low carbohydrate diet; ketogenic diet (Atkin's diet, Eco-Atkin's diet)
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Introduction
Diet limits carbohydrate intake to 25 g/day initially, then 50 g/day after 40% of the weight loss has been achieved. Calorie intake is not limited.
Indications
Beneficial effects:
- weight loss:
- decreased total cholesterol (214 to 203 mg/dL)*
- decreased LDL cholesterol (136 to 126 mg/dL)*
- increase HDL cholesterol (52 to 62 mg/dL)*
- may improve fasting glucose[2]
- 6-month reduction of Hgb A1c of 0.23% in obese patients mean BMI 36[14]
- plant-based low-carbohydrate diet associated with decreased long-term mortality[7]
- might be more effective for both weight loss & for improving several metabolic parameters, even if high in fat content[9]
- may be useful in control of seizures
- health benefits depend more on specific foods than carbohydrate-fat distribution[13]
* mean values from study[1]
Adverse effects
- constipation (68%)
- hallitosis (63%)
- headache[5]
- myalgias[5]
- diarrhea
- muscle weakness
- rash
- concerns for long-term effects[2]
- heart disease (high fat)
- low carbohydrate, high protein diet linked to increased risk for cardiovascular disease in women[8]
- renal failure (high protein)
- osteoporosis (high protein)
- meat-based low-carbohydrate diet associated with increased long-term mortality[7]
- may be associated with risk of cognitive impairment among older adults[14]
Mechanism of action
- diet mimics starvation
- brain uses the fatty acids as its fuel source
- ketonuria develops as a sign of reduced carbohydrate intake
More general terms
More specific terms
References
- ↑ 1.0 1.1 Journal Watch 22(17):131, 2002
Westman EC et al, Effect of 6-month adherence to a very low carbohydrate diet program. J Med 113:30, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12106620 - ↑ 2.0 2.1 2.2 Prescriber's Letter 10(6):32 2003
- ↑ Journal Watch 23(13):103, 2003 Samaha FF et al, A low-carbohydrate as compared with a low-fat diet in severe obesity. NEJM 348(21):2074, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12761364
Foster GD et al, A randomized trial of a low-carbohydrate diet for obesity. NEJM 348(21):2082, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12761365 - ↑ Journal Watch 24(1):5, 2004
- ↑ 5.0 5.1 5.2 Journal Watch 24(14):114, 2004 Yancy WS Jr, Olsen MK, Guyton JR, Bakst RP, Westman EC. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Ann Intern Med. 2004 May 18;140(10):769-77. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15148063
Stern L, Iqbal N, Seshadri P, Chicano KL, Daily DA, McGrory J, Williams M, Gracely EJ, Samaha FF. The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Ann Intern Med. 2004 May 18;140(10):778-85. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15148064
Willett WC. Reduced-carbohydrate diets: no roll in weight management? Ann Intern Med. 2004 May 18;140(10):836-7. No abstract available. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15148073 - ↑ Jenkins DJA et al The effect of a plant-based low-carbohydrate ('Eco-Atkins') diet on body weight and blood lipid concentrations in hyperlipidemic subjects. Arch Intern Med 2009 Jun 8; 169:1046. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19506174
Tuttle KR and Milton JE The 'Eco-Atkins' diet: New twist on an old tale. Arch Intern Med 2009 Jun 8; 169:1027. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19506171 - ↑ 7.0 7.1 7.2 Fung TT et al, Low-Carbohydrate Diets and All-Cause and Cause-Specific Mortality Two Cohort Studies Annals of Internal Medicine 2010, 153:289-298 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20820038 <Internet> http://www.annals.org/content/153/5/289.abstract
Yancy WS Jr et al. Animal, vegetable, or . . . clinical trial? Ann Intern Med 2010 Sep 7; 153:337 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20820043 - ↑ 8.0 8.1 Lagiou P et al Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study BMJ 2012;344:e4026 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22735105 <Internet> http://www.bmj.com/content/344/bmj.e4026
Floegel A Low carbohydrate-high protein diets BMJ 2012;344:e3801 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22718914 <Internet> http://www.bmj.com/content/344/bmj.e3801 - ↑ 9.0 9.1 Ebbeling CB et al. Effects of dietary composition on energy expenditure during weight-loss maintenance. JAMA 2012 Jun 27; 307:2627 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22735432
- ↑ Bazzano LA et al Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial. Ann Intern Med. 2014;161(5):309-318 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25178568 <Internet> http://annals.org/article.aspx?articleid=1900694
- ↑ Thibert RL et al Case 34-2014 - A 7-year-Old Boy with Focal Seizures and Progressive Weakness. N Engl J Med 2014; 371:1737-1746. October 30, 2014 http://www.nejm.org/doi/full/10.1056/NEJMcpc1305993
- ↑ Abbasi J Interest in the Ketogenic Diet Grows for Weight Loss and Type 2 Diabetes. JAMA. 2018;319(3):215-217. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29340675 https://jamanetwork.com/journals/jama/fullarticle/2669724
- ↑ 13.0 13.1 Shan Z, Guo Y, Hu FB et al. Association of low-carbohydrate and low-fat diets with mortality among US adults. JAMA Intern Med 2020 Jan 21 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31961383 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2759134
- ↑ 14.0 14.1 14.2 14.3 14.4 Dorans KS, Bazzano LA, Qi L et al Effects of a Low-Carbohydrate Dietary Intervention on Hemoglobin A1c. A Randomized Clinical Trial. JAMA Netw Open. 2022;5(10):e2238645 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797714
- ↑ Wang H, Lv Y, Yi G, Ren G Association of low-carbohydrate-diet score and cognitive performance in older adults: National Health and Nutrition Examination Survey (NHANES). BMC Geriatrics 2022. 22:983. Dec 20. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36539697 PMCID: PMC9764565 Free PMC article https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-022-03607-1