Nutrient intake in low-carbohydrate diets in comparison to the 2020-2025 Dietary Guidelines for Americans: a cross-sectional study
Open accessAbstract
The percentage of US adults following low-carbohydrate diets (LCD) doubled in the last decade. Some researchers observed this trend with concern and highlighted the potential for nutritional deficiencies and impaired overall diet quality with LCD. The present study investigated nutrient intake in a nationally representative sample of 307 US adults following an LCD. Using cross-sectional data from the National Health and Nutrition Examination Surveys, we compared nutrient intake profiles in said individuals with the daily nutritional goals specified in the current 2020–2025 Dietary Guidelines for Americans (DGA). Results were then compared with the general population consuming a standard American diet. Almost 57 % of low-carbohydrate dieters were female, and the mean age was 48·67 (1·35) years. Individuals consuming LCD exceeded the recommendations for saturated fat, total lipid and sodium intake (both sexes). An insufficient intake was observed for fibre, Mg, potassium and several other vitamins (vitamins A, E, D in both sexes as well as vitamin C in men and folate in women). Neither men nor women met the recommendations for fibre intake. A comparable picture was found for the general population. The potentially insufficient intake of several essential nutrients in LCD warrants consideration and a careful assessment with regard to the current DGA.
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Cites
Effect of lower sodium intake on health: systematic review and meta-analyses
Aburto, N. J., Ziolkovska, A., Hooper, L., Elliott, P., Cappuccio, F. P., & Meerpohl, J. J. (2013) · BMJ · doi:10.1136/bmj.f1326 · Cited by 1,242 · see citing works
Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis
Seidelmann, S. B., Claggett, B., Cheng, S., Henglin, M., Shah, A., Steffen, L. M., Folsom, A. R., Rimm, E. B., Willett, W. C., & Solomon, S. D. (2018) · The Lancet Public Health · doi:10.1016/s2468-2667(18)30135-x · Cited by 776 · see citing works
Dietary Fats and the Risk of Incident Alzheimer Disease
Morris, M. C., Evans, D. A., Bienias, J. L., Tangney, C., Bennett, D. A., Aggarwal, N. T., Schneider, J. S., & Wilson, R. S. (2003) · Archives of Neurology · doi:10.1001/archneur.60.2.194 · Cited by 530 · see citing works
Saturated Fat Consumption and Risk of Coronary Heart Disease and Ischemic Stroke: A Science Update
Nettleton, J. A., Brouwer, I. A., Geleijnse, J. M., & Hornstra, G. (2017) · Annals of Nutrition and Metabolism · doi:10.1159/000455681 · Cited by 511 · see citing works
Ketogenic diets for drug-resistant epilepsy
Martin-McGill, K. J., Bresnahan, R., Levy, R. G., & Cooper, P. N. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001903.pub5 · Cited by 452 · see citing works
Rosqvist, F., Iggman, D., Kullberg, J., Cedernaes, J., Johansson, H.-E., Larsson, A., Johansson, L., Ahlström, H., Arner, P., Dahlman, I., et al. (2014) · Diabetes · doi:10.2337/db13-1622 · Cited by 429 · see citing works
Luukkonen, P. K., Sädevirta, S., Zhou, Y., Kayser, B., Ali, A., Ahonen, L., Lallukka, S., Pelloux, V., Gaggini, M., Jian, C., et al. (2018) · Diabetes Care · doi:10.2337/dc18-0071 · Cited by 428 · see citing works
Freedman, M. R., King, J., & Kennedy, E. (2001) · Obesity Research · doi:10.1038/oby.2001.113 · Cited by 421 · see citing works
Farquhar, W. B., Edwards, D. G., Jurkovitz, C. T., & Weintraub, W. S. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.12.039 · Cited by 348 · see citing works
Zong, G., Li, Y., Wanders, A. J., Alssema, M., Zock, P. L., Willett, W. C., Hu, F. B., & Sun, Q. (2016) · BMJ · doi:10.1136/bmj.i5796 · Cited by 293 · see citing works
Ebbeling, C. B., Feldman, H. A., Klein, G. L., Wong, J. M. W., Bielak, L., Steltz, S. K., Luoto, P. K., Wolfe, R. R., Wong, W. W., & Ludwig, D. S. (2018) · BMJ · doi:10.1136/bmj.k4583 · Cited by 274 · see citing works
Ketogenic diets and chronic disease: weighing the benefits against the risks
Crosby, L., Davis, B., Joshi, S., Jardine, M., Paul, J., Neola, M., & Barnard, N. D. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.702802 · Cited by 229 · cited 4× · see citing works
“The so-called ‘classic’ ketogenic diet is characterised by a 4:1 ratio of fat to carbohydrates(2,4).”
BackgroundInfluentialThe vicious cycle of vitamin a deficiency: A review
Wiseman, E., Barel-Dadon, S., & Reifen, R. (2017) · Critical reviews in food science and nutrition · doi:10.1080/10408398.2016.1160362 · Cited by 215 · see citing works
(2010) · Statistics in the social and behavioral sciences series · doi:10.1201/9781420080674-c1 · Cited by 212 · see citing works
Lipotoxicity: Effects of Dietary Saturated and Transfatty Acids
Estadella, D., do Nascimento, C. M. D. P. O., Oyama, L. M., Ribeiro, E. B., Dâmaso, A. R., & de Piano, A. (2013) · Mediators of Inflammation · doi:10.1155/2013/137579 · Cited by 202 · see citing works
O’Keefe, S. J. (2019) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(19)30257-2 · Cited by 190 · see citing works
Polyunsaturated fatty acids and inflammation
Marion‐Letellier, R., Savoye, G., & Ghosh, S. K. (2015) · IUBMB Life · doi:10.1002/iub.1428 · Cited by 185 · see citing works
Advantages and Disadvantages of the Ketogenic Diet: A Review Article
Batch, J. T., Lamsal, S. P., Adkins, M., Sultan, S., & Ramirez, M. N. (2020) · Cureus · doi:10.7759/cureus.9639 · Cited by 181 · cited 3× · see citing works
“The so-called ‘classic’ ketogenic diet is characterised by a 4:1 ratio of fat to carbohydrates(2,4).”
BackgroundWolfe, R. R., Cifelli, A. M., Kostas, G., & Kim, I.-Y. (2017) · Advances in Nutrition · doi:10.3945/an.116.013821 · Cited by 173 · see citing works
Mazidi, M., Katsiki, N., Mikhailidis, D. P., Sattar, N. A., & Banach, M. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz174 · Cited by 153 · see citing works
Closing America’s Fiber Intake Gap
Quagliani, D., & Felt-Gunderson, P. (2015) · American Journal of Lifestyle Medicine · doi:10.1177/1559827615588079 · Cited by 130 · see citing works
Low-carbohydrate diet scores and risk of type 2 diabetes in men
de Koning, L., Fung, T. T., Liao, X., Chiuve, S. E., Rimm, E. B., Willett, W. C., Spiegelman, D., & Hu, F. B. (2011) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.110.004333 · Cited by 128 · see citing works
Oxidation of Polyunsaturated Fatty Acids and its Impact on Food Quality and Human Health
Tao, L. (2015) · Advanced in Food Technology and Nutritional Sciences - Open Journal · doi:10.17140/aftnsoj-1-123 · Cited by 119 · see citing works
Ranjan, A., Schmidt, S., Damm‐Frydenberg, C., Holst, J. J., Madsbad, S., & Nørgaard, K. (2017) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.12953 · Cited by 101 · see citing works
Johansson, I., Nilsson, L. M., Stegmayr, B., Boman, K., Hallmans, G., & Winkvist, A. (2012) · Nutrition Journal · doi:10.1186/1475-2891-11-40 · Cited by 98 · see citing works
Dietary Fat Intake and Cognitive Decline in Women With Type 2 Diabetes
Devore, E. E., Stampfer, M. J., Breteler, M. M. B., ROSNER, B. A., Kang, J. H., Okereke, O. I., Hu, F. B., & Grodstein, F. (2009) · Diabetes Care · doi:10.2337/dc08-1741 · Cited by 89 · see citing works
Dietary intake data collection: challenges and limitations
Grandjean, A. C. (2012) · Nutrition Reviews · doi:10.1111/j.1753-4887.2012.00545.x · Cited by 89 · see citing works
Low-carbohydrate diets: what are the potential short- and long-term health implications?
Bilsborough, S., & Crowe, T. (2003) · PubMed · Cited by 75 · see citing works
Fechner, E., Smeets, E., Schrauwen, P., & Mensink, R. (2020) · Nutrients · doi:10.3390/nu12040991 · Cited by 64 · cited 1× · see citing works
“with regard to carbohydrate quality), which may also lead to conflicting results in clinical studies(5).”
ResultCalculating the metabolizable energy of macronutrients: a critical review of Atwater’s results
Sánchez-Peña, M. J., Márquez‐Sandoval, F., Anguiano, A. C. R., Velasco-Ramírez, S. F., Ojeda, G. M., & González-Ortiz, L. J. (2016) · Nutrition Reviews · doi:10.1093/nutrit/nuw044 · Cited by 53 · see citing works
Zinn, C., Rush, A., & Johnson, R. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-018846 · Cited by 49 · see citing works
Gunnarsson, A., & Elam, M. J. (2012) · Science as Culture · doi:10.1080/09505431.2011.632000 · Cited by 48 · see citing works
Low‐carbohydrate ketogenic diets in body weight control: A recurrent plaguing issue of fad diets?
Schütz, Y., Montani, J., & Dulloo, A. G. (2021) · Obesity Reviews · doi:10.1111/obr.13195 · Cited by 42 · see citing works
Vitamin E status in healthy population in Asia: A review of current literature
Malik, A., Eggersdorfer, M. L., & Kumar, G. T. (2019) · International Journal for Vitamin and Nutrition Research · doi:10.1024/0300-9831/a000590 · Cited by 37 · see citing works
Benefits of low carbohydrate diets: a settled question or still controversial?
Landry, M. J., Crimarco, A., & Gardner, C. D. (2021) · Current Obesity Reports · doi:10.1007/s13679-021-00451-z · Cited by 31 · see citing works
The Role of Vegan Diets in Lipotoxicity-Induced Beta-Cell Dysfunction in Type-2-Diabetes
Storz, M. A. (2020) · Journal of Population Therapeutics and Clinical Pharmacology · doi:10.15586/jptcp.v27isp2.744 · Cited by 25 · see citing works
Self-citationHolmberg, C. (2015) · International Journal of E-Politics · doi:10.4018/ijep.2015070103 · Cited by 23 · see citing works
Special Diets Among Adults: United States, 2015-2018.
Stierman, B. D., Ansai, N., Mishra, S., & Hales, C. M. (2020) · PubMed · Cited by 19 · see citing works
Storz, M. A., Rizzo, G., Müller, A., & Lombardo, M. (2022) · Nutrients · doi:10.3390/nu14030681 · Cited by 17 · see citing works
Self-citationStorz, M. A. (2020) · PubMed · doi:10.15586/jptcp.v27sp2.744 · Cited by 16 · see citing works
Self-citationAcceptable macronutrient distribution ranges and hypertension
Lee, E., Choi, J., Ahn, A.-L., Oh, E.-J., Kweon, H.-J., & Cho, D.-Y. (2015) · Clinical and Experimental Hypertension · doi:10.3109/10641963.2015.1013116 · Cited by 14 · see citing works
Short term effects of a low-carbohydrate diet in overweight and obese subjects with low HDL-C levels
Can, A. S., Uysal, C., & Palaoğlu, K. E. (2010) · BMC Endocrine Disorders · doi:10.1186/1472-6823-10-18 · Cited by 11 · see citing works
U-SHAPED RELATIONSHIP BETWEEN CARBOHYDRATE INTAKE PROPORTION AND INCIDENT ATRIAL FIBRILLATION
Zhuang, X., Zhang, S., Zhou, H., Du, Z., & Liao, X. (2019) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(19)33766-0 · Cited by 7 · see citing works
Flagged first, then by citations
1 of the 44 references couldn’t be matched to a known paper.
Research works printed but not linked: 6
- [3]Oh R, Gilani B & Uppaluri KR (2022) Low Carbohydrate Diet. StatPearls. Treasure Island, FL: StatPearls Publishing. 30725769
- [16]Freedman MR, King J & Kennedy E (2001) Popular diets: a scientific review. Obes Res 9, 1S– 40S. 11374180
- [24]Atwater WO (1910) Principles of Nutrition and Nutritive Value of Food. US Department of Agriculture, Farmers’ Bulletin 142. Washington, DC: Government Printing Office.
- [28]National Research Council (US) & Subcommittee on the Tenth Edition of the Recommended Dietary Allowances (1989) Recommended Dietary Allowances. 10th ed. Washington, DC: National Academies Press (US). 25144070
- [29]National Academies of Sciences E, Division H and M, Board F and N, et al. (2019) Sodium Dietary Reference Intakes: Risk Characterization and Special Considerations for Public Health. Dietary Reference Intakes for Sodium and Potassium. Washington, DC: National Academies Press (US). 30844154
- [49]Hodge C & Taylor C (2022) Vitamin A Deficiency. StatPearls. Treasure Island, FL: StatPearls Publishing. 33620821
Cited by
Sorted by citations
Shamanna, P., Erukulapati, R. S., Shukla, A., Shah, L., Willis, B., Thajudeen, M., KOVIL, R. R., Baxi, R., Wali, M., Damodharan, S., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-76584-7 · Cited by 59 · see citing works
Shamanna, P., Joshi, S., Thajudeen, M., Shah, L., Poon, T., Mohamed, M., & Mohammed, J. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1485464 · Cited by 56 · see citing works
Levran, N., Levek, N., Sher, B., Gruber, N., Afek, A. B., Ornan, E. M., & Pinhas‐Hamiel, O. (2023) · Nutrients · doi:10.3390/nu15061418 · Cited by 24 · see citing works
Storz, M. A. (2023) · BMC Public Health · doi:10.1186/s12889-023-16859-2 · Cited by 22 · see citing works
Self-citationUsual dietary fibre intake according to diabetes status in USA adults – NHANES 2013–2018
Miketinas, D. C., Tucker, W. J., Douglas, C. C., & Patterson, M. A. (2023) · British Journal Of Nutrition · doi:10.1017/s0007114523000089 · Cited by 19 · see citing works
Ichikawa, T., Okada, H., Hironaka, J., Nakajima, H., Okamura, T., Majima, S., Senmaru, T., Ushigome, E., Nakanishi, N., Hamaguchi, M., et al. (2024) · Journal of Diabetes Investigation · doi:10.1111/jdi.14271 · Cited by 17 · see citing works
Harnessing nutrition to combat MASLD: a comprehensive guide to food-based therapeutic strategies
Reytor-González, C., Simancas‐Racines, D., Campuzano-Donoso, M., Jimenez, J. C., Román-Galeano, N. M., Sarno, G., & Frías-Toral, E. (2025) · Food and Agricultural Immunology · doi:10.1080/09540105.2025.2496499 · Cited by 13 · see citing works
Aksoy, A., Abayomi, J. C., Relph, N., & Butler, T. (2024) · Obesity Reviews · doi:10.1111/obr.13733 · Cited by 11 · see citing works
Diet quality in U.S. adults eating in senior and community centers: NHANES 2009-2018
Storz, M. A., & Ronco, Á. L. (2024) · The journal of nutrition health & aging · doi:10.1016/j.jnha.2024.100379 · Cited by 11 · see citing works
Self-citationHow Well Do Low-PRAL Diets Fare in Comparison to the 2020–2025 Dietary Guidelines for Americans?
Storz, M. A., & Ronco, Á. L. (2023) · Healthcare · doi:10.3390/healthcare11020180 · Cited by 11 · see citing works
Self-citationCifuentes, L., & O’Keefe, S. J. (2024) · Nutrition and Cancer · doi:10.1080/01635581.2024.2316366 · Cited by 9 · see citing works
Storz, M. A., Stübing, F., & Huber, R. (2025) · Nutrition Journal · doi:10.1186/s12937-025-01088-7 · Cited by 6 · see citing works
Self-citationVidmar, A. P., Cáceres, N. A., Schneider, C. R., Shirazipour, C. H., Buman, M. P., de la Haye, K., & Salvy, S. (2022) · Current Obesity Reports · doi:10.1007/s13679-022-00491-z · Cited by 6 · see citing works
Jiang, Y., Shen, Q., Tang, H., Liu, Y., Ju, Y., Liu, T., Cui, L., Li, J., & Wang, X. (2022) · Healthcare · doi:10.3390/healthcare10112245 · Cited by 6 · see citing works
Low carbohydrate high fat-diet in real life; A descriptive analysis of cardiovascular risk factors
Hagström, H., Hagfors, L. N., Hedelin, R., Brunström, M., & Lindmark, K. (2025) · International Journal of Cardiology Cardiovascular Risk and Prevention · doi:10.1016/j.ijcrp.2025.200384 · Cited by 5 · see citing works
Storz, M. A., & Ronco, Á. L. (2025) · Current Developments in Nutrition · doi:10.1016/j.cdnut.2025.107557 · Cited by 3 · see citing works
Self-citationNutrient analysis of three low-carbohydrate diets differing in carbohydrate content
Banner, L., Bradley, B. H. R., & Clinthorne, J. F. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1449109 · Cited by 3 · see citing works
Guo, J., Zhou, Z., Gong, J., Hu, W., & Liu, Y. (2024) · Frontiers in Medicine · doi:10.3389/fmed.2024.1485095 · Cited by 2 · see citing works
Ramlall, C., Singh, N., & Shaik, S. (2025) · Engineering in Life Sciences · doi:10.1002/elsc.70038 · Cited by 2 · see citing works
Storz, M. A., Schmidt, C., & Ronco, Á. L. (2024) · Nutrition and Cancer · doi:10.1080/01635581.2024.2408766 · Cited by 2 · see citing works
Self-citationHassaan, A. I., Ebeed, N. M., Fatouh, A., & Elhariry, H. M. (2026) · Scientific Reports · doi:10.1038/s41598-025-34443-z · Cited by 1 · see citing works
Feeley, J., Abraham, A., GONZALEZ, N., Parab, R., Chadalawada, L., & Pasquel, F. J. (2026) · Primary care diabetes · doi:10.1016/j.pcd.2026.06.004 · Cited by 1 · see citing works
Inaba, S., Shirai, T., Sanada, M., Miyashita, H., Inoue, G., Nagahisa, T., Wakana, N., Homma, K., Fukuyama, N., & Yamada, S. (2024) · Nutrients · doi:10.3390/nu16111658
Almujaydil, M. S., & Almarshad, M. I. (2025) · International Journal of Health Promotion and Education · doi:10.1080/14635240.2025.2478844
Letter to the Editor Regarding the Article by Ostojic (2025): Creatine Intake and Restrictive Diets
Storz, M. A. (2026) · Annals of Nutrition and Metabolism · doi:10.1159/000550318
Self-citationMarcobal, A. M., Ng, K. M., Drexler, R. A., McConnell, B. R., & Amicucci, M. J. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1745303
The Ketogenic Diet in the Prevention and Treatment of Hypertension (HTN)
Rodzeń, Ł., Dyńka, D., Rodzeń, M., Karakuła‐Juchnowicz, H., Łojko, D., Kraszewski, S., Grzywacz, Ż., Bikman, B. T., Unwin, J., Unwin, D., et al. (2026) · Biomedicines · doi:10.3390/biomedicines14081728
- Authors
- Storz, M. A., & Ronco, A. L.
- Affiliations
- University Medical Center Freiburg (DE)
- Corresponding author
- Storz, Maximilian Andreas
- Venue
- British Journal of Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2022-06-22
- Volume
- 129
- Issue
- 6
- Pages
- 1023-1036
- ISSN
- 0007-1145 (ISSN-L)
- 1475-2662
- PMC
- PMC9991840
- OpenAlex
- W4283321824
- Cited by
- 27
- References
- 44
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 10 · 2023: 4 · 2022: 2
- FWCI
- 3.41
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- British Journal Of Nutrition (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- University of Cambridge
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- low-carbohydrate diet, nutrient intake, Dietary Guidelines for Americans, dietary recommendations, dietary fiber, magnesium, potassium, vitamins, saturated fat, sodium intake, diet quality, United States adults
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