorie Diet on the Treatment of Childhood Obesity: A Prospective Controlled StudyMetabolic Syndrome and Related DisordersObese children following a high protein, low CHO diet (<30g/day) lost an average of 5.21 ± 3.44 kg and decreased their BMI by 2.42 ± 1.3 points, compared to the children in the Low Cal Diet (calorie restricted) who gained an average of 2.36 ± 2.54 kg and 1.00 point on the BMI value. A high protein, low carbohydrate, unlimited calorie diet was superior to a restricted calorie protocol for weight loss in obese school age children; moreover, compliance was better. weight loss and BMI37non-randomized Prospective Controlled Study2 monthsobese school age childresn
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2003BrehmA Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy WomenJ Clin Endocrinol MetabBased on these data, a very low carbohydrate diet is more effective than a low fat diet for short-term weight loss and, over 6 months, is not associated with deleterious effects on important cardiovascular risk factors in healthy women.Body comp and CVD risk factors53RCT6 months1healthy women
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2003FosterA Randomized Trial of a Low-carbohydrate Diet For ObesityN Engl J MedThe low-carbohydrate diet produced a greater weight loss (4%) than did the conventional diet for the first six months, but the differences were not significant at one year. The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease. Weight loss and CVD risk factors63RCT1 year1obese adults
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2003HaysEffect of a High Saturated Fat and No-starch Diet on Serum Lipid Subfractions in Patients With Documented Atherosclerotic Cardiovascular DiseaseMayo Clin ProcTo determine whether a diet of high saturated fat and avoidance of starch (HSF-SA) results in weight loss without adverse effects on serum lipids in obese nondiabetic patients. HSF-SA diet results in weight loss after 6 weeks without adverse effects on serum lipid levels verified by nuclear magnetic resonance, and further weight loss with a lipid-neutral effect may persist for up to 52 weeks.weight loss and lipidsprospective single arm6 weeksobese adults with CVD on statins
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2003HickeyClinical Use of a Carbohydrate-Restricted Diet to Treat the Dyslipidemia of the Metabolic SyndromeMetabolic Syndrome and Related DisordersA carbohydrate-restricted diet recommendation led to improvements in lipid profiles and lipoprotein subclass traits of the metabolic syndrome in a clinical outpatient setting, and should be considered as a treatment for the metabolic syndrome.body weight, fasting serum lipid profiles and serum lipoprotein subclasses65retrospective cohortn/aAdults with atherogenic dyslipidemia
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2003SamahaA Low-carbohydrate as Compared With a Low-fat Diet in Severe ObesityN Engl J MedSeverely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet, with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost.Weight loss, lipids, medication132RCT6 months1sever obesity with larger % African American
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2003SondikeEffects of a Low-carbohydrate Diet on Weight Loss and Cardiovascular Risk Factor in Overweight AdolescentsJ PediatrTo compare the effects of a low-carbohydrate (LC) diet with those of a low-fat (LF) diet on weight loss and serum lipids in overweight adolescents. The LC group lost more weight (mean, 9.9 +/- 9.3 kg vs 4.1 +/- 4.9 kg) and had improvement in non-HDL cholesterol levels. There were no adverse effects on the lipid profiles of participants in either group. The LC diet appears to be an effective method for short-term weight loss in overweight adolescents and does not harm the lipid profile.adolescent weight and lipids30RCT12 weeksOverweight adolescents
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2003VolekAn Isoenergetic Very Low Carbohydrate Diet Improves Serum HDL Cholesterol and Triacylglycerol Concentrations, the Total Cholesterol to HDL Cholesterol Ratio and Postprandial Pipemic Responses Compared With a Low Fat Diet in Normal Weight, Normolipidemic WomenJ NutrIn normal weight, normolipidemic women, a short-term very low carbohydrate diet modestly increased LDL-C, yet there were favorable effects on cardiovascular disease risk status by virtue of a relatively larger increase in HDL-C and a decrease in fasting and postprandial triaclyglycerols.fasting lipids, postprandial lipemia and markers of inflammation10randomized crossover4 weeksnormal weight normolipidemic women
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2002HaysResults of Use of Metformin and Replacement of Starch With Saturated Fat in Diets of Patients With Type 2 DiabetesEndocr PractAddition of saturated fat and removal of starch from a high-monounsaturated fat and starch-restricted diet improved glycemic control and were associated with weight loss without detectable adverse effects on serum lipids.weight, glycemic control, lipids283retrospective chart review1 year1Adults on metformin
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2002VolekBody Composition and Hormonal Responses to a Carbohydrate-restricted DietMetabolismAuthors conclude that a carbohydrate-restricted diet resulted in a significant reduction in fat mass and a concomitant increase in lean body mass in normal-weight men, which may be partially mediated by the reduction in circulating insulin concentrations.Weight loss, hormones12single arm prospective6 weeksHealthy normal weght men
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2002WestmanEffect of 6-month Adherence to a Very Low Carbohydrate Diet ProgramAm J MedIn these subjects, the mean body weight decreased 10.3% +/- 5.9% from baseline to 6 months. The mean percentage of body weight that was fat decreased 2.9% +/- 3.2% from baseline to 6 months. Serum total cholesterol level decreased 11 +/- 26 mg/dL, low-density lipoprotein cholesterol level decreased 10 +/- 25 mg/dL, triglyceride level decreased 56 +/- 45 mg/dL, high-density lipoprotein (HDL) cholesterol level increased 10 +/- 8 mg/dL, and the cholesterol/HDL cholesterol ratio decreased 0.9 +/- 0.6 units. A very low carbohydrate diet program led to sustained weight loss during a 6-month period.body weight, body mass index, percentage of body fat (estimated by skinfold thickness), serum chemistry and lipid values, 24-hour urine measurements, and subjective adverse effects.51single arm prospective6 months1overweight or obese but health dults
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2000VolekFasting Lipoprotein and Postprandial Triacylglycerol Responses to a Low-carbohydrate Diet Supplemented With n-3 Fatty AcidsJ Am Coll NutrA hypocaloric low-carbohydrate diet rich in MUFA and supplemented with n-3 fatty acids significantly reduced postabsorptive and postprandial TG in men that were not hypertriglyceridemic as a group before the diet. This may be viewed as a clinically significant positive adaptation in terms of cardiovascular risk status. fasting serum lipoproteins and postprandial triacylglycerol10single arm prospective8 weeks
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Total Number of Participants6,786326