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Low-carbohydrate diets for the treatment of obesity and type 2 diabetes

Hall, Kevin, D.a; Chung, Stephanie, T.b

Current Opinion in Clinical Nutrition and Metabolic Care: July 2018 - Volume 21 - Issue 4 - p 308–312
doi: 10.1097/MCO.0000000000000470
CARBOHYDRATES: Edited by Luc Tappy and Bettina Mittendorfer

Purpose of review Summarize the physiological effects of low-carbohydrate diets as they relate to weight loss, glycemic control, and metabolic health.

Recent findings Low-carbohydrate diets are at least as effective for weight loss as other diets, but claims about increased energy expenditure and preferential loss of body fat are unsubstantiated. Glycemic control and hyperinsulinemia are improved by low-carbohydrate diets, but insulin sensitivity and glucose-stimulated insulin secretion may be impaired, especially in the absence of weight loss. Fasting lipid parameters are generally improved, but such improvements may depend on the quality of dietary fat and the carbohydrates they replaced. Postprandial hyperlipemia is a potential concern given the high fat content typical of low-carbohydrate diets.

Summary Low-carbohydrate diets have several potential benefits for treatment of obesity and type 2 diabetes, but more research is required to better understand their long-term consequences as well as the variable effects on the endocrine control of glucose, lipids, and metabolism.

aLaboratory of Biological Modeling

bDiabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA

Correspondence to Kevin D. Hall, Laboratory of Biological Modeling, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 12A South Drive, Room 4007, Bethesda, MD 20892-5621, USA. Tel: +1 301 402 8248; fax: +1 301 402 0535; e-mail:

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